Breast Cancer Treatment Guidelines
The path through breast cancer detection and breast cancer treatment involves four main phases:
- Tumor removal
- Breast reconstruction (if needed)
Your medical team, consisting of your general surgeon, oncologist, breast reconstructive surgeon and nursing staff will guide you through this process and help you with the decisions you will need to make. Their goal is to deliver the best breast cancer treatment available.
Breast Cancer Detection
About 50% of breast cancer is detected either by a breast self-examination or during a clinical breast examination. The other 50% is detected during a screening mammogram, breast ultrasound or an MRI.
Definitive and complete diagnosis of breast cancer involves obtaining a sample of the breast tissue identified. If the mass is large enough to be felt, a needle breast biopsy can be done to extract tissue. Otherwise, a needle biopsy guided by a mammogram can be done.
Once you have had your cancer identified, the next step is to find out if the cancer is in the lymph nodes. An MRI will likely be ordered to determine if the lymph nodes are involved or not.
There are various breast cancer treatment options available depending on the type of cancer that has been identified by the pathologist. Commonly, patients undergo surgery to remove the cancer. Breast cancer surgery can range from a small lumpectomy, to a double mastectomy. Our breast cancer surgeons extensive skill and experience enable them to perform among the highest-quality breast cancer surgery available.
Your surgeon and oncologist will inform you of the type of cancer that you have, whether or not it has spread to other parts of your body and how aggressive it is. The breast cancer treatment options that are available can be confusing because there are so many options available today. Our medical team takes pride in ensuring that our patients are completely confident in their decisions concerning care. At the Bedford Breast Center, which serves patients throughout the Los Angeles area, we believe that education is as much a factor in treatment success as the breast cancer treatment itself.
Discuss your options and ask any questions you may have including breast reconstruction options. You may be eligible for an innovative treatment developed by our top plastic surgeon, Dr. Lisa Cassileth. Her one-stage breast reconstruction has enabled women to wake up from mastectomy surgery with a breast implant in place, and is one of the best options for breast cancer surgery available. This minimizes the sense of loss connected with mastectomy surgery and avoids the necessity for multiple surgeries.
Breast Cancer Patient Education Act
A big win for the breast cancer community happened on December 18, 2015 when Obama signed into law the Breast Cancer Patient Education Act. This is a huge step forward in making sure that all women who get a breast cancer diagnosis fully understand their breast cancer treatment and breast reconstruction options. At Bedford Breast Center, we’ve been doing this from the start, since we opened, and now we’re so glad to hear that all other women besides our patients will be able to fully educated in all the post mastectomy options so that they can make a informed confident decision about their breast cancer treatment.
Surgical Breast Cancer Treatments
There are three main principles that are followed in breast cancer treatment surgeries:
- Removal of the cancer,
- Checking the axillary lymph nodes,
- Investigating the possibility of metastasis, or spread, of the cancer elsewhere.
Removal of the cancer involves removing enough unaffected tissue surrounding the tumor to confirm that no cancer has been left behind. This is called a clear margin. A margin greater than 2 millimeters is generally required to call a margin ”clear”. Anything less than a clear margin increases the possibility that some cancer was left behind and this runs the risk of cancer recurrence. Radiation or chemotherapy cannot be depended upon to clean up a ‘dirty’ margin.
Checking the axillary lymph nodes is very critical to determine if the cancer has spread. The first place breast cancer spreads is to the lymph nodes in the armpit. In the past, breast cancer surgery involved removing multiple lymph nodes without identifying if all of them contained cancer cells. Recent advances in surgery now indicate that checking the “sentinel” or first draining node in the armpit will predict the condition of the rest of the nodes. This practice decreases the risks of complications of the procedure and preserves normal unaffected lymph nodes which eliminates possible side effects.
Ruling out distant or metastatic cancer is the third step in fully identifying and classifying the cancer. Scans that identify cancer in other parts of the body may alter the treatment plan and are thereby valuable for this reason.
Most physicians will check these scans for “staging” when the patient is first diagnosed. If the tumor is very small and the prognosis isfavorable with little chance of spreading to other organs these advanced scans may not be ordered. Negative scans are reassuring to the patient providing peace of mind. These negative scans also serve as a baseline for future surveillance imaging, all going towards providing among the finest breast cancer treatment Los Angeles has available.
Breast Cancer Treatment Options
Breast Conserving Surgery
Lymph Node Biopsy
Minimally Invasive Lumpectomy
One-Stage Breast Reconstruction