Breast Cancer
Yearly annual mammograms in women after the age of 40 are recommended to screen for small, clinically undetectable tumors. Most women who have annual mammograms will not have any clinical symptoms from a newly diagnosed breast cancer. Some women may be recommended to undergo regular breast MRI’s in addition to annual mammograms for reasons such as dense breast tissue or breast implants. The most common symptom of a breast cancer is a palpable mass. Other indications of Most patients diagnosed with a new breast cancer do not have a family history of breast cancers. Having said that, people with an extensive family history of breast and ovarian cancer may want to be evaluated further with genetic testing to rule out certain syndromes that may place them at increased risk for these cancers. While there is increasing evidence that diet and lifestyle may play a role in breast cancer risk, the most established risk factor is the use of exogenous estrogen such as oral contraceptives, fertility treatments, and hormone replacement after menopause. A breast cancer diagnosis is usually made with a biopsy. This is often done under ultrasound, mammographic, or MRI guidance. Once the diagnosis is made, you may be recommended to undergo further staging studies with the above studies or with a CT scan, PET scan, or bone scan. Women with early stage tumors usually have the option of pursuing breast conservation surgery In the event that chemotherapy is recommended, the radiation is usually deferred until after the chemotherapy is complete. Your medical oncologist will review the risks, benefits, and side effects of a course of chemotherapy with you if it is recommended. External beam radiation is typically delivered to the remaining breast over a 5 to 7 week course of treatment, Monday through Friday. Breast radiation is usually very well tolerated, but may include fatigue, skin burning, skin peeling or blistering, and shooting pains within the breast tissue. Your radiation oncologist will monitor your symptoms closely during treatment and recommend medications as needed. In some cases, a course of brachytherapy may be recommended to the tumor bed in lieu of a 5-7 week course of radiation. Your radiation oncologist will evaluate your specific tumor data to determine whether this is an appropriate treatment option for you. Mammosite is one example of a brachytherapy treatment and is offered at several of our treatment centers. This treatment is delivered by placing a balloon within the tumor bed at the time of lumpectomy. Once the tumor pathology is available and it is determined that you are an appropriate candidate for Mammosite, the radiation is delivered to the tumor bed using a radioactive source that is fed through a catheter into the center of the balloon. Treatments are typically delivered over a 5 day course with two treatments each day for a total of 10 treatments. Your physician can discuss this treatment option with you further at the time of your consult. Women with more advanced breast cancers may be recommended to undergo adjuvant radiation to the chest wall and/or lymph nodes. Standard features that indicate a recommendation for post-mastectomy radiation include 4 or more positive lymph nodes, extensive matting of lymph nodes, skin or nipple involvement, large tumors, and positive surgical margins. Your surgeon and radiation oncologist will review your case at length to determine whether post-mastectomy radiation is appropriate for you. In other cases, your surgeon and medical oncologist may recommend neo-adjuvant chemotherapy Following radiation for breast cancer, the treated breast may have a slightly different appearance and texture. You will be followed with regular breast exams as well as regular imaging with mammograms or breast MRI’s. In many cases, patients will be recommended to take a 5 year course of hormone suppression therapy to reduce the chance of tumor recurrence or the development of a new breast cancer. Your medical oncologist will discuss the risks of this therapy with you. Most women who undergo lumpectomy for breast cancer will require radiation to the remaining breast or tumor bed to reduce the chance of locoregional recurrence. Radiation can be delivered using conventional External Beam Radiation over 5-7 weeks or by using brachytherapy called MammoSite where an internal source of radiation is placed in the tumor cavity over 5 treatment days. Not all patients are appropriate candidates for MammoSite. Your physician can help you decide which treatment option is most appropriate for you. Some patients will benefit from radiation to the chest wall and/or lymph nodes after a mastectomy. Your physician can explain why you may or may not be recommended to have post-mastectomy radiation. MammoSite 5 day targeted radiation therapy
For more information about MammoSite, please visit their web site.
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Breast cancer is the most common type of cancer in women in the United States. The incidence of breast cancer in the US has been increasing since the 1970’s, a fact that is thought, in part, to be due to environmental factors such as lifestyle and diet. 99% of breast cancers occur in women, although men are also at risk for breast cancer.
breast cancer include palpable masses in the axilla, change in breast size, skin dimpling, itching or redness of the nipple or skin, nipple inversion, and nipple discharge. 
(lumpectomy) or mastectomy (removal of the entire breast). In most cases, patients undergoing lumpectomy will be recommended to undergo an adjuvant course of radiation therapy to the remaining breast to reduce the risk of local recurrence.
before your surgery in order to make the tumor more likely to be completely removed at the time of surgery. In most cases, patients who are recommended to undergo neo-adjuvant chemotherapy will also be recommended to undergo radiation after surgery whether it be a lumpectomy or a mastectomy. Your doctors will discuss your case at length prior to beginning treatment to determine which treatment is most appropriate for you.
