Breast Cancer Treatment
At Norton Cancer Institute, we know how scary and stressful a diagnosis of breast cancer can feel. But you can rest assured our Breast Health Program offers everything you need to face your condition with confidence.
Our dedicated breast health care team is skilled in the most advanced techniques available. We will devise a personalized plan of care for you, based on the type and stage of your tumor and overall treatment goals. Plus, you have access to leading national breast cancer clinical trials right here in Louisville, as well as a suite of cancer support services to keep you informed and empowered every step of the way.
Breast Multidisciplinary Clinic
Norton Cancer Institute patients who receive a breast cancer diagnosis now have the option to be seen by multiple specialists the same day through a Breast Multidisciplinary Clinic. The multidisciplinary setting offers the convenience of fewer appointments, thereby reducing travel and time in beginning next steps in their care.
Patients’ cases are presented to a group of multidisciplinary providers, and treatment plans are discussed in the Breast Tumor Board. This allows the treating provider to ensure all options are considered prior to the course of treatment.
A Norton Cancer Institute patient navigator supports each patient along their journey, every step of the way
Breast Cancer Surgery
Surgery is used to remove a tumor from the breast, check for lymph node involvement and reconstruct the breast. The type of surgery depends on the patient, and type, size and location of the tumor.
- Breast conservation surgery (lumpectomy or partial mastectomy): Only the tumor is removed along with a small portion of normal tissue. The breast is left mostly intact.
- Oncoplastic surgery: The use of plastic surgery techniques to preserve the best cosmetic outcome while removing the tumor.
- Breast removal (mastectomy): The entire breast is removed with or without reconstruction at the same time.
- Skin-sparing mastectomy: This technique preserves as much of the breast skin as possible to provide the skin needed for immediate reconstruction.
- Nipple-sparing mastectomy: In certain cases, all breast tissue can be removed except the nipple to allow for immediate reconstruction.
- Sentinel lymph node biopsy: A radioactive tracer and blue dye are injected near the tumor to help find the “sentinel” node, the first lymph node that guards the rest of the nodes in the axilla or underarm area. The first few lymph nodes that pick up the tracer are removed and tested for cancer. If the sentinel nodes are negative, it lets the physician know that remaining lymph nodes are likely to be negative and no other lymph node surgery is needed.
- Axillary node dissection: This procedure removes the lymph nodes under the arm when there is known disease. The lymph nodes are the filters of the blood stream and catch the cancer cells before they can spread to the rest of the body. The number of lymph nodes involved with cancer helps the doctors make treatment decisions.
- Mediport: This intravenous port is placed internally for patients needing long-term IV access for chemotherapy, antibiotics or nutrition.
The goal of radiation therapy is to kill cancer cells and prevent recurrence of the disease using X-rays and other types of radiation.
- Whole breast irradiation: Given in short daily courses over a six-week period.
- Accelerated whole breast irradiation: More radiation over a shorter time period, typically one to two weeks.
- Partial breast irradiation: A medical device is inserted during surgery to deliver radiation to a smaller area of the breast. It can be used in small tumors in certain cases.
Chemotherapy is used to kill cancer cells with medicines delivered in varied cycles through either an IV or a pill. It may be used to shrink a tumor before surgery, to kill cancer cells that remain in the body after surgery or radiation or to treat tumors that have developed in other areas of the body.
This type of therapy uses medications to stop the growth of cancer cells that rely on hormones. It may be used to decrease the chance of cancer returning or a new cancer developing after surgery. It also can be used to treat cancer that has spread. Hormonal therapy often is taken as a daily pill, with treatment continuing for several years or as long as it appears to be working if it is being taken for active disease.
Genomic tests, or gene expression testing, look at a specific tumor’s genes to help determine what’s driving its growth. These are not the same as genetic tests that determine inherited risk or genetic predisposition for developing cancer. The size of the tumor, lymph node involvement, hormone receptor status of the cancer and the tumor’s own genomic profile help the physician make the right treatment decision for the specific type of cancer.
Breast Reconstruction Options
Reconstruction takes place either at the time of or following a mastectomy.
- Oncoplastic reconstruction: This procedure combines plastic surgery techniques with breast surgical oncology. When a large lumpectomy is required that will leave the breast distorted, the remaining tissue is sculpted to realign the nipple and areola and restore a natural shape and appearance to the breast.
- Implants: An implant is a medical-grade sac filled with silicone gel (synthetic material) or sterile saltwater (saline) that increases breast size or restores the contour of a breast after mastectomy.
- Autologous reconstruction: There are many types of reconstruction procedures that use the patient’s own tissues to reconstruct a breast area instead of or in addition to implants. These are called autologous reconstruction techniques and include:
- Transverse rectus abdominis musculocutaneous (TRAM) flap: In this procedure, tissue from the lower abdominal wall is moved up to the chest to create a breast mound. It usually does not require an implant. Moving muscle and tissue from the lower abdomen to the chest results in flattening of the lower abdomen, with results similar to a “tummy tuck.”
- Deep inferior epigastric perforators (DIEP) flap: A technique in which skin and soft tissue are taken from the abdomen to re-create the breast without using the abdominal muscle.
- Latissimus dorsi flap: A section of skin and muscle from the back is used to reconstruct the breast. An implant also may be used with this procedure.
- Fat grafting: Fat tissue is removed from other parts of the body, usually the thighs, belly and buttocks, by liposuction. The tissue is then processed in a lab and injected into the breast area to re-create the breast.
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