Breast Cancer

Breast cancer is the most common type of cancer in American women, according to the American Cancer Society.

• Each year, nearly 216,000 women and 1,500 men learn they have breast cancer.
• Another 59,000 women learn they have in situ or noninvasive breast cancer.
• Nearly 40,000 women will die from breast cancer each year.

Risk Factors for Breast Cancer

Most women who develop breast cancer do not have known risk factors, but some factors may increase the chance of developing this disease. One of these risk factors is age — more than 75 percent of women diagnosed with breast cancer are over age 50. Other factors include:

• Early onset of menstruation.
• Family history of breast cancer in your mother or sister.
• Hormone replacement therapy with estrogen and progesterone.
• Alcohol consumption.
• A personal history of breast cancer or prior breast biopsy for benign disease.

Diagnosing Breast Cancer

Breast tumors are typically, but not always, painless, so it is important to have any breast or underarm lump checked. Swelling, discoloration, thickening of the skin or nipple discharge also should be checked immediately.

• In some cases, a biopsy to determine if you have breast cancer will be done in an office setting using a needle to remove cells from the lump.
• A stereotactic biopsy uses mammography targeting to pinpoint smaller tumors and permit a small amount of tissue to be removed by a needle for diagnosis.
• Your surgeon may suggest removing the lump to see if you have cancer.

Types of Breast Cancers

The breast is made up of ducts and lobules surrounded by fatty tissue.

• Cancer confined within a duct is called ductal carcinoma in situ (DCIS). Lobular carcinoma in situ (LCIS) is cells confined to a lobule.
• Tumors that break through the wall of the duct or lobule are called infiltrating ductal or infiltrating lobular carcinomas.
• Inflammatory breast cancer may involve the entire breast with specific skin changes and swelling.

Breast-Conserving Surgery

Studies have shown that women with early-stage breast cancer who have a lumpectomy to remove the cancer followed by radiation live just as long as women who have a mastectomy and may be preferred by many women. The standard of care after breast-conserving surgery is external beam radiation therapy. Often, this follows chemotherapy.

• Your surgeon will perform an operation called a lumpectomy, also called a partial mastectomy, excisional biopsy or tylectomy, to remove the tumor. In some cases, a second operation called a re-excision may be needed if microscopic examination finds tumor cells at or near the edge of the tissue that was removed (called a positive or close margin).
• To see if your cancer has spread, your doctor may remove several lymph nodes from under your arm (axilla). If any of these nodes contain cancer cells, more nodes may be removed.
• Breast-conserving surgery is not suitable for all breast cancer patients. Talk with your surgeon to see if this is the best procedure for you.
  

Treatment Options

Radiation therapy is commonly used after surgery to treat breast cancer. External beam radiation therapy is typically delivered to the breast, sometimes including the lymph nodes in the lower neck and armpit, over 15-30 daily treatments. The main side effect that patients experience during breast cancer radiation therapy is usually inflammation of the skin. Our team can help manage any side effect you have during treatment to make it as comfortable as possible for you.  We work closely with the breast surgery and medical oncology teams at Rutgers New Jersey Medical School to coordinate your care.

External Beam Radiation Therapy

External beam radiation therapy involves a series of daily outpatient treatments to accurately deliver radiation to the breast.

• Painless radiation treatments are delivered in a series of daily sessions. Each treatment will last less than 30 minutes, Monday through Friday, for five to seven weeks.
• The usual course of radiation treats only the breast, although treatment of the lymph nodes around the collarbone or the underarm area is sometimes needed.
• 3-dimensional conformal radiotherapy (3D-CRT) combines multiple radiation treatment fields to deliver very precise doses of radiation to the breast and spare surrounding normal tissue.
• Intensity modulated radiation therapy (IMRT) is a form of 3D-CRT that further modifies the radiation by varying the intensity of the radiation beams. It is currently being studied for treating breast cancer.
• Side effects might include skin irritation, like a mild to moderate sunburn, mild to moderate breast swelling and fatigue.

 

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