Video

On Cancer: Meet Breast Cancer Surgeon Lisa Sclafani

By Memorial Sloan Kettering  |  Wednesday, January 16, 2013

Breast cancer surgeon Lisa Sclafani, who practices at Memorial Sloan Kettering Commack, wants newly diagnosed patients to leave her office with hope and with a plan of action for treating the cancer.

Comments

Tuve cácer de mama derecha hace 6 años y quiero conocer el portal que me permitirá saber si tendré nuevamente cácer en los próximos años.

Buenas tardes, Nydia. Para aprender más sobre nuestros programas del cáncer de mama – incluso información para estimar el riesgo de que el cáncer reaparesca – visite nuestra página en el Web: http://www.mskcc.org/cancer-care/adult/breast. ¡Gracias por su comentario!

Mi Hermano tiene cancer de melanoma metastasico pulmonar, grado 4, estadios C. Quisiera saber sie tienen algo diferente al tratamiento q le proponen que es: interferon-interlukin que segun tengo entendido esta descontinuado o ipilimumab-yervoy. No tiene mutacion braf. Este viernes le hicieron un nuevo Pet Scan en el IESS en Quito Ecuador. Cualquier informacion que se digne dar, vamos a estar muy agradecidos. Mi No de Telf es 593 999832009. Gracias .aria Teresa Arias V.

Gracias por su comentario. Usted puede encontrar más información sobre melanoma aquí: http://www.mskcc.org/cancer-care/adult/melanoma. Si quiere hacer una cita con un doctor de Memorial Sloan-Kettering por favor llame al 212-639-4900. Si llama desde un lugar que no sea los EE.UU., puede usar el servicio de acceso directo de AT&T. Primero marque el número de acceso del país en que está, luego 888-675-7722.

Are the risks of reoccurence the same with 2nd excision + radiation as with mastectomy?

We spoke with Dr. Sclafani, and she said that this is a complex question which is likely best discussed with your surgeon who knows your exact pathology. However, if your question is about a patient whose initial lumpectomy doesn't get clear margins, a re-excision that achieves clear margins results in the same recurrence rate as if it was achieved with the initial lumpectomy. In other words, the lumpectomy is successful and is appropriate treatment as long as negative margins are eventually achieved, even if it takes more than one operation.

6 years post left breast mastectomy stage 3 cancer with lymph involvement. Now have pain and burning under mastectomy scar and now pain and burning spreading to other breast. Nipple is very itchy on right breast. My oncologist took me off Arimidex 6 motnhs ago. Should I be back on it or back on something?

Thank you for your comment. We are unable to answer personal medical questions on our blog. To make an appointment with a Memorial Sloan-Kettering physician, please call 800-525-2225.

I want to know after a lumpectomy-why do you have to have re excision you cant get every single cell don't even know where thy are there are no perfect margins--its all too much

Francine, thank you for your comment. You can find more comprehensive information about breast cancer diagnosis and treatment at this link:

http://www.mskcc.org/cancer-care/adult/breast

My sister has been prescribed Arimidex following breast cancer treatment and is constantly developing urinary track infections.. Is this a side effect or the result of decreased immune system. Also, is there any research that supports wearing thong underwear and development of UTI's?

Dear Diane, we are sorry to hear about your sister's diagnosis. Unfortunately, we cannot answer personal medical questions like this on our blog. We would encourage her to consult with her oncologist about the urinary track infections she is experiencing. If she would like to make an appointment with one of our specialists, please ask her to call our Physician Referral Service at 800-525-2225. Thank you for your comment.

Hi Doctor,
Thank you for your time.
Our situation is as follows, my wife was diagnosed with breast cancer in October 2014. Since then she has completed Radiation Therapy. As part of her longer term cancer management she has been prescribed arimidex. However, we were advised that there were three prescriptions options offered on the market that were chemically similar:
1) Arimidex approved by the FDA in 1995, manufactured by Astrozenica (UK);
2) Femera approved by the FDA in 1997, manufactured by Norvartis (Switzerland); and
3) Aromasin approved by the FDA in 1999, manufactured by Pharmacia & UpJohn (United
States)
However, while investigating the drugs, I discovered that arimidex and femera are chemically similar but aromasin has a different chemical structure. We have been advised that anyone of these products would be acceptable brand name or generic. I have two questions:

A) What makes aromasin chemically different? And
B) If money is no object, is there a potential qualitative difference between drug manufactures or minimal side effects of some of these drug?
Kind regards,
Charles White

Dear Charles, we are sorry to hear about your wife' diagnosis. We would encourage you to go back to your wife's oncologist to discuss which drug may be most appropriate for her. You may also find it useful to read through some of our patient education materials, which offer overviews on each of these medications:

Aromasin
http://www.mskcc.org/cancer-care/patient-education/resources/exemestane

Arimidex
http://www.mskcc.org/cancer-care/patient-education/resources/anastrozole

Femara
http://www.mskcc.org/cancer-care/patient-education/resources/letrozole

We hope this is helpful. Thanks you for reaching out to us.

Yes, reading though the material was helpful. Thank you very much for your quick response.
Kind regards,
Charles White

I know that there is a large price gap between the International Nonproprietary Name (INN) (or generic name) and trade name. We have been researching Arimidex / Astrozenica. The pricing gaps have been tremendous, for example the following are quotes for a 30 day drug supply of:

Arimidex price quotes are almost $500.00 per one month supply; and
Astrozenica price quotes are from $6.00 to $32.00 per one month supply. These quotes are from some national drug chains and mass merchandisers.

The question that we struggle with is,” With such a price difference in the cost for these maintenance drugs, is there a difference in quality control?” We are fortunate that the cost of drugs, even with the ranges stated above, are not cost prohibitive. That being said, it is painful to accept the situation and then be faced by an additional stress of making a decision based on the assumption of chemical structure being similar.
Is there any insight, you can provide or point to concerning medication manufacturing and generic risk -if any - versus the trade name. If we are overly concerned about something that is non-material let me know.

Thank you for your time.
Charles White

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