The Right Breast Cancer Treatment for You

Thanks to advances in oncology and more personalized treatment, more and more women survive a diagnosis for breast cancer.  According to the American Cancer Society, death rates for breast cancer have dropped steadily every year since 1989.  It is estimated today that 98 percent of women with early-stage breast cancer, or cancer that has not spread beyond the breast, are still alive at least five years after their diagnosis.

One reason is that doctors are matching treatment modalities to the specific biology and genetic makeup of each individual’s cancer.

While almost all women will have surgery to treat breast cancer, not all women will have the same type of surgery.  Most women with early-stage breast cancer can safely choose between a mastectomy (removal of the entire breast) and a lumpectomy (removal of only the cancerous tumor plus some nearby healthy tissue). Your doctor can help you decide which option is right for you.

Typically, a lumpectomy is followed by five to six weeks of radiation therapy to destroy any remaining cancer cells in a breast. For certain types of small breast cancers, shorter courses of partial breast radiation therapy can be performed. Intraoperative radiation therapy, or IORT, is a procedure that allows breast surgeons to work together with radiation oncologists in the OR to precisely deliver a single dose of highly targeted radiation administered at the time of lumpectomy, while the patient is still under anesthesia. Radiation therapy may also be recommended for some women after a mastectomy.

Depending on the characteristics of their cancer, women may also be treated with:

Intraoperative Radiation Therapy – IORT. Some patients with early stage breast cancer now have the option of receiving both cancer surgery and radiation treatment at the same time. Intraoperative Radiation Therapy (IORT) eliminates the need for weeks of travel to receive radiation therapy, disruption to daily lives, and anxiety. For patients meeting certain criteria, IORT can deliver a complete dose of radiation in one treatment during the surgical procedure.

With IORT, our surgeons can remove the cancer while preserving the remaining breast tissue. Immediately after the cancer is removed, a small inflatable balloon is placed into the surgical cavity. Radiation therapy is then delivered to the tumor site in as little as eight minutes. Once radiation therapy is delivered, the surgeon removes the balloon and completes the operation.

Hormone therapy. About two-thirds of women with breast cancer have tumors that are fed by estrogen. Doctors have successfully treated these tumors for years with the antiestrogen medicine tamoxifen.

But another type of medicine, called an aromatase inhibitor (AI), is also available for postmenopausal women with estrogen-sensitive tumors. Treatment with an AI reduces the risk of cancer returning more than using tamoxifen alone, research shows.

Chemotherapy. Here doctors use drugs that travel through the bloodstream to fight cancer cells in most parts of the body. Chemotherapy may be recommended before surgery to help shrink a tumor or after surgery to help kill any cancer cells that may have been left behind or spread. Chemotherapy may also be prescribed for advanced breast cancer.

Targeted therapy. This type of treatment attacks specific abnormalities in cancer cells. For example, the drugs trastuzumab (Herceptin) and Pertuzumab (Perjeta) are now routinely given to women with breast cancer cells that test positive for a protein called HER2. Breast cancers with too much of this protein tend to grow and spread aggressively. Trastuzumab and Pertuzumab help slow and stop this growth.