Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Breast cancer is the most common type of cancer in women, accounting for 23 percent of all cancers diagnosed in women. The incidence of breast cancer has been increasing globally, and in industrialized countries it is 3 times higher than in developing countries. In the United States, both the cure rate and the 5-year survival rate have significantly improved over the last 20 years. This is due to improved screening as well as better available treatments.
In the United States, approximately 1 woman in 8 will develop breast cancer at some point in her lifetime. Men can also get breast cancer, although it is much more rare (approximately 1 in 1,000 men will develop breast cancer).
Early diagnosis with regular screening is one of the most important tools we have to fight this disease. If breast cancer is found early, treatment is likely to be more effective and less complex. There are a variety of screening methods to help find breast cancer.
We will work with you to individualize your treatment of breast cancer. Depending upon the location of the tumor and the severity of the cancer, the treatments may include surgery, radiation therapy, chemotherapy, hormonal therapy, and targeted therapy.
Understanding breast cancer and what to expect can help you make informed decisions about your care.
There are many factors that can increase the risk of breast cancer for women:
Most women diagnosed with breast cancer will be the first in their family to develop this disease. However, having a relative with breast cancer may increase your risk of developing breast cancer.
There are some individuals who have a significant family history but may not have clearly identifiable gene mutations.
Some factors associated with your pregnancy history can influence the risk of breast cancer. These include the following:
Male breast cancer is 100 times less common than female breast cancer, affecting around 2,000 men per year in the United States, typically between the ages of 60 and 70. There are several factors that can increase the risk of breast cancer for men:
There are some things you can do to help reduce your risk of developing breast cancer. Healthy lifestyle choices include:
Regular screening and early diagnosis are the most important tools to fight this disease.
In many instances, breast cancer may not have symptoms. If symptoms are present, they can include:
If you experience any of these symptoms, you need to make an appointment with your personal physician or your gynecologist to discuss your concerns.
Symptoms of male breast cancer include lumps or thickening of the breast tissue, nipple retraction, nipple discharge, and changes on the skin such as swelling, skin redness, or scales. If you notice any of these symptoms, contact us to schedule an examination.
If breast cancer is suspected on breast exam or in imaging studies, we may recommend a procedure known as a biopsy to determine whether cancer is present. Some women with dense breasts may need extra tests or a biopsy to get a better look at their breast tissue. During the biopsy, we will remove a sample of tissue from your breast. Even when this is necessary, most biopsies do not show cancer.
The biopsy may be accompanied by ultrasound technology to locate and remove the tissue sample. If the tumor is palpable (can be felt), the biopsy can be performed through the skin (percutaneously) without ultrasound. The biopsy can be performed in a variety of ways:
The sample will be sent to the pathology laboratory for full testing.
The stage of breast cancer can help you and your treatment team understand your prognosis and make decisions about treatment. You will get your staging information in your pathology report and from your doctor. Staging is based upon 4 characteristics:
The following are some of the most common stages of breast cancer:
The staging process is important to help determine the best treatment plan for you.
Early diagnosis with regular screening is one of the most important tools we have to fight this disease. If breast cancer is found early, treatment is likely to be effective and less complex. There are a variety of screening methods to help find breast cancer. Depending upon the type and severity of your cancer, they can include imaging (mammogram, ultrasound, or MRI) and clinical breast exam.
Depending on your specific situation, imaging can include a mammogram, ultrasound, or MRI (magnetic resonance imaging), as appropriate. A mammogram is an X-ray of the breast. While a mammogram does not prevent breast cancer from developing, it can help detect the breast cancer at an early stage, allowing for more effective treatment. The frequency of your recommended mammogram is based upon your personal medical history.
Here are the general guidelines we use for recommending a mammogram:
It is especially important for women with dense breasts to have regular mammograms. Breast density is not a new discovery. It has always been one of the things that we consider when reading a mammogram. We will inform you if you have dense breasts so that you can discuss your screening options with us.
An MRI is occasionally used to screen women at high risk of breast cancer. If you have a family history of breast cancer, our genetics experts can assist you in figuring out whether you are at high risk of breast cancer. The MRI is very sensitive and may detect abnormalities that are noncancerous as well as cancerous.
As part of your regular medical exam, we may also do a clinical breast exam, looking for any abnormalities or changes in your breasts. The exam can be performed by your gynecologist, personal physician, or other health care professional.
We will work with you to individualize your treatment of breast cancer. Depending upon the location of the tumor and the severity of the cancer, treatments may include:
We may recommend one or more of these treatments.
One of the most important aspects of cancer therapy is good self-care during the treatment period and beyond. There are several things that you can do to improve your overall health and well-being during treatment:
We may also discuss with you the possibility of enrolling in a clinical trial. Clinical trials are research studies designed to improve treatment for cancer patients. Some trials investigate new cancer drugs and treatments, while others compare standard treatments to newer promising treatments. All of the standard treatments we use today achieved that status by being the most effective in a previous clinical trial.
Clinical trials are offered at nearly all the oncology clinics at our medical centers in Northern California. We have clinical trials available for many types of breast cancer. Please ask your doctor if a clinical trial may be available for you.
Following mastectomy (removal of the breast by surgery) for breast cancer, you have a variety of options available to you:
The important thing to remember is that you have many options, and we will work with you to choose the best option for you. You can view our Emmi tool to learn more about the possibilities of breast reconstruction.
If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.
If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.
During your office visit, we will discuss your medical and family history and I will perform a physical exam. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options and develop a treatment plan that is right for you.
If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.
For general medical advice, our Appointment and Advice line is available 24 hours per day, 7 days per week.
If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line. You will be connected with a nurse who can give you immediate advice.
If you are experiencing a serious problem or an emergency, call 911 or go to the nearest Emergency Room when the clinic is not open.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the Radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.
As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available at any time that is most convenient for you. From my home page you can:
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.