frequently asked questions

 

WHICH TYPE OF PATIENTS DO YOU TREAT?

Dr. Seagren is dedicated to caring for women with breast cancer as well as women who have a deleterious genetic mutation that significantly increases her risk of getting breast cancer.

 

I WAS TOLD I AM NOT A CANDIDATE FOR NIPPLE SPARING MASTECTOMY. WHAT ARE MY OPTIONS?

Many times, we meet women who were told they are not candidates for a nipple sparing mastectomy and/or immediate reconstruction. Our approach to each patient is personalized and Dr. Seagren's experience often differs from other surgeons. Dr. Seagren believes most women are candidates for nipple sparing techniques and benefit from immediate reconstruction.

 

WHAT IF I CHOOSE LUMPECTOMY?

For women diagnosed with breast cancer, they often have multiple treatment options. Surgery is usually one of the first decisions they will make. Most women are candidates for lumpectomy OR mastectomy. There are many factors that influence a woman's decision regarding surgical approach. We believe it is a very personal and personalized decision. Each woman is unique and each breast cancer diagnosis is unique. Dr. Seagren will review the biology of your particular diagnosis, the unique circumstances of your case, and your personal values; this will help you make a decision that is right for you. We call this shared decision making and it the best way to approach healthcare.

 

I HAVE A DELETERIOUS BRCA MUTATION. WHAT ARE MY OPTIONS?

If you would like to discuss your care with Dr. Seagren, please send an email request for consultation by using the link provided below. Generally speaking, women with a deleterious BRCA mutation should begin screening at least 10 years before the age of the youngest affected family member and at the latest, by age 25. This should include breast cancer screening, which includes an annual clinical breast exam AND mammogram AND breast MRI. Surgical risk reduction is an option you should discuss in detail with a breast surgery specialist. There is not yet an effective method for ovarian cancer screening, however most women with a BRCA mutation will have annual pelvic exams, a trans-vaginal ultrasound, and a blood draw to measure the level of CA-125. Typically, these women will be prescribed an oral contraceptive pill to lower their risk of ovarian cancer. Risk reducing surgery to remove the ovarian tissue should be discussed with a gynecologist who specializes in surgery for women with BRCA mutations, as the surgical technique requires removal of the entire fallopian tube in addition to the ovaries. This surgery is recommended once a woman has completed her family and/or by the age of 35.

 

WHAT IF I DON'T LIVE IN SEATTLE?

We are happy to consult and collaborate with your local physicians to assist you in any way that we can. We often treat women who travel from outside the state of Washington, to receive their surgical care with Dr. Seagren in Seattle.

 

WHO WILL BE MY SURGEON?

Dr. Seagren will often collaborate with one of her surgical colleagues for women who choose a bilateral procedure. Combining their shared experiences, expertise, and techniques has allowed them to provide a consistent, predictable, surgical result from both an oncologic standpoint (cancer removal) as well as the esthetic outcome (reconstruction). During the pre-operative planning phase, Dr. Seagren will coordinate a joint consultation or a separate consultation for you to meet her surgical colleague, to ensure you feel confidant and well supported by your surgery team.

 

SHOULD I GET A SECOND OPINION?

We strongly believe that knowledge is power. A second opinion is never a bad idea. We encourage our patients to meet with other physicians and surgeons. Likewise, we welcome patients into our practice who may have already met with a surgeon. We are happy to provide you with a second opinion.

 

WILL INSURANCE COVER THE COST OF A GENETIC TEST?

Generally speaking, if you have health insurance in the United States, the genetic test will be covered. It is considered preventative care! Insurance companies and your particular insurance plan may vary in the degree by which they cover the cost of this test. Out-of-pocket, this test is quite expensive, but we will NOT run the test unless our lab has received approval by your insurance company. Furthermore, we will work on your behalf to get the test covered and/or work out an affordable option for you.

 

I HAVE SEEN GENETIC TESTS OFFERED BY VARIOUS COMPANIES ONLINE OR IN TELEVISION COMMERCIALS. ARE THESE TESTS SAFE?

Genetic testing, particularly, at-home test kits, have become widely available for a variety of applications. The recent creation of technologically advanced DNA sequencing machines has lead to the eruption of this market. Unfortunately, this market is not regulated and the quality of the test results are variable. Inaccurate results can be harmful and may cause a women to make a decision for risk reducing surgery, that is not indicated. That is why Dr. Seagren utilizes the only FDA approved lab, Myriad. This lab has the most amount of genetic data/knowledge, consistent quality, reliable results, and is the industry gold-standard.