Breast Cancer

Early detection significantly improves breast cancer outcomes. While routine screening mammograms are vital, being aware of potential symptoms is also important. Common signs and symptoms of breast cancer may include:

• A new lump or mass in the breast or underarm (armpit)
• Swelling of all or part of a breast (even if no distinct lump is felt)
• Skin irritation or dimpling (sometimes resembling an orange peel)
• Breast or nipple pain
• Nipple retraction (turning inward)
• Redness, scaliness, or thickening of the nipple or breast skin
• Nipple discharge other than breast milk (including blood)

If you notice any changes in your breasts, it's essential to see a healthcare provider promptly. Diagnosing breast cancer at St. Luke's involves advanced technology and expertise:

• Advanced breast imaging (mammography, ultrasound, MRI)
• Image-guided biopsy
• Pathology testing to determine tumor characteristics

Our dedicated breast health centers across the St. Luke's network, including locations in Bethlehem and Allentown, offer convenient access to comprehensive breast cancer screening and diagnostic services.

Breast cancer is not a single disease. Your care team describes breast cancer in several ways, including where it begins and how it looks under the microscope, which biomarkers or receptors are present, and the stage of the cancer. Together, these features help guide treatment.

Breast cancer by type:

• Ductal carcinoma in situ (DCIS): Non-invasive breast cancer in which abnormal cells are confined to the milk ducts and have not spread into the surrounding breast tissue.
• Invasive ductal carcinoma (IDC): Most common type of invasive breast cancer. It begins in a milk duct and grows into the surrounding breast tissue.
• Invasive lobular carcinoma (ILC): Invasive breast cancer that begins in the milk-producing lobules of the breast.
• Inflammatory breast cancer (IBC): Rare, aggressive form of breast cancer that may cause rapid breast swelling, redness, warmth, or skin changes. It often requires a specialized treatment approach.

Breast cancer by biomarkers:
Breast cancer cells are routinely tested for estrogen receptors (ER), progesterone receptors (PR), and HER2. These results are important because they help determine which treatments are most likely to work.

• Hormone receptor–positive (HR-positive) breast cancer: The cancer is positive for estrogen receptors and/or progesterone receptors. These cancers may respond to endocrine, or hormone-blocking, therapy.
• HER2-positive breast cancer: The cancer has increased HER2 protein or amplification of the HER2 gene. HER2-targeted therapies can be highly effective for these cancers. Some HER2-positive cancers are also hormone receptor–positive.
• Triple-negative breast cancer (TNBC): The cancer is negative for estrogen receptors, progesterone receptors, and HER2. Treatment may include chemotherapy, immunotherapy, and other therapies depending on the individual cancer and its stage.

Breast cancer stage:
Stage describes how extensive the cancer is and is separate from breast cancer sub-type.

• Stage 0: Non-invasive breast cancer, most commonly DCIS.
• Stages I and II: Generally considered early-stage invasive breast cancer.
• Stage III: Breast cancer that is more extensive within the breast and/or regional lymph nodes but has not spread to distant organs. It is sometimes called locally advanced breast cancer.
• Stage IV, or metastatic breast cancer: Breast cancer that has spread beyond the breast and regional lymph nodes to another part of the body, such as the bones, liver, lungs, or brain.

Your treatment plan is based on the combination of your breast cancer type, biomarker results, stage, overall health, and individual preferences. Your breast cancer team will review these findings with you and develop a personalized treatment plan.

Multidisciplinary Breast Case Conference
Our team meets weekly for a Multidisciplinary Breast Case Conference - commonly known as a tumor board, where imaging, pathology, treatment plans, patient goals, and available clinical trials are reviewed collaboratively. Together, we develop a unified treatment roadmap that promotes faster decision-making, stronger care coordination, and improved patient outcomes.

Meet the Core Clinical Team

• Breast Surgeon: Leads surgical treatment and focuses on complete tumor excision while preserving function.
• Radiation Oncologist: Delivers precise radiation therapy to treat cancer while sparing healthy tissue.
• Medical Oncologist: Manages chemotherapy, immunotherapy, and targeted systemic treatments.
• Pathologist: Examines tumor tissue to determine cancer type, grade, receptor status, and other biomarkers critical for diagnosis and treatment planning.
• Radiologist: Interprets imaging studies to detect, characterize, and monitor breast lesions, and assess response to therapy.
• Plastic Surgeon: Performs breast reconstruction and oncoplastic procedures to restore form and optimize cosmetic outcomes after cancer surgery.
• Genetic Counselor: Assesses family history and inherited risk, provides education on genetic mutations (such as BRCA1/BRCA2), recommends and interprets genetic testing.

St. Luke's University Health Network provides personalized, cutting-edge breast cancer treatment plans developed by a multidisciplinary team of specialists. Treatment must be individualized, one size does not fit all. Your care team designs your plan based on the type of cancer, stage, genetics and genomics, and your individual goals and preferences.

Treatment options may include:

• Surgery: Including breast-conserving procedures and a mastectomy
• Radiation Therapy: Precise targeting to reduce recurrence
• Systemic Therapies: Such as chemotherapy, hormone therapy, and immunotherapy