What is breast cancer?(back to top)
Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. Nearly 75 percent of breast cancer cases are diagnosed in women age fifty and older. Although breast cancer is more common in older women, it does occur in younger women and also in men.
How is breast cancer diagnosed? (back to top)
Screening tests can find cancers early, so when your physician suspects breast cancer, he or she will order a mammogram, ultrasound, or other additional testing. If an abnormal area in your breast is detected, a biopsy may be performed.
A biopsy is done by removing a small amount of tissue with a needle, or a larger amount of tissue may need to be removed during surgery. The tissue is then sent to the pathologist and a diagnosis of cancer may be confirmed at that time.
Inflammatory Breast Cancer (IBC) is a rare, but dangerous form of breast cancer. IBC is difficult to detect because it often lacks a distinct lump or tumor. Symptoms of IBC include swelling and redness of the breast, a sudden change in breast size (usually only on one side), unusual dimpling of the skin, and swollen lymph nodes in the neck or under the arm. These symptoms are often ignored or misdiagnosed, and this misdiagnosis can result in delayed treatment, and therefore reduce survivability.
Breast cancer treatment options(back to top)
Breast cancer can be treated with local or systemic therapy. Some patients receive both kinds of treatment. Local therapy, which includes surgery and radiation therapy, is used to remove or destroy breast cancer in a specific area.
Systemic treatments, which include chemotherapy and hormonal therapy, are used to destroy or control cancer throughout the body. Some patients have systemic therapy to shrink the tumor before local therapy. Others have systemic therapy to prevent the cancer from coming back or to treat cancer that has spread.
Surgery
Surgery is the most common treatment for breast cancer. There are two main objectives for surgery. The first is to remove the tumor. The second is to evaluate the lymph nodes to determine if the cancer has spread.
There are two types of surgery to remove the cancer – partial mastectomy and mastectomy:
- Partial Mastectomy - an operation that saves as much of your breast as possible by removing only the lump plus a surrounding area of normal tissue. This is an outpatient procedure, so you are home the same day. Radiation is critical after a partial mastectomy, to reduce the risk of the cancer reoccurring.
- Mastectomy - an operation where your surgeon will remove all of the breast tissue — the lobules, ducts, fatty tissue and a strip of skin with the nipple and areola.
- Conventional mastectomy means your surgeon will remove your entire breast. You usually are in the hospital overnight. You will be flat-chested after this procedure, but can wear a mastectomy bra that contains a prosthetic breast for visual uniformity, or you can have delayed reconstruction.
- Reconstructive surgery - if reconstruction is an option, your surgeon will refer you to a plastic surgeon. Your options will include reconstruction with a synthetic breast implant or reconstruction using your own tissue.
- Skin-sparing mastectomy is removal of the breast tissue through a small incision around the areola, leaving the skin behind. This procedure creates an envelope of skin inside which a plastic surgeon can reconstruct the breast. The cosmetic results are very good; however this is an add-day procedure that requires a hospital stay of several days.
Evaluating the Nodes
Three of the most important factors in the treatment of cancer are tumor size, nodal status and presence or absence of cancer outside of the breast and lymph nodes. This information combined will help classify the cancer and determine the most effective treatment.
This evaluation is called staging. The surgeon will evaluate the lymph nodes at the time of surgery.
Radiation Therapy
Radiation therapy, which is also called radiotherapy, uses high-energy rays or particles to destroy cancer cells. This treatment is used to kill any cancer cells remaining in the breast, chest wall, or underarm area after breast-conserving surgery. It may also be needed after mastectomy in certain cases. Before you undergo radiation, a radiation oncologist and physicist plan the precise delivery of the radiation to minimize radiation to your vital organs and maximize the radiation to the affected area.
There are two types of radiation therapy – external beam radiation and brachytherapy:
External beam radiation uses a machine called a linear accelerator to treat the entire breast from the outside. In some cases, surrounding tissue is also treated. External beam radiation therapy is painless. Each treatment lasts only a few minutes and is similar to getting an x-ray. The therapy is typically given 5 days a week for 6 weeks.
Brachytherapy, also called internal or partial-breast radiation, uses a balloon-tipped catheter to insert radioactive pellets into the cavity that was created during surgery. This method treats only the tissue surrounding the tumor site and can usually be completed in 5 days. A new device, called Contura, uses a multi-channel catheter to facilitate better control over the dosage and direction of the radiation. Because it is more targeted than previous methods, Contura makes this option available to women with smaller breasts or more complicated tumor sites. The Brown Cancer Center is the only facility in the region using Contura.
Chemotherapy
Chemotherapy uses drugs to destroy cancer cells. The drugs enter the bloodstream and travel throughout the body. Chemotherapy may be recommended to kill any remaining cancer cells following surgery, or to control cancer growth and relieve symptoms. Most chemotherapy drugs are given intravenously or in pill form.
Hormonal Therapy
Hormonal therapy keeps cancer cells from getting the hormones they need to grow. It is used to treat cancers that are fed by estrogen – known as hormone receptor positive tumors. Like chemotherapy, hormonal therapy can affect cancer cells throughout the body.
Immunotherapy
The immune system is your body’s way of fighting disease. Immunotherapy helps this system control or kill cancer cells.
Clinical Trials and Research(back to top)
In addition to using the most advanced methods of diagnosis and treatment, the Brown Cancer Center is constantly examining new approaches to cancer treatment. Brown Cancer Center physicians participate in and initiate a wide range of ongoing clinical trials and research, giving you access to new therapies that may not yet be available in other parts of the world.
If you have general questions about your condition, the Brown Cancer Center, or free services available to you and your loved ones, please contact the Mint Jubilee Resource Center at 502.562.4158 or 866.530.5516.
What is breast cancer?(back to top)
Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. Nearly 75 percent of breast cancer cases are diagnosed in women age fifty and older. Although breast cancer is more common in older women, it does occur in younger women and also in men.
How is breast cancer diagnosed? (back to top)
Screening tests can find cancers early, so when your physician suspects breast cancer, he or she will order a mammogram, ultrasound, or other additional testing. If an abnormal area in your breast is detected, a biopsy may be performed.
A biopsy is done by removing a small amount of tissue with a needle, or a larger amount of tissue may need to be removed during surgery. The tissue is then sent to the pathologist and a diagnosis of cancer may be confirmed at that time.
Inflammatory Breast Cancer (IBC) is a rare, but dangerous form of breast cancer. IBC is difficult to detect because it often lacks a distinct lump or tumor. Symptoms of IBC include swelling and redness of the breast, a sudden change in breast size (usually only on one side), unusual dimpling of the skin, and swollen lymph nodes in the neck or under the arm. These symptoms are often ignored or misdiagnosed, and this misdiagnosis can result in delayed treatment, and therefore reduce survivability.
Breast cancer treatment options(back to top)
Breast cancer can be treated with local or systemic therapy. Some patients receive both kinds of treatment. Local therapy, which includes surgery and radiation therapy, is used to remove or destroy breast cancer in a specific area.
Systemic treatments, which include chemotherapy and hormonal therapy, are used to destroy or control cancer throughout the body. Some patients have systemic therapy to shrink the tumor before local therapy. Others have systemic therapy to prevent the cancer from coming back or to treat cancer that has spread.
Surgery
Surgery is the most common treatment for breast cancer. There are two main objectives for surgery. The first is to remove the tumor. The second is to evaluate the lymph nodes to determine if the cancer has spread.
There are two types of surgery to remove the cancer – partial mastectomy and mastectomy:
- Partial Mastectomy - an operation that saves as much of your breast as possible by removing only the lump plus a surrounding area of normal tissue. This is an outpatient procedure, so you are home the same day. Radiation is critical after a partial mastectomy, to reduce the risk of the cancer reoccurring.
- Mastectomy - an operation where your surgeon will remove all of the breast tissue — the lobules, ducts, fatty tissue and a strip of skin with the nipple and areola.
- Conventional mastectomy means your surgeon will remove your entire breast. You usually are in the hospital overnight. You will be flat-chested after this procedure, but can wear a mastectomy bra that contains a prosthetic breast for visual uniformity, or you can have delayed reconstruction.
- Reconstructive surgery - if reconstruction is an option, your surgeon will refer you to a plastic surgeon. Your options will include reconstruction with a synthetic breast implant or reconstruction using your own tissue.
- Skin-sparing mastectomy is removal of the breast tissue through a small incision around the areola, leaving the skin behind. This procedure creates an envelope of skin inside which a plastic surgeon can reconstruct the breast. The cosmetic results are very good; however this is an add-day procedure that requires a hospital stay of several days.
Evaluating the Nodes
Three of the most important factors in the treatment of cancer are tumor size, nodal status and presence or absence of cancer outside of the breast and lymph nodes. This information combined will help classify the cancer and determine the most effective treatment.
This evaluation is called staging. The surgeon will evaluate the lymph nodes at the time of surgery.
Radiation Therapy
Radiation therapy, which is also called radiotherapy, uses high-energy rays or particles to destroy cancer cells. This treatment is used to kill any cancer cells remaining in the breast, chest wall, or underarm area after breast-conserving surgery. It may also be needed after mastectomy in certain cases. Before you undergo radiation, a radiation oncologist and physicist plan the precise delivery of the radiation to minimize radiation to your vital organs and maximize the radiation to the affected area.
There are two types of radiation therapy – external beam radiation and brachytherapy:
External beam radiation uses a machine called a linear accelerator to treat the entire breast from the outside. In some cases, surrounding tissue is also treated. External beam radiation therapy is painless. Each treatment lasts only a few minutes and is similar to getting an x-ray. The therapy is typically given 5 days a week for 6 weeks.
Brachytherapy, also called internal or partial-breast radiation, uses a balloon-tipped catheter to insert radioactive pellets into the cavity that was created during surgery. This method treats only the tissue surrounding the tumor site and can usually be completed in 5 days. A new device, called Contura, uses a multi-channel catheter to facilitate better control over the dosage and direction of the radiation. Because it is more targeted than previous methods, Contura makes this option available to women with smaller breasts or more complicated tumor sites. The Brown Cancer Center is the only facility in the region using Contura.
Chemotherapy
Chemotherapy uses drugs to destroy cancer cells. The drugs enter the bloodstream and travel throughout the body. Chemotherapy may be recommended to kill any remaining cancer cells following surgery, or to control cancer growth and relieve symptoms. Most chemotherapy drugs are given intravenously or in pill form.
Hormonal Therapy
Hormonal therapy keeps cancer cells from getting the hormones they need to grow. It is used to treat cancers that are fed by estrogen – known as hormone receptor positive tumors. Like chemotherapy, hormonal therapy can affect cancer cells throughout the body.
Immunotherapy
The immune system is your body’s way of fighting disease. Immunotherapy helps this system control or kill cancer cells.
Clinical Trials and Research(back to top)
In addition to using the most advanced methods of diagnosis and treatment, the Brown Cancer Center is constantly examining new approaches to cancer treatment. Brown Cancer Center physicians participate in and initiate a wide range of ongoing clinical trials and research, giving you access to new therapies that may not yet be available in other parts of the world.
If you have general questions about your condition, the Brown Cancer Center, or free services available to you and your loved ones, please contact the Mint Jubilee Resource Center at 502.562.4158 or 866.530.5516.