Another great question. It depends on the patient and her level of anxiety. Years ago I was uniformly aggressive in my recommendations. Having survived Stage lll breast cancer myself, I was fully in favor of bilateral mastectomies. As I have aged and met more patients I will share with you that my attitude is a little different. If the patient is not ready to have both her breasts removed then she should not be pressured to have mastectomies. With a combination of breast exams by professionals, MRIs, mammograms and sonograms, these patients can be followed closely until one of two things happens: the patient develops cancer and then the decision is not so much elective as therapeutic, or, if she cannot tolerate the stress of the vigilance and then is ready to undergo more definitive surgery to prevent cancer. In my 20+ year career as a physician, I have rarely met a patient who regretted having bilateral mastectomies, but many who regretted not doing so. As for the ovaries, I remain aggressive. If the patient has a high risk of cancer, I explain that vigilance is far from perfect and the hormonal function of the ovaries can be replaced a number of ways, but ovarian cancer is very difficult to cure. Another great question. It depends on the patient and her level of anxiety. Years ago I was uniformly aggressive in my recommendations. Having survived Stage lll breast cancer myself, I was fully in favor of bilateral mastectomies. As I have aged and met more patients I will share with you that my attitude is a little different. If the patient is not ready to have both her breasts removed then she should not be pressured to have mastectomies. With a combination of breast exams by professionals, MRIs, mammograms and sonograms, these patients can be followed closely until one of two things happens: the patient develops cancer and then the decision is not so much elective as therapeutic, or, if she cannot tolerate the stress of the vigilance and then is ready to undergo more definitive surgery to prevent cancer. In my 20+ year career as a physician, I have rarely met a patient who regretted having bilateral mastectomies, but many who regretted not doing so. As for the ovaries, I remain aggressive. If the patient has a high risk of cancer, I explain that vigilance is far from perfect and the hormonal function of the ovaries can be replaced a number of ways, but ovarian cancer is very difficult to cure.

Not sure what you are referring to when you say "massage". Do you mean traditional massage or manual lymph drainage which is sometimes referred to as "massage" although it is not part of the traditional massage protocol?

Are you asking about having a massage for its generalized beneficial effects, or are you asking about massage as a component of post-mastectomy rehabilitation treating swelling, neuropathy, scar tissue and fibrosis? Not sure what you are referring to when you say "massage". Do you mean traditional massage or manual lymph drainage which is sometimes referred to as "massage" although it is not part of the traditional massage protocol?

Are you asking about having a massage for its generalized beneficial effects, or are you asking about massage as a component of post-mastectomy rehabilitation treating swelling, neuropathy, scar tissue and fibrosis?

The HALO test is based on data that showed that women with nipple discharge had a higher risk of breast cancer over the course of their lives. A machine that looks and acts a lot like a breast pump massages the breast and uses a vacuum-like action to seek fluid. Unfortunately, a large number of women will have nipple fluid in this circumstance, some say as high as 50%. Trying to figure out what to do with them afterward is a challenge. Data have shown that send nipple aspirated fluid for cytologic evaluation is not particularly helpful in figuring out who is at risk, nor does it diagnose or rule out cancer definitively. I have found that it makes women more anxious. The theory is that these women will be followed more closely, but that is a double-edged sword. They undergo more testing and probably more biopsies, but ultimately I have not seen data proving that more lives are saved.

As for BREVAGEN, it is a model based on combining the Gail Model (a risk assessment tool that is known to be inaccurate for many reasons) with a mouth swab looking for 7 single nucleotide polymorphisms (SNPs) which can modify the Gail risk upward or downward. In the fine print of the test, it acknowledges that it works best in Caucasians over the age of 35. It doesn't take into account breast cancer in the father's side, second- and third-degree relatives with cancer, nor does it consider other related cancers as risk factors. The idea is an interesting one, but needs to be developed further.
The HALO test is based on data that showed that women with nipple discharge had a higher risk of breast cancer over the course of their lives. A machine that looks and acts a lot like a breast pump massages the breast and uses a vacuum-like action to seek fluid. Unfortunately, a large number of women will have nipple fluid in this circumstance, some say as high as 50%. Trying to figure out what to do with them afterward is a challenge. Data have shown that send nipple aspirated fluid for cytologic evaluation is not particularly helpful in figuring out who is at risk, nor does it diagnose or rule out cancer definitively. I have found that it makes women more anxious. The theory is that these women will be followed more closely, but that is a double-edged sword. They undergo more testing and probably more biopsies, but ultimately I have not seen data proving that more lives are saved.

As for BREVAGEN, it is a model based on combining the Gail Model (a risk assessment tool that is known to be inaccurate for many reasons) with a mouth swab looking for 7 single nucleotide polymorphisms (SNPs) which can modify the Gail risk upward or downward. In the fine print of the test, it acknowledges that it works best in Caucasians over the age of 35. It doesn't take into account breast cancer in the father's side, second- and third-degree relatives with cancer, nor does it consider other related cancers as risk factors. The idea is an interesting one, but needs to be developed further.

I would say that this is very normal to have these difficulties, but would also say that with time most of my patients are very happy with their reconstructions, and these emotional difficulties usually go away with time. I also have a number of patients who have finished the reconstruction process and have volunteered to speak with new patients, and this can often be very helpful for new patients. Additionally, having a very understanding spouse or significant other, as well as family and/or friends, is usually very helpful. I would say that this is very normal to have these difficulties, but would also say that with time most of my patients are very happy with their reconstructions, and these emotional difficulties usually go away with time. I also have a number of patients who have finished the reconstruction process and have volunteered to speak with new patients, and this can often be very helpful for new patients. Additionally, having a very understanding spouse or significant other, as well as family and/or friends, is usually very helpful.

Tough question...
I have to say that the most difficult issue is wondering how many other family members have inherited this gene mutation.
I deal with all issues in my life in a positive way. I am a very positive person & I ALWAYS look for the funny & the good in life.
I try to enjoy every day & help others. I love my friends & my family. Tough question...
I have to say that the most difficult issue is wondering how many other family members have inherited this gene mutation.
I deal with all issues in my life in a positive way. I am a very positive person & I ALWAYS look for the funny & the good in life.
I try to enjoy every day & help others. I love my friends & my family.

This is the easiest question of all for me.
I was my mom's caretaker for 2 years. I literally went through her cancer diagnosis & treatment with her as well as taking her last breath with her.
When my next family member was diagnosed & we found out that we carried the BRCA gene mutation, in my mind it wasn't an if for me, it was a when.
I knew that I had to do everything that I could to not go down this road.(No woman in my family has lived past the age of 60.)
I knew that for me giving up my breasts & ovaries was my only choice with the odds stacked so high against me. In MY opinion taking prophylactic measures was far easier than the choices I would have to make if I developed one cancer cell. This is the easiest question of all for me.
I was my mom's caretaker for 2 years. I literally went through her cancer diagnosis & treatment with her as well as taking her last breath with her.
When my next family member was diagnosed & we found out that we carried the BRCA gene mutation, in my mind it wasn't an if for me, it was a when.
I knew that I had to do everything that I could to not go down this road.(No woman in my family has lived past the age of 60.)
I knew that for me giving up my breasts & ovaries was my only choice with the odds stacked so high against me. In MY opinion taking prophylactic measures was far easier than the choices I would have to make if I developed one cancer cell.

Wow... that is one powerful question!
While I was going through my "previvor" experience, I was invited to join a group of women breast cancer survivors. Since I have the BRCA gene mutation, I have lived the breast cancer experience with my family members. I can certainly empathize with the breast cancer community, but those of us who have never heard the words: YOU HAVE BREAST CANCER are NOT the same.
This same group invited me to a luncheon that I happily attended to show my support & friendship.
When it was time to check in, I was asked if I was a survivor & I honestly said no. I was told that I could not sit with my group of friends.
At this point, I was just a blog with a huge following. I had over $2000.00 in donations in my purse to present.
Yes...I made the phone call to someone high up (who was expecting me) to tell them what was going on.
At this point, my someone met me, apologized profusely & I vowed that I would start our group for "people like me" and I did. Wow... that is one powerful question!
While I was going through my "previvor" experience, I was invited to join a group of women breast cancer survivors. Since I have the BRCA gene mutation, I have lived the breast cancer experience with my family members. I can certainly empathize with the breast cancer community, but those of us who have never heard the words: YOU HAVE BREAST CANCER are NOT the same.
This same group invited me to a luncheon that I happily attended to show my support & friendship.
When it was time to check in, I was asked if I was a survivor & I honestly said no. I was told that I could not sit with my group of friends.
At this point, I was just a blog with a huge following. I had over $2000.00 in donations in my purse to present.
Yes...I made the phone call to someone high up (who was expecting me) to tell them what was going on.
At this point, my someone met me, apologized profusely & I vowed that I would start our group for "people like me" and I did.

Thank you for inviting me today to answer some questions.
Creating a 501(c)(3) was not as difficult as the decision to create & maintain one was. Once I made the decision to become a not for profit I just turned to professional advice. Accountant, attorney & a team of doctors, social workers & genetic counselors to turn to for help when needed.
I started the group with a personal donation of $25.00 to our checking account & I also made the personal donation of all start up costs.
previvorsandsurvivors.com is something I believe in & am commited to as it is a much needed group in our community.
I am now proud to say that we are a full fledged group with a caring board to help me help others.
Thank you for inviting me today to answer some questions.
Creating a 501(c)(3) was not as difficult as the decision to create & maintain one was. Once I made the decision to become a not for profit I just turned to professional advice. Accountant, attorney & a team of doctors, social workers & genetic counselors to turn to for help when needed.
I started the group with a personal donation of $25.00 to our checking account & I also made the personal donation of all start up costs.
previvorsandsurvivors.com is something I believe in & am commited to as it is a much needed group in our community.
I am now proud to say that we are a full fledged group with a caring board to help me help others.

Another great question. It depends on the patient and her level of anxiety. Years ago I was uniformly aggressive in my recommendations. Having survived Stage lll breast cancer myself, I was fully in favor of bilateral mastectomies. As I have aged and met more patients I will share with you that my attitude is a little different. If the patient is not ready to have both her breasts removed then she should not be pressured to have mastectomies. With a combination of breast exams by professionals, MRIs, mammograms and sonograms, these patients can be followed closely until one of two things happens: the patient develops cancer and then the decision is not so much elective as therapeutic, or, if she cannot tolerate the stress of the vigilance and then is ready to undergo more definitive surgery to prevent cancer. In my 20+ year career as a physician, I have rarely met a patient who regretted having bilateral mastectomies, but many who regretted not doing so. As for the ovaries, I remain aggressive. If the patient has a high risk of cancer, I explain that vigilance is far from perfect and the hormonal function of the ovaries can be replaced a number of ways, but ovarian cancer is very difficult to cure. Another great question. It depends on the patient and her level of anxiety. Years ago I was uniformly aggressive in my recommendations. Having survived Stage lll breast cancer myself, I was fully in favor of bilateral mastectomies. As I have aged and met more patients I will share with you that my attitude is a little different. If the patient is not ready to have both her breasts removed then she should not be pressured to have mastectomies. With a combination of breast exams by professionals, MRIs, mammograms and sonograms, these patients can be followed closely until one of two things happens: the patient develops cancer and then the decision is not so much elective as therapeutic, or, if she cannot tolerate the stress of the vigilance and then is ready to undergo more definitive surgery to prevent cancer. In my 20+ year career as a physician, I have rarely met a patient who regretted having bilateral mastectomies, but many who regretted not doing so. As for the ovaries, I remain aggressive. If the patient has a high risk of cancer, I explain that vigilance is far from perfect and the hormonal function of the ovaries can be replaced a number of ways, but ovarian cancer is very difficult to cure.

Not sure what you are referring to when you say "massage". Do you mean traditional massage or manual lymph drainage which is sometimes referred to as "massage" although it is not part of the traditional massage protocol?

Are you asking about having a massage for its generalized beneficial effects, or are you asking about massage as a component of post-mastectomy rehabilitation treating swelling, neuropathy, scar tissue and fibrosis? Not sure what you are referring to when you say "massage". Do you mean traditional massage or manual lymph drainage which is sometimes referred to as "massage" although it is not part of the traditional massage protocol?

Are you asking about having a massage for its generalized beneficial effects, or are you asking about massage as a component of post-mastectomy rehabilitation treating swelling, neuropathy, scar tissue and fibrosis?

The HALO test is based on data that showed that women with nipple discharge had a higher risk of breast cancer over the course of their lives. A machine that looks and acts a lot like a breast pump massages the breast and uses a vacuum-like action to seek fluid. Unfortunately, a large number of women will have nipple fluid in this circumstance, some say as high as 50%. Trying to figure out what to do with them afterward is a challenge. Data have shown that send nipple aspirated fluid for cytologic evaluation is not particularly helpful in figuring out who is at risk, nor does it diagnose or rule out cancer definitively. I have found that it makes women more anxious. The theory is that these women will be followed more closely, but that is a double-edged sword. They undergo more testing and probably more biopsies, but ultimately I have not seen data proving that more lives are saved.

As for BREVAGEN, it is a model based on combining the Gail Model (a risk assessment tool that is known to be inaccurate for many reasons) with a mouth swab looking for 7 single nucleotide polymorphisms (SNPs) which can modify the Gail risk upward or downward. In the fine print of the test, it acknowledges that it works best in Caucasians over the age of 35. It doesn't take into account breast cancer in the father's side, second- and third-degree relatives with cancer, nor does it consider other related cancers as risk factors. The idea is an interesting one, but needs to be developed further.
The HALO test is based on data that showed that women with nipple discharge had a higher risk of breast cancer over the course of their lives. A machine that looks and acts a lot like a breast pump massages the breast and uses a vacuum-like action to seek fluid. Unfortunately, a large number of women will have nipple fluid in this circumstance, some say as high as 50%. Trying to figure out what to do with them afterward is a challenge. Data have shown that send nipple aspirated fluid for cytologic evaluation is not particularly helpful in figuring out who is at risk, nor does it diagnose or rule out cancer definitively. I have found that it makes women more anxious. The theory is that these women will be followed more closely, but that is a double-edged sword. They undergo more testing and probably more biopsies, but ultimately I have not seen data proving that more lives are saved.

As for BREVAGEN, it is a model based on combining the Gail Model (a risk assessment tool that is known to be inaccurate for many reasons) with a mouth swab looking for 7 single nucleotide polymorphisms (SNPs) which can modify the Gail risk upward or downward. In the fine print of the test, it acknowledges that it works best in Caucasians over the age of 35. It doesn't take into account breast cancer in the father's side, second- and third-degree relatives with cancer, nor does it consider other related cancers as risk factors. The idea is an interesting one, but needs to be developed further.

Hi AnneMarie,
I would suggest that you call your genetic counselor. The genetic counselor knows your history & can advise you best..That's just MY OPINION!
xoxo Tobey Hi AnneMarie,
I would suggest that you call your genetic counselor. The genetic counselor knows your history & can advise you best..That's just MY OPINION!
xoxo Tobey