Breast Cancer   

If so, how often do you check?

For example, when would you recommend clinical exam for surveillance versus imaging with MRI, CT or PET? 

Does the type of breast cancer factor into your decision making?

What is your treatment algorithm?

Do you feel differently about using these in patients with a history of HR-negative breast cancer?

Her gynecologist wants her on hormone replacement therapy.

The patient is on a dose of 22 mg of methotrexate weekly for severe rheumatoid arthritis. If you would discontinue the methotrexate, how long would y...

Since both pregnancy and cancer are risk factors for VTE, is there data to guide when or if we should prophylactically anticoagulate? If so, what shou...

I have heard of long-term pentoxifylline and Vitamin E daily combination that can prevent and even reverse radiation fibrosis (Delanian et al., PMID 1...

Would you offer it to a woman with a history of a provoked DVT?

Patient had significant GI side effects with Trental. (This particular case involved a second course of radiation for a secondary lung cancer 30+ year...

If a patient had prior breast conserving treatment and now has inflammatory breast disease, would you prophylactical send the patient to a cardiologis...

If this is bothersome to the patient, are there any topic ointments or medications that can help if used? 

Do you allow patients with breast cancer on tamoxifen to use black cohosh?

Is there data that it actually helps?

Presuming that work-up for cardioembolic sources is negative, how would you proceed?

Does the answer change on proximity/distance from breast (i.e. what if pelvis or lower extremity?)

We usually recommend copper IUDs, but that's not feasible in all women.

Would your counseling change if she reported a history of unplanned pregnancy? Is there any wording or waiver you might be able to use warning her of ...

How do you decide on resumption or change of therapy?

How would you approach chemoprevention if tamoxifen is 

Are there exercises, massage techniques, or support garments that are effective at preventing or reversing lymphedema of the breast?

What do you do/say when a discussion of evidence-based information doesn't convince a patient that this is her best chance of cure? Some patients even...

When a physical exam is important and telehealth is not a good option, should we be proactive and reschedule or should we continue to see them as sche...

How would you approach a post-menopausal woman who now wishes to start adjuvant endocrine therapy more than 3 years since surgery?  

Tamoxifen prophylaxis has not been studied in women <35 years old, but it would be reasonable to assume they would benefit.

What patient and disease factors may influence your decision?

Do your recommendations differ if patients are pre or postmenopausal given the data?

If a patient is due for their yearly mammogram on the breast that has been diagnosed with cancer but is still undergoing active treatment (chemo or ra...

Do you test for pregnancy prior to each cycle? 

I have a patient who will be climbing to the base camp of Mount Everest. Does a climb to 15,000 feet increase her risk? Should she wear a compression ...

Knowing that the analysis now is more detailed than it was 10 years ago. What about non-Ashkenazi Jewish breast cancer patients with suspic...

Patient does not qualify for breast cancer screening by annual MRI per criteria (IBIS lifetime risk<20%, no known genetic predisposition,...

Recent NEJM study showed an increased breast cancer relative risk in longer durations of hormonal contraceptive use that could last up to 5 years. Pre...

In light of two phase III randomized trials showing duloxetine (S1202) and acupuncture (S1200) both improve AIMSS, which would you try first? Wou...

Is there a role for routine use of additional or alternative imaging modalities for these patients, such as tomosynthesis, MRI, or ultrasound?  I...

Does your recommendation change depending on the agents they received?

A 40 year old patient receiving post-op RT for  breast cancer asked me if there is any risk for her becoming pregnant after completing RT. Eric H...

The 2013 ASCO guidelines and current NCCN guidelines recommend yearly mammograms but our radiologists are still recommending mammograms every 6 m...