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Surgical Treatment of Breast Cancer—Past, Present, and Future: A Conversation with Deborah E. Farr, MD

Deborah E. Farr, MD.

In this interview, Deborah E. Farr, MD, Associate Professor in the Department of Surgery at the UT Southwestern Simmons Comprehensive Cancer Center, discusses the benefits of recent advances in the surgical treatment of breast cancer. She also gives insight into how breast cancer surgery may continue to evolve in the coming years and shares advice for counseling patients with breast cancer who are undergoing surgery.

This interview has been conducted in partnership with the National Breast Cancer Foundation (NBCF). Recognized as one of the leading breast cancer organizations in the world, NBCF is Helping Women Now® by providing early detection, education, and support services to those affected by breast cancer. A recipient of Charity Navigator's highest 4-star rating for 14 years, NBCF provides support through their National Mammography Program, Patient Navigation, breast health education, and patient support programs. For more information, please visit https://www.nationalbreastcancer.org/

Oncology Data Advisor: What are some of the recent advances in the surgical treatment of breast cancer?

Deborah E. Farr, MD: Breast cancer is continuing to evolve, not only in surgery, but also in our multidisciplinary care with radiation oncology, medical oncology, and plastic surgery. One of the things that has advanced in breast cancer in the last 10 years, I would say, is the onset of oncoplastic surgery, which is a way of removing a portion of the breast—colloquially known as a lumpectomy—and rearranging the tissue so that it's more aesthetically placed instead of having a large defect in the breast. The other thing that we can do is targeted axillary lymph node biopsies with localization of a little marker we call a seed that helps us find the exact specific lymph node that we're looking for, which could have been previously biopsied instead of removing several lymph nodes without knowing which was the lymph node that was biopsied. All these things are really great in the advancement of giving people more tailored care.

Oncology Data Advisor: What factors go into the selection of patients with breast cancer for surgery?

Dr. Farr: When women come to us, they usually get the choice between either a lumpectomy or a mastectomy. Sometimes if the area of suspicion is too large or if the patient is not able to tolerate radiation, they are not good candidates for a lumpectomy. Sometimes they prefer to have a mastectomy due to family history or to reduce their chance of recurrence. Otherwise, we go through the pros and cons of both approaches, but they are equal in terms of survival. A lot of times, we say that a woman doesn't choose to have breast cancer, but she can choose how she'd like to treat it.

Oncology Data Advisor: That's good to know. Thank you. How do you foresee the surgical treatment of breast cancer evolving in the coming years?

Dr. Farr: In the coming years, I think breast cancer therapy will continue to grow and evolve with all the research that's being put into breast cancer. Hopefully one day, we can get to the point where we can treat breast cancer with just medicine, and maybe surgery will not have to be performed. I think the way in which surgery is performed is also continuing to improve with new techniques that are evolving every day, hopefully to give people better options, better cosmetic results, increased sensation, and overall a better quality of life after surgery. Luckily, we're at an institution where we're able to study that and give people the best care possible.

Oncology Data Advisor: Very good answer. Thank you. Do you have any advice for members of the cancer care team for managing patients who have undergone breast cancer surgery?

Dr. Farr: I think the best thing that I can say is to just ask questions. Ask questions until you completely understand and are at peace with the therapy that you've been offered, with what you've gone through and what you will go through. I think the better that a patient understands their care, the more they're able to participate and advocate for themself. Ultimately, each individual patient is very unique, and what is the right answer for one patient might not be the right answer for another patient. The more that the patient is able to understand and communicate what's best for her, I think the better care that patient gets.

Oncology Data Advisor: I'm really glad to hear that. Well, thank you so much, Dr. Farr.

About Dr. Farr

Deborah E. Farr, MD, is an Associate Professor of Surgery and the Section Head of Breast Surgery at UT Southwestern Simmons Comprehensive Cancer Center. Dr. Farr's research interests include surgical resident education and disparities among different populations of breast cancer patients.

This transcript has been edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of Oncology Data Advisor. 


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