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Q: Is breast cancer treatable?
A: Yes, breast cancer is treatable.

Q: Do I need to leave the Princeton area to get
better care?

A: No, Dr. Dultz is well educated and highly
qualified to provide the best possible care
for her breast cancer patients and their families.
She works with other specialists who are equally
well trained and qualified.

Q: What is breast cancer?
A: Breast cancer is a process that begins
when the cells of the breast undergo malignant
changes. The normal cell is damaged and
converts into a cell thatbegins to grow in an
uncontrolled growth pattern. If the cancer cells
continue to grow, they may spread to other sites in the body. This is called metastasis.

Q: What causes breast cancer?
A: The causes of breast cancer are not known. There are factors associated with an increased risk of developing breast cancer. Being female is the highest risk factor. In addition, advancing age, family history and environmental factors are thought to contribute to the development of breast cancer.

Q: What are the symptoms of breast cancer?
A: Most of the time there are no symptoms with breast cancer. It usually is found in a mammogram or as a lump in the breast that isn’t painful. However, ANY change in your breast should be checked by your doctor. Other changes may include:

  • Thickening in the breast,
  • Redness, swelling, warmness or darkening of the breast
  • Pucker –A pucker is an indentation in the skin. Ladies look in the mirror and raise your arms. You may only see it when you lift your arm above
    your head.
  • Pulling or tightening in the breast
  • Pain or tenderness not tied to your monthly cycle.
  • Nipple tenderness, discharge, or physical changes to the nipple such as inversion

Q: What is a mammogram?
A: A mammogram is a low dose radiation x-ray that is used to look inside of the breast. It is the best screening tool that is widely available to detect breast cancer at its earliest, most treatable stages. Mammograms can detect cancers even when they are too small to be felt by you or your doctor.

Q: Why should you get a screening mammogram?
A: The experts have shown that early detection is very important to surviving breast cancer. Mammograms can detect cancers that are very small. Breast cancer is one of the most common types of cancer in women and it is also one of the most detectable cancers because of screening mammograms. If a cancer is found on a mammogram and treated early, the survival rate is excellent.

Q: Who should get a mammogram?
A: Women 40 years of age and older should get yearly mammograms. A woman under 40 with either a family history of breast cancer, or other concerns about her risk, should inquire from her doctor when to begin screening. Sometimes, these women begin screening earlier than 40 years old.

Q: What are the recommendations for the early detection of breast cancer?
A: Women 40 or over should have a clinical breast exam yearly performed by her doctor. In addition, a mammogram should be performed yearly. Although there is some discussion about the importance of monthly breast self examination, a woman should know what her breasts feel like so she could detect any changes that may occur. She should discuss this with her doctor. This is important because although mammograms do detect most cancers, approximately 10% of cancers are not seen with a regular mammogram.

Q: Do young women get breast cancer?
A: Yes. Although the majority of breast cancer occursin older women, it can occur in young women too. Any lump found at any age needs professional evaluation by a doctor.

Q: What do I do if I find a Lump?
A: Go to your doctor. Any new lump needs to be evaluated regardless of a woman’s age or history. This may begin with a thorough history and physical exam and may necessitate a mammogram or a sonogram. She may need a biopsy as well.

Q: What is a biopsy?
A: A biopsy is when a part of the tissue is taken for pathologic evaluation. There are several different types of biopsies that can be performed. Most can be done in the office with local anesthesia while others may need to be done in the operating room.

 

Q: What if my biopsy shows a cancer?
A: Fortunately today, there is a lot of progress that has been made with the treatment and outcomes for breast cancer. There are several surgical options as well as new medical and radiation options for women with breast cancer. In addition, there are many areas or excellent resources to turn to for information, help and support. Breast cancer can be treated successfully if it is detected early.

Q: Who will help me through the process once I have been
diagnosed with breast cancer?

A: In my office and at our breast center, we are lucky to have a Breast Navigator and an excellent, caring staff that will help a patient through the scary and unknown path of this devastating diagnosis. She will help you set up appointments with referring doctors, facilitate additional tests if needed and provide ongoing emotional support to the patient and the family.

Q: Why Do I Need So Many Doctors?
A: If you are diagnosed with breast cancer, your chances for getting the best possible results are greatest when you're first diagnosed. Because of this, it's very important that all cancer specialists involved in your diagnosis and treatment participate in discussions that will determine the strategy for your breast cancer care. Also, the fact that they are all working together ensures that all doctors are on the same page and considering the whole landscape of your treatment, not just their specialty.

Q: What Does Each Specialist Do?

Breast Surgical Oncologist
A surgeon who has completed his or her general surgery residency and has gone on to complete a fellowship in breast surgical oncology. During a breast fellowship, the surgeon not only learns the latest surgical techniques for performing biopsies and operations for breast cancer, but she/he also spends time with the other experts in breast cancer, such as the medical oncologists, radiation oncologists and plastic surgeons. This additional training allows the surgeon to understand all aspects of the breast cancer treatment- from diagnosis to surgery to chemotherapy to radiation. The breast surgeon has to work very closely with the other oncologists to provide the best and latest care for patients with breast cancer to ensure the best results.

Medical Oncologist
A physician who specializes in the medical treatment of cancer. Medical oncologists have a thorough knowledge of how cancers behave and grow. This knowledge is used to calculate your risk of recurrence as well as the possible need for and benefits of additional or adjuvant therapy (such as chemotherapy or hormonal therapy). Your medical oncologist generally manages your overall medical care and monitors your general health during your course of treatment. He or she checks your progress frequently, reviews your lab and X-ray results and coordinates your medical care before and after your course of treatment.
Radiologists. Specialists who are trained at interpreting X-rays or other forms of imaging that look into the body.

Radiation Oncologist
A physician trained in cancer treatment using radiation to reduce the chance of the cancer from returning. They work very closely with the breast surgeon to plan the best way to deliver the radiation to the breast or chest wall after surgery.

Plastic/Reconstructive Surgeon
A plastic surgeon who specializes in state of the art breast reconstructive techniques to help restore the body after major surgery. They work very closely with the breast surgeon and usually at the same time as the breast surgeon. The plastic surgeons that Dr. Dultz frequently works with have completed additional training in breast reconstruction, including complicated flap reconstructions and also implant reconstruction.

Radiologist
A specialist trained at interpreting x-rays and other forms of imaging. A radiologist is often the first doctor to identify a problem in the breast and direct them to Dr. Dultz.

Breast Health Navigator
A registered nurse who has received the certification of Breast Health Navigator assists patients by coordinating care and providing education and support.

 

Rachel P. Dultz, MD, FACS
Breast Surgical Specialist, LLC
300B Princeton Hightstown Road, Suite 102, East Windsor, NJ 08520 | Phone: (609) 688-2729 | Fax: (609) 688-2709