All posts by bcsurgery

Take-home Messages from #FORCE17


Here are 4 key messages of #FORCE17, which held its 10th anniversary conference last week on hereditary cancer issues.

  1. One-step and done? Nearly all breast reconstruction is not. Beware too, of scarless mastectomies claims.
  2. Breast reconstruction options for larger-framed women are improving. Now 3 of 10 women get nipple-sparing operations.
  3. Expect more gene discoveries in the next year or two that identify the deadliest tumors needing more aggressive treatment for prostate, pancreatic and other cancers where hereditary plays a role.
  4. Men need genetics testing too.

Summarized by Patricia Anstett, author, “Breast Cancer Surgery and Reconstruction: What’s Right for You,” from presentations at the conference of Facing Our Risk Empowered (FORCE).

Lumpectomy guidelines reduce need for return operations, study shows

After years of women returning for repeat lumpectomies because the margins of their tumor contain cancer, new guidelines are reducing these re-operations. Here’s a new study on the issue:

Breast Surgery Author Wins National Award; Breast Cancer and Other Work Cited

The AWC National Board of Directors is pleased to announce the 2017 Headliner Award to Patricia Anstett of the AWC Detroit Chapter.

Patricia Anstett’s 40-year career as a journalist has always exemplified the highest professional standards.  Anstett is an accomplished journalist, mentor and leader who worked at major newspapers in Chicago, Washington, D.C. and Detroit, including the last 22 years of her journalism career as medical writer for the Detroit Free Press. In April, 2017 she was inducted into the Michigan Journalism Hall of Fame.

Her medical writing is respected for its accuracy, comprehensiveness, expansive reach and helpful, comforting story-telling. She broke news, told memorable stories and put the spotlight on questionable, shoddy and unethical practices in medicine that brought about important changes. Some of her most significant reporting led to improvements in the quality of mammography standards in Michigan; explained how medicine failed patients at the end-of-life as the Jack Kevorkian assisted suicide debate raged; and propelled new guidelines at the University of Michigan to guard against fraudulent expense account standards and unethical use of research money for a doctor’s private gain.
At the same time, she was a voice for change and gender equality in news coverage and hiring in her own newsroom and within journalism. She mentored more than a dozen interns, mostly minority women, and did classroom teaching around the country as an editor-in-residence at a time when largely male journalism schools were clamoring to bring more women into the classroom to talk to the growing number of women entering the field.
Always honest, courageous and thorough, she is widely recognized for reporting on health issues. Her extensive reporting on all aspects of mammography–compliance with state standards, large pricing differences, insurance reimbursement, access for Medicaid patients and funding for a state and federally-funded program that paid for free mammograms for low-income women– was distinctive, informative, relentless and meaningful.
Her stories had such an impact that failing centers closed; hospitals improved staffing and purchased new machines, including modern digital models proven to be more reliable than older ones. Former State Rep. Maxine Berman, who sponsored the 1989 legislation that created Michigan’s mammography standards and subsequent legislation to improve it, writes: “Without Pat’s unfailing interest and incisive articles, I honestly believe that my legislation may well not have passed or have been diluted into uselessness.”
Anstett retired in 2012 from the Detroit Free Press, after 30 years there, but remains fully engaged as an author in the most fulfilling mission of her career. She has written two books, including “Breast Cancer Surgery and Reconstruction: What’s Right for You,’’ published in 2016 by Rowman & Littlefield.
Anstett has been an AWC member since her college days and has been active in chapters throughout her career.  She is a past president of the AWC Detroit Chapter and was honored by this chapter with the Headliner and Diamond Awards.
Anstett will accept the AWC Headliner Award at the AWC National Professional Development Conference in Addison, TX, where she will also be the speaker at the Headliner Award luncheon on Tuesday, Sept. 19, 2017.

New Pain Relief Options After Breast Reconstruction

Linda holding pain system bag Apr 28 2017

Detroit breast cancer survivor, Dr. Linda Johnson, is shown here with the “On-Q Pain Relief System, which she used to reduce post-operative pain after breast reconstruction. It is a non-narcotic system. “This is a little pump about the size of a small can of soup that contains pain reliever that comes into your system automatically for a few days after surgery,’’ says Johnson, a retired school principal. “The pump goes to a tiny plastic tube that the surgeon installs in your chest. This little dickens really worked!!  All I had to do was to carry it around in the little nylon bag shown in the picture.  By day I used it like a shoulder bag and at night I just kept it beside me in the bed. The doc will take out the 4 or 5 inches of tubing that went into my body when I go for my check up next week.  Easy breezy, it gives a constant stream of pain relief, and doesn’t involve pills.” For details:


Over or Under: Breast Implant Placement Debate Continues

Where to place breast implants — under the chest muscle or over it — remains more a plastic surgeon’s choice. It’s an important discussion, in particular, for thinner, very active women, who sometimes complain that implants move inappropriately when they exercise. In plastic surgery, this is an issue known as “distortion.”

Here one doctor provides some clarity on why he and many other doctors prefer to place implants under the chest muscle.

For more discussion on implant placement, see our book’s breast implant chapter. It discusses types of implants; problems; placement concerns and other issues.






Breast Surgery Author Inducted into Michigan Journalism Hall of Fame

Patricia Anstett, a long-time Detroit medical writer and author of a unique new breast cancer surgery book, is one of five journalists inducted into the Michigan Journalism Hall of Fame.  They will be honored  April 9  in East Lansing.

The others inducted are include two John Gallagher, Detroit Free Press urban affairs writer and author, and David Gilkey, a former Free Press photographer killed on assignment last year in Afghanistan for NPR; Detroit News investigator reporter Stephen Cain; and Mary Kramer, editor, Crain’s Detroit Business.

The award cited Anstett’s long career covering mammography improvements in Michigan and breast cancer advances; investigative reporting that led to the removal of the chief urologist at the University of Michigan for serious expense account violations; and her book, published this year with photography by Detroit Free Press photographer Kathleen Galligan.Anstett Photo

Left: Anstett on assignment in San Antonio to watch breast reconstruction surgery.



Reconstructed Breasts Lose Sensation, NYT Reports

One of the realities about breast reconstruction that is rarely mentioned is the loss of sensation in the breast. Here, the NYT in a front-page story, reports one of the key issues that launched reporting for “Breast Cancer Surgery and Reconstruction: What’s Right for You.”

Public Health Leader Shares Life as Stage 4 Breast Cancer Survivor

Former Michigan public health director Vern Anthony continues to educate, this time with information that helps more understand that a cancer recurrence, even two as she has had, is not a death sentence. Her most important advice: Live your life fully. And she has tips about what NOT to say to someone with cancer.