In part one of their breast cancer discussion on the Healthful Woman podcast, host Dr. Nathan Fox discusses breast cancer screening, diagnosis, and treatment with Dr. Christina Weltz, an assistant professor of surgery and surgical oncology at Mount Sinai Hospital.
Why Breast Surgery Has Become Specialized
During the podcast, Dr. Weltz explained that breast surgery, once considered a routine part of general surgery, has developed into its own specialized field. Modern breast care requires surgeons to understand radiology, pathology, medical oncology, plastic surgery, and radiation oncology, as treatment decisions depend on a comprehensive understanding of these disciplines. This ensures that every aspect of care, from your diagnosis to treatment planning and reconstruction, is handled with quality care.
The Importance of Clinical Judgment in Breast Cancer Treatment
While surgical technique is critical, Dr. Weltz discussed that the most impactful decisions can occur before entering the operating room. Choosing which operation to perform and when to operate is important. Dr. Weltz shared, “Historically, it was always surgery first when it came to breast cancer, largely because there really weren’t other options but in so many situations now, it is far better to treat the patient, you know, neoadjuvantly with chemotherapy or hormonal therapy prior to doing surgery and the nuances of that are also incredibly important to make the right decision.” She highlighted triple-negative breast cancer as an example. Although aggressive, it responds extremely well to chemotherapy. For many of these patients, beginning systemic therapy before surgery leads to better control of the disease, demonstrating how essential treatment beforehand is in breast oncology.
Why Breast Exams Are So Challenging
During the conversation, both physicians discussed the complexity of performing and interpreting clinical breast exams. Dense or fibrocystic tissue can complicate routine examinations. Dr. Weltz shared, “The difficulty in discerning normal density from something that could be worrisome, something that could even potentially be malignant, is so incredibly challenging.” Dr. Weltz stated that after more than 20 years in practice, clinical breast exams remain one of the hardest parts of her job.
The Role of Benign Breast Disease in Patient Care
Although breast cancer treatment is a major part of her practice, Dr. Weltz expressed how important it is to treat benign breast conditions. Many patients arrive worried after discovering a lump, assuming the worst. However, an ultrasound or biopsy often reveals a benign finding, such as a cyst. Helping patients move from fear to relief is one of the most rewarding aspects of her work and remains a crucial part of breast health care.
Learn More
If you are interested in learning more about breast cancer, listen to the full episode of the Healthful Woman podcast. If you have concerns about breast cancer, contact Carnegie Women’s Health or Carnegie Imaging to schedule an appointment by completing our online contact form.
