00;00;00;03 - 00;00;42;23
Dr. Amy Comander
My name is Dr. Amy Commander. I'm a breast oncologist, and I'm here to help address your questions that you may have about things that you have googled. Is it safe to take collagen supplements if you have an estrogen receptor-positive breast cancer? I honestly think we need more research to understand if that particular supplement is actually safe to take, along with important medications such as tamoxifen or aromatase inhibitors or along with chemotherapy. We actually do have a study published in the Journal of Clinical Oncology just a few years ago showing that patients with breast cancer who were taking various types of supplements during chemo, unfortunately had a worse outcome.

00;00;43;02 - 00;01;02;01
Dr. Amy Comander
So even if it's a collagen supplement that someone's taking with a desire to improve their skin and their hair and their nails, I have to say I'm very skeptical, and I just say, you know, I think it's really important to focus on getting important nutrients from your diet rather than from a powder that you don't really know what's exactly in that.

00;01;02;22 - 00;01;29;08
Dr. Amy Comander
What are the side effects of letrozole? There is the potential for joint pains in about one in three women. In some women it can be quite manageable, but in some women it can be distressing, and sometimes we do have to switch around their medication to manage it best. Other potential side effects do include hot flashes, as well as a decline in bone density, which we carefully monitor.

00;01;29;23 - 00;01;58;08
Dr. Amy Comander
Many patients tolerate these medications very well, but in some cases we do have to make modifications to ensure that these medications are well tolerated, since they are so important for the treatment of hormonally sensitive breast cancer. Are we ever able to wear an underwire bra after undergoing a lumpectomy and radiation therapy? Many women do find that wearing an underwire bra shortly after surgery actually is uncomfortable,

00;01;58;08 - 00;02;27;20
Dr. Amy Comander
and therefore the breast surgeons often do not recommend it, and there's likely other reasons as well. They want to ensure that the surgical incisions are healing appropriately without abrasion, etc. It's certainly safe to wear an underwear bra, but I would really encourage a patient to discuss this with her breast surgeon as to when it would be okay to wear that type of bra because often, shortly after surgery, the surgeons do recommend a more supportive kind of sports bra garment to wear initially, just while that healing process is going on.

00;02;27;28 - 00;02;48;25
Dr. Amy Comander
My head feels sore where my hair is growing back. Is this normal? I do think that's a normal sensation and nothing to be worried about. Your scalp has been through a lot during chemotherapy treatment and you know, the hair's growing back and that's a blessing and it's usually something that resolves, so I do not think it's something to be overly concerned about.

00;02;49;06 - 00;03;17;18
Dr. Amy Comander
My breast cancer has an orange peel, texture and appearance after my mastectomy. What could be causing this? I would say that that type of appearance of the skin is worrisome and often seen with a diagnosis of inflammatory breast cancer. However, if an individual has undergone a mastectomy, it's highly unlikely that this appearance on her skin represents a recurrence of her breast cancer.

00;03;17;27 - 00;03;51;04
Dr. Amy Comander
It is much more likely that this swollen appearance represents swelling of the breast, possibly something called breast edema, which could be a manifestation of lymphedema or post-surgical changes. So I would strongly recommend that this individual follow up with her plastic surgeon to have a thorough evaluation. What do the results of my pathology report mean? So an understanding of the pathology report is really key for a patient to understand the implications of his or her diagnosis.

00;03;51;12 - 00;04;32;16
Dr. Amy Comander
We know that breast cancer is not one disease. There are many different subtypes of breast cancer, and that pathology report can really help answer those questions. Specifically, what is the type of breast cancer and what is the grade of the breast cancer which refers to the architecture of the cells in the tumor, and then what's actually also most important is the receptor profile, and that refers to is the tumor hormonally sensitive, meaning is it sensitive to the female hormones, estrogen and progesterone and does the tumor over express a protein called HER2/neu.

00;04;32;27 - 00;05;03;15
Dr. Amy Comander
So these are key factors that are in the pathology report that each patient should understand after receiving this diagnosis. How long do you need to wait to get a tattoo after chemotherapy? I think it really depends on when the individual wants to get that tattoo and where it is on the body. Certainly, if the tattoo is related to a nipple reconstruction, I would really recommend that the patient discuss this further with her doctor or plastic surgeon as to when it is appropriate to do that.

00;05;03;26 - 00;05;23;29
Dr. Amy Comander
If the individual wants to get a tattoo somewhere else on her body, certainly she wants to ensure that her blood counts have recovered fully that there's not an increased risk for infection, etc. So I think it's certainly fine to get a tattoo, but I think it's a great question that the patient should ask her medical team. How long can a remission last?

00;05;24;11 - 00;05;49;05
Dr. Amy Comander
So an understanding of a patient's risk for recurrence really depends on the features of the tumor. What is the stage of the tumor? What type of breast cancer did the patient have and what are those receptors subtypes, namely estrogen receptor, progesterone receptor and HER2. So a full understanding of these features is really key for a patient to understand his or her prognosis,

00;05;49;16 - 00;06;11;13
Dr. Amy Comander
and then that patient can have a conversation with the doctor about the treatments you're recommending. How much are they can lower my risk of recurrence and why are they important and in this conversation is very important, and these types of subtleties one can really not glean from Dr. Google. Do I have to worry about getting lymphedema over the course of my entire life?

00;06;11;15 - 00;06;37;24
Dr. Amy Comander
Lymphedema is definitely a concern among breast cancer survivors and certainly with treatments that we currently use. Our goal is to hopefully minimize the occurrence of lymphedema in our patients, but certainly it does still happen. Therefore, in my practice, we carefully monitor our patients for any signs of lymphedema, and do our best to be proactive to help minimize this complication,

00;06;38;01 - 00;07;00;05
Dr. Amy Comander
but it is an important side effect that patients who have had particularly an axillary lymph node dissection, do need to be aware of. Remember, what is written on the internet is not necessarily accurate information. A trusted resource is always your own medical team who knows your own individual history and can give you the best guidance and answer to your questions.