Breast cancer originates in the breast tissue. The earliest form or breast cancer is labeled In Situ. In these cases, the abnormal cells or tumor is contained within the duct or lobes and has not spread, or invaded, other tissue. Women with In Situ breast conditions are considered at higher risk for invasive breast cancer.
Invasive breast cancer occurs when cancer cells that originated in the milk ducts or lobes spread to other healthy surrounding tissue. Sometimes invasive or infiltrating breast cancer can travel to other parts of the body through the blood stream and lymph system.
Inflammatory breast cancer is a rare and aggressive form of breast cancer gives the appearance of inflammation. There also may also be a sudden increase in breast size; itchy breast skin; breast pain; swollen lymph nodes under the arm or above the collar bone; nipple retraction; and a change in breast skin color. This form of breast cancer usually affects younger women and is more common among young African American women. This breast cancer tends to spread early throughout the body.
Symptoms for breast cancer may include:
- Swelling in the armpit
- A change in the size and shape of the breast
- Fluid leaking from only one nipple
- Change in the size of shape of the nipple
- Changes in color, shape or texture of the nipple or areola
- Unusual pain in only one breast or armpit that do not appear to be caused by regular cyclical changes
Your doctor may perform a clinical breast exam, review symptoms and refer you for additional testing. Because every woman is unique, St. Luke’s offers an Individualized Breast Screening Program based on unique risk factors and offering the latest technologies, including 3D Tomosynthesis and Automated Breast Ultrasound (ABUS) while adapting to individual patient needs.
St. Luke’s offers leading treatments and a team approach to diagnosing and fighting breast cancer. In fact, historically, St. Luke’s is known as a regional leader in breast cancer care.
Did you know St. Luke’s was first in our area to perform sentinel lymph node biopsy for breast cancer starting in 1997, even setting up a training program for all surgeons in the Lehigh Valley to learn this innovative procedure, regardless of affiliations.
Regionally, St. Luke’s was first to offer IRB-approved clinical trials testing vaccines for breast cancer and to use Mammaprint®, a 70-gene genomic test that safely excludes many patients from unnecessary chemotherapy. St. Luke’s was also first locally to use the “breath-hold” technique for all left-sided breast cancers that get radiation therapy to significantly decrease the amount of radiation that hits the heart.
St. Luke’s became the first and only hospital in Pennsylvania to offer clinically-proven Intrabeam® Intraoperative Radiation Therapy (IORT) for some early breast cancers, reducing the standard six weeks of radiation therapy to one day.
St. Luke’s was also first locally to hire fellowship-trained surgical oncologists to ensure patients receive the best care, offer a breast cancer nurse navigator and establish a formalized high-risk screening program coordinated by a genetics counselor and open to all women in the Lehigh Valley.
St. Luke’s was also first in the area to offer low-dose 3D mammography and automated breast ultrasound (ABUS) to detect breast abnormalities in those with dense breasts.
The breast cancer team at St. Luke’s continues to identify and develop new technologies, clinical trials and services to provide all patients with the best possible breast care.
Treatment options for breast cancer may include the following:
- Breast Cancer Surgery
- Sentinel Lymph Node Biopsy
- Radiation Therapy
- Intraoperative Radiation Therapy (IORT)
- External beam radiation therapy (whole breast irradiation)
- Partial breast irradiation
- Promising clinical trials
- Targeted biologic therapies
- Gene expression profile testing
- Breast reconstruction
Breast Cancer Surgery
In every field of medicine, specialization makes a difference – cancer surgery is no exception. Studies have shown that finding the best-trained, educated and experienced surgeon to perform breast cancer surgery can significantly improve care and survival. Surgical oncologists have completed specialized fellowships and participate in societies dedicated to cancer and breast surgery. Patients receiving care through St. Luke’s Cancer Centers have access to St. Luke’s fellowship-trained surgical oncologists and a breast surgical oncologist.
There are two components of breast cancer surgery. The first deals with removing the breast tumor; this can be done either by removing the entire breast (mastectomy) or removing just the tumor and a small amount of surrounding normal breast tissue (breast-conserving surgery or lumpectomy. This is followed by sentinel lymph node biopsy to find out whether the tumor has spread to the lymph nodes.
Typically, women who are candidates for a breast cancer lumpectomy undergo surgical removal of the tumor followed by a six-week course of external beam radiation therapy (EBRT). EBRT continues to be a highly-effective treatment approach and has long been considered the gold standard of care.
Sentinel Lymph Node Biopsy
Sentinel lymph node biopsy is necessary to find out whether the tumor has spread to the lymph nodes. Ideally, breast surgery and lymph node surgery are performed at the same time.
Intraoperative Radiation Therapy (IORT)
Some women with early stage breast cancer who are candidates for lumpectomy may also benefit from Intraoperative Radiation Therapy (IORT). IORT is fast and effective and gives women who are candidates for breast conservation an excellent option. IORT can spare some women weeks of radiation therapy.
What makes IORT so unique? In some cases, a single IORT treatment performed in the Operating Room in about 30 minutes immediately following lumpectomy may be the only radiation treatment a woman needs. Still, women who require additional standard radiation therapy in conjunction with IORT can have their treatments over a shorter period of time.
Following surgical removal of the tumor and using a cone-shaped applicator, low-energy, high-dose X-rays target the tumor bed cavity where recurrence is most likely. IORT is precise and immediate and allows many women to resume their daily routine faster and with better quality of life.
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