“Learn your options” – surgeon and survivor Dr. Anne Peled explains why patient advocacy is so essential

Throughout Breast Cancer Awareness Month we're speaking to a number of people who've been affected by breast cancer, hearing about their personal experiences and the breast cancer issues they feel passionately about.

This week, we caught up with California-based Dr. Anne Peled – Plastic and Reconstructive Breast Surgeon, Co-Director of Sutter Health and breast cancer survivor.

We discussed the learnings she’s taken from her own experience into her practice, how we can help to improve the patient decision-making process and why she’s thrilled to be taking part in the #MagTeam100 challenge.

Q) As a breast cancer surgeon, what was it like to receive the diagnosis yourself?

AP: I was diagnosed with stage one breast cancer a few years ago at the age of 37 and like many people, there was a huge initial shock with finding out about the diagnosis.

But once I knew it, I was really able to settle in and take my time to get all the information that I needed. One of the things I tell my patients is even though psychologically it is so scary to get a diagnosis, you have time to learn your options, get the education you need and make the right choices for yourself.

So I felt for myself, that was a huge benefit – having time and expertise to really know what was the right choice for me. And I hope other patients do the same.

Q) What can we do to improve access to quality information for patients during this difficult time?

AP: One of the challenges is that everyone knows someone who’s been through it and a lot of times you get the stories from other people that may not be part of your story or your journey. So it can be difficult to find the right information that you need.

I really recommend that people go online to try to find groups that are similar to them and their stories. Some of my favorites are the Breasties, a group focused on women going through both breast cancer and breast cancer prevention surgeries, and Force, a group for women with a genetic predisposition to breast or ovarian cancer.

So try to go in there, hear other’s experiences but figure out what your goals and priorities are and how they fit in. 

"Find a community that has similar goals to yours and it will help you get better information for really making the right choices."

Q) Having seen both sides, what advice do you give colleagues and peers to empower patients in their decision-making process?

AP: When I went through breast cancer myself, one of the things I was so struck by was how hard it was to make a decision – and I had every bit of information I could possibly have as a trained breast and plastic surgeon.

So when I speak with other surgeons and providers about how to talk to patients, I say really get to know your patients, their lives and what’s important to them. Are they active? Do they have young families? Do they have busy jobs? What matters to them about their bodies and their goals? Does it scare them to ever think about going through an MRI or mammogram again?

As providers if we can all really get to know our patients in that way, it allows us to truly have a conversation with them. It means we can understand what they’re looking for and make a shared decision, rather than just giving advice and recommendations based on our priorities.

Q) Are there any stories from your own treatment that may be helpful to patients diagnosed with breast cancer?

AP: I feel like there are so many things I learned having gone through my diagnosis, but the main one is to stay active during treatment. For me, it helped psychologically to have that space.

I wore my running clothes to radiation every day. I did a 10K race after I finished radiation and I just felt like I had this thing that was all mine and made me feel good about myself. I could clear my head and have something to look forward to every day, which was hugely important.

"Exercise really got me through both surgery and radiation and I really recommend to women - even if you're not a person that exercises a lot - to just walk and get outside."

Q) Patient advocacy is clearly very important to you. Can you tell us a little more?

you. Can you tell us a little more?

AP: The key thing for people going through treatment to realize is that ultimately it is your body and only your body going through treatment. But it can be really hard sometimes for people to advocate what feels best to them, or they may not even know all of their options.

For example, after I started going through my own treatment, we started nerve preserving mastectomies and reconstruction at our practice. And it’s been amazing to see how much that changes people’s perceptions of themselves and ability to get back to their life after surgery.

So I would say, the key is that if it doesn’t feel right to you, and you’re worried about side effects and consequences, getting a second opinion is always OK. Really advocate for what is going to feel best to you because ultimately, it’s you going through it and you’ll be the one moving past it.

Q) How can we make patients better aware of their surgical options - from oncoplastic surgery through to breast reconstruction?

AP: One of the things I continue to be – unfortunately – amazed by is how few women are given information about breast reconstruction, particularly lumpectomy reconstruction or oncoplastic surgery.

So we try this month and every month to bring up the idea of asking your surgeon for better options. Asking where your scars are going to be. Asking about lumpectomy or mastectomy reconstruction. Find out what your choices are and get the full spectrum of those options.

With Breast Reconstruction Awareness Day coming up on the 21st October, we have a great opportunity to educate women about their choices and help advocate for themselves to get to know the full spectrum and find a choice that’s right for them.

Q) Finally, do you have any plans to mark Breast Cancer Awareness Month?

AP: One of the things we are so excited about for our practices here is actually thinking about it as Breast Cancer Action Month.

The idea of awareness around breast cancer is incredibly important but I think especially in the setting of COVID, we want to think about what can we do to take action. 

"We want women to have less chance of getting breast cancer, have better treatment options for breast cancer and focus on metastatic breast cancer as well."

So for our practice, we’ll be having a regular video series with patient interviews about their treatment and how they made decisions they did. We’re really excited about showing people the full spectrum of options.

We’re also incredibly excited about raising awareness and funds towards metastatic breast cancer organizations such as METAvivor; stage four cancer needs more research, and funding is essential.

And the final thing is the #MagTeam100 challenge. It’s been great, getting me out there exercising and I’m delighted that the funds are going to go to Prevent Breast Cancer to help with awareness and funding prevention. So I think it’s going to be a great month and I’m really excited for all of it.