Dr. Rebecca Baskin is a breast surgeon at Williamson Medical Center and is a breast cancer survivor herself. In honor of Breast Cancer Awareness Month, we were able to sit down with her and chat about her experience.
Can you tell us a little bit about your story with breast cancer?
Dr. Rebecca Baskin: So, I was actually diagnosed at 36 with breast cancer. At that time I was a general surgeon. I did a lot of breast surgery as well and actually found a lump when I was in the shower. My youngest was about 6 months old at the time and I had stopped breastfeeding and gone back to work. I was also younger than 40 so I had never had a mammogram before so that was my first episode of having a mammogram and ultrasound. There was a suspicious-looking mass on my imaging so very quickly had a core biopsy. I actually worked with one of my peers who helped me make decisions about what surgery I wanted and moved forward from there.
Back then, there were two buckets you were in. You were either positive or negative and needed chemo or didn’t need chemo. It was a lot more straightforward. Things have changed a lot since then. I did need chemotherapy so I had surgery and chemotherapy but with the surgeries that I chose I did not have radiation therapy.
What inspired you to start working in the industry?
Dr. Baskin: I was a general surgeon and in general surgery, we do a lot of breast health work, so helping women with benign breast issues as well as cancers. As a female surgeon, already about 60-70% of my work was breasts. I also did thyroids and colons and things like that. When I came back, it really opened my eyes being on the patient side of things. I’ve always enjoyed the variety of what I did but I felt when I came back that I really needed to focus and things were changing so quickly, in a lot of different fields but especially in breasts. Over time, talking with my family and talking with my partners, I eventually transitioned over and specialized in breasts. Now I am 100% breast cancer and breast health surgery.
How have things changed since you started working in the industry/went through treatment vs today? What’s better? What’s the same?
Dr. Baskin: Early in my career, we were doing extra education and learning how to do ultrasound-guided core biopsies. As a surgeon, we were originally doing those and now radiologists as well as surgeons do biopsies. We’re doing a lot more diagnosis up front, not in the operating room but with course. That’s truly the preference, which I think it’s always a good idea and our guidelines say that it’s best to know what the diagnosis is as best you can before you start doing surgery.
I think one of the things that has changed is there are a lot of cancers now that are actually treated by an oncologist with chemotherapy before we do surgery. That percentage has changed a lot because as we improve and do more and more studies we realize some of these women, if we can do their treatment before surgery and realize that we have shrunk the tumor to nothing, they now can not have to have as much chemotherapy or additional chemotherapy.
The recommendations have changed on sizes and types of cancer for that. I think since I’ve been doing this over 20 years obviously the addition of MRI has changed things a lot and trying to get planning for cancer surgery, trying to determine better how big that cancer might be, and to make sure there’s not another cancer in that breast or the opposite breast before the woman makes her decision for surgery. When I say a woman I don’t mean to discriminate. We do have a few men obviously that have breast cancer. It’s much less common but we do take care of both men and women are proponents for screening as well.
I think the value and the accuracy of mammograms have greatly increased over time. Some of the new technology is something called 3D tomosynthesis. Women that have really dense breast tissue can ask for 3D tomosynthesis and it gets a better picture of their breast. I tell women it’s kind of like having action shots of your breast. When you’re in that compression, the camera actually moves and takes different pictures. The computer can reconstruct the breast in a 3D model so the radiologist can scroll through that imaging. Instead of just looking at two flat pictures of your breast they now can scroll through the tissue a lot more like an MRI or CT.
We’re finding things a lot smaller and earlier, especially in women with dense breast tissue, that we might not find for a while with just 2D imaging.
Is there a memorable/impactful moment that stands out to you since you started working?
Dr. Baskin: I think one of the most impactful things is when we see a woman back that has had a very advanced disease and they’re still survivors and thrivers with us. I have some very young patients. The longer I’ve been working the more variety you have. I’ve had several young patients that are doing very, VERY well. They’re disease free and surviving and thriving and 20 years ago we might not have had that same outcome.
The changes in surgeries, in reconstruction options, and in cosmetic results for these women that I believe has improved over time as well.
I think we’re seeing longevity that we have not seen before. We’re seeing these women live very long and happy lives after, even when they have advanced or more aggressive cancers. That’s always beneficial to me to have those ladies come back and see them and remind myself that we do this for a reason and we’re doing this, not just for what’s going on with that patient this year, but 5 years from now, 10, 15, and 20. To get to see those women so far out and having a great life, that’s when it really comes back to us.
Can you talk a little bit about how companies like Pretty in Pink Boutique are changing the treatment process?
Dr. Baskin: I think it’s always good for us to remember we get so focused on the treatment process, the surgeries, the chemotherapy or endocrine therapy, and radiation, and they’re all very important but also our quality of life after those things are over. How we’re living with our diagnosis after.
Pretty in Pink Boutique has always been so helpful for women at all stages of their cancer journey. They do the measurements for the lymphedema sleeves and the gloves. They’re also helping us preoperatively get women fitted for post-operative bras. Even for women that are having lumpectomies so that it helps them be comfortable and decreases some delayed bruising and bleeding and keeps them more comfortable.
Also, they’re there for us, for women that choose mastectomy with no reconstruction: measuring those bras, getting them in the right prosthesis. It’s just another level of care that I think is very important for women on a daily basis. These are things that affect their life every day. Making sure that we have that aftercare, one of the words that we use, is that we’re making sure we’re still taking care of that woman after the immediacy because all the days that come after it are important too.
What is one piece of advice you would give to someone going through treatment right now?
Dr. Baskin: I think obviously attitude is always important but I also think that remembering that your journey is yours and not to get overwhelmed by everyone else and all your friends and family making recommendations. It’s good to hear those things but remember that your journey is yours and every woman’s journey is different. I see many cancer patients every month and our recommendations differ from patient to patient and their journey is going to differ. Just keep a positive attitude and remember that we’re with them through this whole thing. I think we definitely oftentimes want to get things done so quickly but realize a lot of times this is a journey and we just take every little step at a time. Get past that hump and celebrate that victory before we go to the next one.
Is there anything else you would like to add?
Dr. Baskin: I think there is always a good time to talk about screening and just to remind women of some of our recommendations. I know there was some confusion a few years ago about the task force and you don’t have to start mammograms as early or do them as often. I like to let most people know that this is what is called “general population” so for women that have never had biopsies, they don’t have dense breast tissue, and don’t have any family members that have had breast cancer. That’s a very small percentage of women so we still all feel in gynecology, radiology, and breast surgery, general surgery to start screening mammograms yearly at age 40 and to continue until you have at least– maybe you don’t have 10 yeast of longevity left, and that is not a number. There’s no set age to stop mammograms. It’s more based on the woman’s health and how long she and her doctor feel she has left to live.
We still want to be screening. We’re catching things earlier and smaller. The smaller and earlier we catch them, the less treatment that’s actually required in the long run. With 3D tomosynthesis, we’re having fewer callbacks and we also have many of the facilities, just like Williamson Breast Center, we have the smart curve paddle. It’s a more ergonomic paddle that gets better, more even distribution. We think it’s more comfortable and many patients say it’s more comfortable to have that compression. We don’t want women to be scared about getting screenings. We want them to get their screening and not wait too long.
The other thing that we talk about is that if there is a family history of young breast cancers, 40 may be too late to start screening for those women. You want to start screening 10 years younger than your youngest relative when she was diagnosed with breast cancer. You can always have that conversation with your primary care doctor and your gynecologist to see what is your risk and when is it a good idea to start screening.
Pretty in Pink Boutique
If you or a loved one is battling breast cancer, know that Pretty In Pink Boutique provides support through it all. If you are looking for a compassionate ear that will listen or if you have questions, please reach out. Pretty In Pink Boutique is committed to your well-being the whole way through and may be able to assist or provide resources to help you or a loved one.
Please contact us via phone or email us and let us know how we can help. Call (615) 777-PINK.