Breast cancer recovery is about more than survival—it’s about reclaiming a vibrant, fulfilling life. Instead of focusing solely on survivorship, we need to embrace what I call “livingship”: the journey of truly thriving after treatment. This approach focuses on ensuring patients not only survive but thrive in their cancer-free lives.
A personal journey in medicine
My path to becoming a breast cancer specialist was shaped by early aspirations and personal experiences with family members affected by breast cancer. These experiences have driven my commitment to advancing breast cancer care. For many practitioners, surgery day represents “cancer-free day”—a significant milestone that marks not just the end of cancer but the beginning of a new chapter in patients’ lives.
Advanced surgical techniques and holistic care for comprehensive recovery
Modern breast surgical oncology and oncoplastic reconstruction techniques allow physicians to treat cancer while minimizing its physical impact. By employing cutting-edge techniques to preserve the breast’s natural appearance, surgeons can contribute significantly to a patient’s emotional recovery and overall quality of life. However, the commitment to care must extend far beyond surgery. These approaches, combined with comprehensive support and proactive measures to prevent complications, help ensure patients can experience true “livingship” throughout their recovery journey.
Addressing lymphedema: A common but preventable complication
One of the most significant challenges faced by survivors of breast cancer is lymphedema, a chronic condition causing swelling due to lymphatic fluid buildup. Up to 82 percent of breast cancer patients are at potential risk, with factors like surgery, chemotherapy, radiation, diabetes, and high BMI increasing susceptibility.
Historically, lymphedema was often only noticed at later stages—what many describe as the “tree trunk” stage—when it’s much harder to treat effectively. However, when caught early, lymphedema is curable and reversible, just like early-stage breast cancer.
Modern clinics now integrate high-tech screenings for lymphedema into routine check-ups. Using a scale-like device that employs bioimpedance spectroscopy (BIS), medical teams can measure extracellular fluid in less than a minute, identifying patients who may benefit from early intervention and potentially preventing progression to chronic lymphedema.
Today, BIS is rapidly gaining ground as a go-to technology in breast cancer survivorship care. Just recently, the National Accreditation Program for Breast Centers (NAPBC), a quality program of the American College of Surgeons, updated its 2024 accreditation standards. For the first time, these standards include BIS as an evidence-based, objective measurement for managing lymphedema. NAPBC-accredited programs are required to adhere to evidence-based survivorship guidelines, regularly monitor their compliance, and undergo an onsite review every three years to maintain accreditation.
Patients often become highly engaged with this screening process, taking an active role in their recovery. This proactive approach, combined with at-home exercises like arm stretching, helps patients participate actively in their recovery and overall health.
The future of breast cancer care
A breast cancer team’s goal should be to make lymphedema screenings as routine as mammograms. Early detection allows for the implementation of preventive measures, which can significantly enhance patients’ quality of life after treatment. By detecting potential issues early, we can implement preventive measures, significantly improving our patients’ quality of life post-treatment.
This proactive approach embodies a commitment to “livingship.” We’re not just treating cancer; we’re empowering patients to live full, active lives without the constant shadow of their past diagnosis.
Promising advancements in breast cancer treatment
The field of breast cancer treatment is rapidly evolving, with exciting developments on the horizon:
- Neoadjuvant therapy: We’re increasingly using targeted therapies and immunotherapy before surgery, often allowing us to perform less invasive procedures.
- Precision medicine: Treatments are becoming more personalized, targeting specific genetic mutations in tumors.
- Oncoplastic surgery: By combining oncology with plastic surgery techniques, better aesthetic outcomes can be achieved while effectively treating cancer.
- Sensation preservation: For mastectomy patients, we’re developing techniques to preserve or restore sensation in the chest wall, significantly improving quality of life.
- Less invasive procedures: We’re moving toward hidden scar surgery and exploring alternatives to traditional surgical approaches.
Empowering patients through education
A crucial part of the approach should be educating patients about their condition and treatment options. Informed patients are empowered patients, better equipped to actively participate in their care and recovery.
As the fight against breast cancer continues to advance, let’s remember that our ultimate goal isn’t just to extend life, but to enhance its quality. Through innovative treatments, comprehensive care, and a focus on long-term well-being, we’re working to ensure that every breast cancer patient can look forward to a future of not just surviving, but truly living.
The journey from breast cancer diagnosis to “livingship” is unique for each patient, but it’s a journey no one must face alone. Walk alongside patients every step of the way, celebrate their victories, and support them through challenges. Together, we’re not just fighting cancer—we’re championing life.
Allison A. DiPasquale is a breast oncologist.
