Robin Roberts' Doctor Answers Your Breast Cancer Questions

Aug. 13, 2007 — -- When "Good Morning America" anchor Robin Roberts announced she was battling breast cancer and would seek treatment, countless well wishes poured in from viewers.

Some questioned when she would return to work after having her surgery. Roberts' doctor and others she met through e-mails said getting back to work would be the best medicine.

Roberts returned to work today, but she is just one of the many women fighting cancer and trying to maintain a normal life.

Dr. Lauren Cassell, chief of breast surgery at Lenox Hill Hospital in New York and Roberts' doctor, said patients can expect to feel different after various forms of treatment. She addresses some common treatment questions below.

How soon can women get back to work after treatment?

My goal is to give my patients back their life. Everything we do is geared toward helping them do that.

It depends on the woman and the kind of treatment she has, but there's no reason why a woman can't go back to work during her treatment.

A patient gets chemotherapy every two or three weeks and there will be a few days around the treatment when she won't feel well.

However, we now have great meds that minimize side effects, so even if she has chemo Friday, she can be back at work Monday. Therefore, most women can miss one day of work and feel good enough to go back.

The biggest issue for women who undergo chemo is hair loss. As a doctor it's important that I make sure my patients are prepared for that to happen.

Most of my patients get wigs. I'll tell them to get a wig before they lose their hair, so the wig maker can match their natural hair, or to bring a picture with them. Other women choose to wear a bandana or scarf. I have one patient who sewed bangs into a scarf so that she would have the look of hair without the hotness of a wig.

Not all chemo regimens cause women to lose their hair.

What about the effects of radiation?

Most patients just fit radiation into their regular schedule. They can go before work, during lunch or after work. Fatigue is the biggest side effect.

No one has to know you're having radiation. You can choose to keep it private. Not everyone wants to share what they're going through.

What about the effects of a lumpectomy?

A lumpectomy is used when breast cancer is found at its earliest stage. It's done like a biopsy, and you can leave the hospital that same day or overnight if we have to test the glands.

Most of these procedures are ambulatory and done under local anesthetic with a sedative. You're out the same day. Women are usually out of work for about a week to 10 days.

What about the effects of a mastectomy?

A mastectomy takes a few weeks to come back from. Reconstruction adds more time, depending on how extensive the reconstruction is.

How long will it take to recover emotionally?

It's important to keep in mind that every patient is different and has have to do what's best for them. Getting right back into the swing of things is the key to the recovery process.

For many patients, sitting home is terrifying. I tell my patients that, when they leave the hospital, they are healthier than when they came in.

Many women feel as if their bodies betrayed them. There is no warning and no symptoms to breast cancer. Patients will tell me how well they care for themselves, and are angry that this has happened to them.

How important are mammograms?

Mammograms are the gold standard, the baseline test. It will show what a sonogram won't.

A sonogram is a complementary test. If a breast is too dense or unclear for some reason, a doctor will order a sonogram for more information. The problem with sonograms is that they pick up a lot of things — cysts, lesions, etc. — that don't need treatment, but doctors see them and must take the next step to check them out.

Both tests are needed when there is a significant family history or when breast tissue is dense enough to cause the mammogram to be unclear. Your doctor should determine whether extra tests, a sonogram or even an MRI are needed.

When should we start getting mammograms?

Women should start by age 40. If there's a strong family history, they should start earlier. A rule of thumb is to take the age their family member was diagnosed and start 10 years earlier (if mother diagnosed at 40, a daughter should start at 30).

What about self-exams?

Of course, the most important thing is self-exams — this is when we find cancer at its earliest stage. Many women are uncertain what they are looking for, but should get comfortable with their own breasts and know how they usually feel. When something feels different, they should contact their doctor.

For more information on dealing with breast cancer check out breastcancer.org.