Breast Cancer Treatment

.................

Breast Cancer Diagnosis

Breast cancer treatment at Reid begins with an accurate diagnosis. If your radiologist sees suspicious areas on a screening mammogram or your provider detects something abnormal during a physical exam, he or she will want to investigate further to determine whether you have breast cancer. You may need to have additional tests, such as:

· Breast MRI: MRI, or magnetic resonance imaging, uses magnets to create images of breast tissue.

· Breast ultrasound: A breast ultrasound uses sound waves to take images of breast tissue and is especially helpful in visualizing lumps a mammogram cannot. Ultrasounds can also help doctors understand the difference between cysts, which are rarely cancerous, and solid masses, which might need further testing to rule out cancer.

· Diagnostic mammogram: A radiologist will take more X-rays of the breast in a diagnostic mammogram than in a standard screening mammogram.

After additional imaging, if your clinician still suspects cancer, you will have a biopsy, which is the only way to confirm a breast cancer diagnosis. During this test, a general surgeon removes breast tissue or fluid and sends it to a lab to see if cancer cells are present. The Reid Breast Center offers two types of image-guided biopsy to help doctors find tumors:

· Stereotactic breast biopsy, which uses mammograms to guide surgeons to the site of the tumor

· Ultrasound-guided breast biopsy, which uses ultrasound imaging to aid in the biopsy

If your test results reveal you have cancer, your provider will stage it before deciding which type of treatment is most appropriate for you. Staging breast cancer can be complex because of all the factors involved. However, in general, doctors are looking at a tumor's size and whether it:

· Contains proteins called estrogen receptors or progesterone receptors

· Has cancer cells that look like healthy cells (its grade)

· Has spread to nearby lymph nodes

· Has spread to other organs (metastasized)

· Produces a protein called HER2

Breast cancer surgery

Many women with breast cancer will have surgery to treat their disease. Reid's general surgeons are all members of The American Society of Breast Surgeons and have unique expertise in performing many breast cancer surgeries.

Lumpectomy

Also called breast-conserving tumor removal, a lumpectomy involves removal of cancerous tumors as well as some tissue around the cancer. Your surgeon will leave healthy tissue intact. You may also hear this procedure referred to as a partial mastectomy.

Mastectomy

During this procedure, your surgeon will remove your entire breast or, in the case of a double mastectomy, both breasts. There are a few different types of mastectomies:

· A total mastectomy involves removing the entire breast, part of your chest muscle, and skin.

· A modified radical mastectomy is similar to a total mastectomy but also includes your underarm lymph nodes.

· A skin-sparing mastectomy leaves behind the skin covering your breast to aid in breast reconstruction, but the nipple, areola, and breast tissue are all removed.

· A nipple-sparing mastectomy leaves behind the skin, nipple, and areola, allowing for a more natural-looking breast.

Your surgeon will review your cancer's stage and let you know which option might be most appropriate for you.

Breast reconstruction

Many women choose reconstructive surgeries to avoid using external breast prosthetics and feel more comfortable with their bodies after treatment. Reid's plastic and reconstructive surgeon can work with you and your surgical team before your procedure to allow for breast reconstruction later on.

Radiation therapy

Radiation therapy [1] uses high-energy rays or particles to destroy cancerous tissue. Reid Cancer Center offers sophisticated radiation therapies to treat cancer as effectively as possible while sparing healthy tissue.

Accelerated partial breast irradiation is available to women in the early stages of their diagnosis. This therapy, recommended for certain patients who have had surgery to remove a tumor (lumpectomy), delivers minimal amounts of radiation. Women can also receive treatment in five days rather than several weeks, as with traditional forms of radiation therapy.

Brachytherapy involves radioactive seeds or pellets placed after surgery in the area where the tumor was removed. These seeds or pellets deliver internal radiation to destroy remaining breast cancer cells.

Systemic therapies

Systemic therapies for breast cancer involve medications — taken by mouth, via injection, or infusion — that can reach cancer cells almost anywhere in the body. Reid's medical oncologists and hematologists use your cancer's stage and size, as well as your long-term goals for treatment, to determine which of the following therapies is right for you:

· Chemotherapy[2] involves one or more medications delivered intravenously or by injection.

· Hormone therapy is usually used for hormone receptor-positive cancers — cancers with estrogen or progesterone receptor proteins, which attach to estrogen and progesterone and help breast cancer cells grow. Hormone therapies work by interfering with hormones' ability to bind to those proteins or by lowering levels of those hormones.

· Immunotherapy[3] helps your body's immune system fight breast cancer. Breast cancer cells can look like healthy cells, so your immune system doesn't fight them like it might attack a virus or bacteria. Immunotherapies train your immune system to recognize what makes breast cancer cells harmful.

· Targeted therapy medications work in many ways. They can be used on HER2-positive breast cancers — cancers in which the HER2 protein is present — to stop breast cancer cells from reproducing or block the HER2 signal, which tells cells to grow. They can also be used for hormone receptor-positive cancers, sometimes in combination with hormone therapies, to stop cells from dividing. And targeted therapy can be used on cancers with the BRCA1 and BRCA2 gene mutations to destroy cells with the mutated genes. Oncologists may combine targeted therapies with chemotherapy to increase chemotherapy's effectiveness.

Lymphedema management

Lymphedema, in which fluid accumulates in the arms and legs, is common among breast cancer patients. About 5% of patients experience it in their first year of a cancer diagnosis, and 30% to 40% experience it during their lifetime.

Reid's comprehensive lymphedema program can often help. Certified lymphedema specialists use massage and compression techniques to redirect built-up fluid so the body can flush it out. Lymphedema management is available with a physician referral for all breast cancer patients.

Reid's oncologists and general surgeons are here to help you navigate a breast cancer diagnosis. Call (855) 935-8773 to discuss your options for care.