When diagnosed with breast cancer, oncologists will present treatment and surgical options to patients who must then choose which path to take. The decision should be personal, based on what an individual wants to achieve with therapy. For women, societal pressures may lead them to elect an option, say breast reconstruction, which does not meet their own needs and wants.

“Breast cancer can take a heavy physical and emotional toll on an individual,” said Anne Wallace, MD, surgeon and director of the Comprehensive Breast Health Center at UC San Diego Health. “It’s important for women to hear all the facts, the science behind treatment options and the risks and benefits that go with each step. Then a woman should be able to choose her treatment plan based on the data presented to her.”

Wallace suggests women begin to discuss their preferences early with their health care team and loved ones, but be open to hearing the facts and science behind choices.

“Women should feel empowered to speak up and make choices that will help them return to a new normalcy and not be pressured by outside influences,” said Wallace. “A recent example of this is some women are not choosing reconstruction. As long as a woman has been given reconstruction counseling, it is her choice if she decides to decline.”

The National Cancer Institute estimates 266,000 women will be diagnosed with breast cancer in 2018 — that’s one in eight women. More than 40,000 will die from the disease this year.

The earlier breast cancer is detected, the better the chances of recovery and survival. In the earliest stages, the five-year survival rate (the percentage of people who live at least five years after diagnosis, excluding other causes of death) is 99 percent. If the cancer has spread to local lymph nodes, the five-year survival rate drops to 85 percent. If the cancer metastasizes to more distant parts of the body, the rate falls to 27 percent.

People with a family history of breast disease or a mutation in a breast cancer risk gene such as BRCA1 or BRCA2, are at higher risk of developing cancer. In addition, age, high levels of radiation, elevated levels of estrogen (which can be caused by genetic conditions), other diseases, some kinds of medical treatment and lifestyle can increase a person’s risk of breast cancer.

Wallace is both a breast oncology surgeon and a plastic surgeon who specializes in breast health, focusing on breast cancer and breast reconstruction. Her dual training provides a unique perspective and understanding of the patient’s needs. She or another member of the breast health team are available to discuss different aspects of this disease during Breast Cancer Awareness Month.