Weston radiologist and novelist offers alternatives to breast removal

Weston radiologist Heather Frimmer, at right, with her family, from left, Ari, 10; Frimmer’s husband Benjamin; and Jonah, 12.
Weston radiologist Heather Frimmer, at right, with her family, from left, Ari, 10; Frimmer’s husband Benjamin; and Jonah, 12.

Bedside Manners, a novel written by Weston resident and radiologist Dr. Heather Frimmer, will be published in October by Spark Press. The book is based upon her experiences on the job.

“This a mother-daughter story that takes a look at the doctor-patient relationship from both sides of the operating table,” said Frimmer, 44, who specializes in breast imaging.

Frimmer has a bachelor’s degree in psychology and pre-med from Brandeis University. She graduated from Cornell University Medical School in Manhattan.

She and her husband Benjamin, a theater teacher and quality assurance officer with Weston Emergency Medical Services, have two sons —  Jonah, 12 and Ari, 10.

Her book launch is Sunday, Oct. 21, at 2 p.m., at Westport Barnes & Noble, 1076 Post Rd East. There’ll be a book signing and refreshments.

In the novel, the mother develops breast cancer while the daughter is learning to be a surgeon. The mother character was inspired “by all of my interactions with patients over the years, and the daughter character has a lot of me in her,” Frimmer said. “Her personality and a lot of the experiences she has while she’s in medical school were inspired by my own experiences.”

Advice for high-risk women

Prophylactic mastectomy, or surgery to remove one or both breasts to reduce the risk of developing breast cancer, is not the end-all solution for women who are high risk, according to Frimmer.

“I see a lot of patients at high risk for breast cancer.  With so much about this topic in the media, many of them automatically jump to that,” she said. “I have to talk them down.”

A great disadvantage of prophylactic mastectomy is that it involves a long recovery time.

“It can take several weeks. Also, it requires general anesthesia, which comes with its own risks,” she added.

Most women who are having this type of surgery also want breast reconstruction, which can cause issues such as implants rupturing or failing and needing to be replaced, Frimmer said.  

“Breast reconstruction can require a lot of surgery to get a good cosmetic result and surgeries come with risks,” Frimmer said.

A woman is considered high risk when she has a greater than 20% chance of developing breast cancer in her lifetime. The average risk of developing breast cancer is 12%, or 1 in 8, over the course of a lifetime.

The first and best way to stay cancer-free, according to Frimmer, is to get an annual mammography.

“You should start getting an annual mammography 10 years before the age your youngest relative was diagnosed with breast cancer, but no later than age 40 if no one in your family has had breast cancer,” Frimmer said, adding, “Don’t skip a year.”

She added that the most common time to get diagnosed is the 50s and 60s, “but I’ve diagnosed women as early as their 20s.”

In addition to a mammogram, there are several other tests available that can detect breast cancer, such as a breast MRI (Magnetic Resonance Imaging).

“This is the most sensitive test we have, and that means it finds the most cancers,” Frimmer said. “It finds cancers that are not detectable on mammography and breast ultrasound.”

A breast MRI is offered at most radiology offices. It requires an injection of gadolinium, which goes in through an IV.

“It lights up the cancer while the rest of the breast tissue is darker, so the contrast helps us differentiate cancers from normal tissue,” Frimmer said.

The patient would need to get a prescription from her doctor to get the procedure done, according to Frimmer. “She can talk it over with her doctor to determine whether it’s something that she wants to do. Her breast surgeon or gynecologist needs to order the test.”

The test takes an hour. If women are claustrophobic, they may find it difficult because they have to go into an enclosed tube, Frimmer said.

Medications

Medications are also an option to decrease the risk of breast cancer, Frimmer said. One type of medication is called chemoprevention. An oncologist who treats breast cancer can educate women more about chemoprevention.

To ensure healthy breasts, it’s extremely important, according to Frimmer, for all women to develop a strong relationship with their breast specialist.

“A breast surgeon is the best person to assess for any subtle changes in one’s breasts,” Frimmer said.

“This person knows what their patients’ breasts feel like since he or she has already examined them before, knows what the woman’s baseline is, and is able to establish whether any changes are worrisome or not,” Frimmer said.

Furthermore, according to Frimmer, all women should know their own breasts.

“The most important thing is to notice any changes and to bring them to the attention of your doctor right away,” Frimmer said.

Changes can include puckering of the skin, pulling in of the nipple, or a lump. However, these changes and others aren’t necessarily a sign of cancer.

“Don’t become alarmed,” Frimmer said. “A lot of times normal changes in the breast like cysts or other benign masses or lump scan cause these symptoms, so don’t jump to conclusions.”

When it comes to preventing cancer, it’s not a time for women to hold back in asking questions.

“Some women don’t know whether or not they are high risk,” Frimmer said. “If they have this question or any other, they should hesitate to ask their doctor.”

According to Frimmer, a theme that comes across in her book is that being high risk and being diagnosed with breast cancer “are both very anxiety-provoking situations that can cause a lot of confusion and fear,” she said. “It’s important to remember that we have good screening tests and excellent treatment, and that breast cancer is almost always curable. As long as you’re in the care of a good doctor and good medical team you are going to get through this.”

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