Author Q&A

Dr. Port talks about what prompted her to write The New Generation Breast Cancer Book, the most important thing women need to know about breast cancer prevention, her top advice for someone newly diagnosed, and more. Have your own question for Dr. Port? Visit the contact page to submit one.

Image of Doctor Elisa Port in Surgery

In this age of information overload, patients come to me all the time with print-outs of articles they’ve found on the Internet, covered with Post-It notes and highlighted passages. When a woman is with me in my office, I go through all of it with her and usually I’m saying, This doesn’t apply to you, that doesn’t apply to you, that doesn’t apply to you either. These women turn around and ask, What should I read then? And where should I be getting information?

I realized that there wasn’t a book or a source to refer them to. There was a need for a guidebook for women who are newly diagnosed with breast cancer who are inundated with information—but who want to get their facts straight, and hopefully come through with their optimism intact. I knew I couldn’t (and had no intention of) writing a book to counsel each individual woman on her particular case, but I thought I might be able to consolidate the best information and create a roadmap for how to navigate the process and provide guidance on how to get the best information and treatment. The book is insider’s advice on how to get through it.

There is no one-size-fits-all approach to treating breast cancer anymore, and that’s because we have so much to offer now. If you are diagnosed with breast cancer, understand that there’s a lot out there that will not apply to your case. It’s essential to find the best doctor you can so you get individualized, personalized care.

It’s important that women know there are factors within our control and factors out of our control. Many factors related to breast cancer risk, we have no control over. You can’t control if your mother has breast cancer. You can’t control if you’ve inherited the BRCA gene. You can’t control at what age you got your period or started menopause. The two main risk factors that women cancontrol are obesity and heavy alcohol intake. And they can also make sure that, after the age of 40 (at least for most women of average risk), they get an annual mammogram. Early detection is key.

One of biggest ones is that needle biopsies spread cancer, which simply isn’t true. Another big one is that if you don’t have a family history of breast cancer, then you’re not at risk for getting it, and conversely if you do have a family history, you are absolutely going to get it. In actuality, you can get breast cancer if you don’t have a family history. And you might not get breast cancer if you do.

Take a deep breath. It’s not an emergency. Follow the steps in the book to make sure you get the best care possible. One of the first steps will be finding a doctor—usually it starts with the surgeon—who is a breast surgery specialist and an expert in this area.

Most of what I’ve seen put out there by celebrities is incredibly valuable in terms of raising public awareness about specific issues related to breast cancer. But because there is no one-size-fits-all, for most women, the story that the celeb is telling will not apply on an individual basis. But what’s great is that most of the stories are incredibly powerful messages that do raise awareness about critical issues.

A very, very small number of men will be diagnosed with breast cancer. In the U.S., it’s about 2,500 cases a year. On the flipside, there is a lack of awareness about male breast cancer. It’s really important if a man feels a lump or notices something different or new about his body that he seeks medical attention right away. Early detection is the key. Men should also be aware if they have a family history of breast or ovarian cancer, and the BRCA gene affects men too.

I’d always been interested in taking care of people and making a contribution—I just didn’t know how that would play out. I actually studied language in college and earned a degree in Spanish and French. After I graduated, I had an internship at the NYC Department of Health. It was really amazing, and I thought, This is what I want to do!so I went back to school to finish my pre-med requirements.

Once I was in medical school, it became very clear to me that surgery was for me. The only other area of medicine that really interested me was psychiatry, and since breast cancer has such important psychologic implications, in fact I end up doing a bit of that when I counsel patients. Treating women with breast cancer really combines so many of the things about medicine I find fulfilling.

The role of surgeon  is one of the last jobs left where you have to be physically present—I can’t examine a patient by phone or operate by phone—and I love that face-to-face component. I also love taking care of women and being part of their lives at a critical juncture. To play a part in helping to figure out the best approach to cure cancer and to minimize damage is extremely rewarding. For many women, breast cancer is very emotionally charged in terms of how they feel about themselves sexually and how it impacts their femininity. Women want to feel optimistic that they’re going to look and feel good, and I’m dedicated to giving them the best result from a cancer and from an aesthetic standpoint.

I was on staff at Sloan Kettering for about 11 years when I was approached by the leadership at Mount Sinai and Glenn and Eva Dubin, the philanthropists and founders of the center, with the opportunity to develop something completely new and different, a center that would have all the aspects of care that a woman with breast cancer needs under one roof—not only the medical components like surgery, radiation, and chemotherapy, but the things I consider equally as important: the support system, nutrition guidance, yoga classes, and more. I envisioned this new center as a calming, peaceful environment that wasn’t so overwhelming and huge that a woman felt lost within it, but it also wouldn’t be so small she felt like it could only provide one aspect of her care.

The Dubin Center now fills that niche. It’s everything a woman diagnosed with breast cancer needs under one roof, and we shepherd each patient through the process from step to step, cultivating a very personal, calming, patient-centered environment. We perform very serious medicine with very serious, cutting edge research, and yet women walk in and say, I feel like I’m in a spa!

Life is busy, that’s for sure. There is so much to do! Mondays and Wednesdays are devoted to seeing patients in the office, Tuesdays and Thursdays are full days in the operating room, and Fridays are spent going back over the week and addressing what’s outstanding, from phone calls to meetings to patient follow-ups and other tasks, like planning new programs and going over research progress at the center and focusing on what we’re doing to make it better for our patients.

On surgery days, I’m in the operating room by seven in the morning and I go all the way through. I also spend a significant part of each day, about two to three hours, returning phone calls that have come in from patients during the day.

And then when I’m seeing patients in the office, anywhere from six to ten in a day are newly diagnosed with breast cancer. We’re meeting for the first time, and I’m helping them figure out what the best path is. Those visits are the most intensive. I also see every single person I operate on a week or two after their surgery to make sure they’re healing well and to go over the results and connect them with the next phases of their care.

The hardest part of my job is that as great as the outlook is for breast cancer for most women, the reality is there are some stories that don’t have a happy ending. There are many factors out of my control and out of the patient’s control, and women do have recurrences or new cancers develop. These are devastating. Giving bad news is the hardest part of my job, but it’s also one of the most important, because it’s essential patients know that we’re there with them on their path regardless of where it goes, and we’ll never leave their side. We’ll make sure they get the best care from start to finish, wherever that may lead us.

There are so many things I love about this job. I love being in the operating room. To walk out of the OR and say, Gosh, I  just cured this woman of cancer, that’s just unbelievable. Since the survival for breast cancer is so high, many of our patients come back for years after their diagnosis for their checkups. The truth is I get a lot of gratification out of those visits. I feel like I could sit and talk to each one of these women for hours and get caught up on their lives. It’s just so wonderful to see a young girl that I took care of showing me pictures of her wedding or her child, or another woman showing me pictures of her grandson’s wedding and thinking, Wow, I played a part of making this person present for that moment. It’s incredibly inspiring. It’s one of the most important parts of what I do, seeing how everyone is doing five and ten years later.