Breast Cancer

Although it is true that breast cancer is the most common type of cancer among women, only a small percentage of breast health screenings result in a diagnosis of breast cancer.

Early detection of breast cancer is critical to a woman's long-term survival, which is why it is so vital that women regularly undergo mammography, breast exams and other screening options.

If you are diagnosed with breast cancer, surgery is often part of the treatment. In recent years, a number of new surgical treatment options have become available. Southcoast Hospitals offers the latest range of surgical and medical treatment options for breast cancer, performed by highly trained and board-certified staff surgeons. See card listing surgeons who perform breast surgery at all three of our hospital sites.

Surgical Treatment for Breast Cancer

Breast Conserving Surgery: Several surgical treatments are now available for breast cancer that conserve breast tissue while effectively treating the cancer. For most women with early stage breast cancer, breast conservation surgery is as effective as mastectomy, with studies showing survival rates to be the same.
• Lumpectomy: This involves surgical removal of the cancerous lump and a surrounding margin of normal tissue. If this margin is found to contain cancerous cells upon testing, additional tissue will be removed. Radiation is usually given for about six weeks following lumpectomy.

• Partial or segmental mastectomy (quadrantectomy): This removes more breast tissue than lumpectomy (up to one quarter or more of the breast.) Radiation therapy usually follows the surgery.

• Simple or total mastectomy: This involves removal of the entire breast but does not remove underarm lymph nodes or muscle tissue from beneath the breast.

• Modified Radical Mastectomy: This involves removal of the entire breast and some of the underarm lymph nodes. This is the most common type of surgery for women with breast cancer who are having the entire breast removed.

• Radical Mastectomy: This involves removing the entire breast along with underarm lymph nodes and the chest wall muscles under the breast. Once very common, this surgery is rarely performed today since the modified radical mastectomy has been proven to be as effective in treating cancer as radical mastectomy.

Biopsy:

• Lymph Node Biopsy: This is often performed with breast cancer surgery to determine if the cancer has spread to nearby lymph nodes. It involves removal of lymph nodes, most often in the arm pit area, and testing them for cancerous cells. The presence of cancer cells in lymph nodes often affects the course of treatment.

• Sentinel Node Biopsy: This is a new technique that involves injection of radioactive dye into the area around the tumor. Lymphatic vessels carry the substance into the "sentinel node" - the first lymph node that the tumor drains into and thus the most likely node to contain cancer cells. The surgeon then removes this sentinel node for further testing. If it contains cancer cells, then other nodes are removed as well. If the sentinel node is cancer free, then no other lymph node surgery is needed. This limited sampling of lymph nodes is not appropriate for everyone.

Medical Treatment for Breast Cancer

• Chemotherapy: Chemotherapy is sometimes recommended as part of treatment for breast cancer, particularly if the cancer has spread to any lymph nodes. Chemotherapy usually involves intravenous injection of a variety of drugs to kill any cancer cells that may still be present in the body or inhibit cancer cells from dividing. There have been a number of developments with new chemotherapy drugs and using different combinations of drugs to make therapy more effective. There are also new drugs available to combat some of the side effects of chemotherapy.

• Radiation Therapy: Radiation therapy is sometimes used either alone or in combination with chemotherapy. Radiation involves the use of x-rays to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside of the body to send radiation to the cancer site. Internal radiation therapy involves radiation that is delivered by needles, seeds, wires or catheters that are implanted in the body directly into or near the cancer site.

• Hormone Therapy: When cancer is biopsied, it is tested to determine whether the cancer cells are affected by hormones like estrogen. Hormones are natural substances produced by our bodies which circulate in the blood stream. The presence of some hormones, like estrogen, has been shown to cause certain cancers to grow. If tests show that the cancer is hormone-sensitive, then there are several drugs available that will inhibit or stop production of these hormones.

• Herceptin: Recent research has shown that about 30 percent of women with breast cancer have an excess of a protein called HER2, which makes tumors grow quickly. A genetically engineered drug, Herceptin, binds to HER2 and kills excess cancer cells, theoretically leaving healthy cells alone.

  Herceptin is an intravenous treatment that is used alone in patients who have had little success with other drugs, or as a first-line treatment in combination with the drug Taxol. Studies have shown that Herceptin increases survival rates for some patients and can prolong life for patients whose cancer has proven very difficult to treat with standard chemotherapy drugs.