?Ideally, everything you’re about to read will soon be of no interest to you.
We are getting closer to the day when there will be no need to be aware that October is Breast Cancer Awareness Month, when there will be a cure, and when all the information I’m about to tell you concerning new diagnostic and treatment options will be as useful as a how-to manual for a Model-T.
But until a cure is identified, it’s good to know the medical field is doing its best to find cancer at the earliest stages and to give patients the best treatments possible.
One of the most innovative technological breakthroughs in breast cancer detection and screening is tomosynthesis, or 3-D mammography. For young women and others with dense breast tissue, traditional mammography’s ability to detect small, more easily treatable tumors is limited.
By offering 3-D images of the breast, tomosynthesis can help doctors get a much clearer picture of what is happening. After the FDA approved tomosynthesis last year, Hoag became the only hospital in Orange County to offer 3-D mammograms commercially. Only a handful of other centers in the state offer the technology.
I am hopeful that 3-D mammography will become the gold standard. One of my patients had been advised by a colleague to seek 3-D mammography, even though she was not a traditional “dense breast tissue” candidate. Her 3-D mammogram found a tumor at its earliest stage while traditional 2-D images did not identify this area. The patient’s treatment was relatively easy and her outcome is excellent.
We’ve made great strides in not only safely and effectively removing cancer cells, but in preserving the breast’s appearance, too.
In the past, the only surgical option was radical mastectomy, removing breast tissue, lymph nodes, muscle and, in some cases, portions of the rib cage. Frankly, it was a pretty brutal operation, and it could be quite debilitating.
Now we are able to safely remove less breast tissue and fewer lymph nodes. And while the focus of surgery remains getting the cancer out successfully, some maneuvers can be performed to make the breast look its best after surgery. Everything from altering the incision site to partnering with plastic surgeons allows us to offer women an appearance that is as good – and in some cases, even better – than before surgery.
Intraoperative Radiation Therapy
Following a lumpectomy, we usually recommend radiation therapy to help ensure breast cancer doesn’t recur. Whole breast radiation therapy, which can cause temporary skin changes such as those seen in sunburn as well as some tissue scarring, traditionally lasts for six to seven weeks. Options treating a portion of the breast, or partial breast irradiation, may offer the benefit of completing treatment in a matter of five days but can have some downsides in the way that it is implemented and/or increased scarring to the radiated area after treatment.
For women who qualify, we can now offer a new option in partial breast irradiation, intraoperative radiation therapy, which is faster, easier and involves fewer side effects. After completing a lumpectomy, a surgeon inserts a device into the cavity left behind by the tumor and delivers one dose of radiation therapy directly to the site. Within 8-18 minutes their radiation therapy is done. The goal is that these patients wake up from anesthesia having completed not only their surgical treatment but their full radiation therapy course as well.
In the past, everybody with invasive breast cancer received high dose chemotherapy. Now, we are able to test the biology and behavior of the cancer to determine which medications may work best. In some cases, this testing may actually let us know that chemotherapy may cause more harm than good. This spares women unnecessary complications and helps them get better, faster.
If you have read this far, chances are you or someone you love, have had some experience with breast cancer. I hope this has helped.
But more than anything, I hope all this information becomes unnecessary very soon.
Lisa Guerra, M.D. is a fellowship-trained breast surgeon on the Hoag Breast Care Center Surgical Team.
This article was originially published in The Current.