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Breast Cancer Treatment Options

If you are diagnosed with cancer, navigating the treatment options can be a daunting task. At Centegra, we have specialists who are dedicated to helping you through the treatment journey. Our breast health and oncology nurse navigators will provide the education and resources you need to make decisions and coordinate care in collaboration with your caregivers.

The Centegra Comprehensive Breast Program offers a complete range of treatments from breast and cancer specialists.

Breast Cancer Surgery

There are three main types of surgery to remove breast cancer:

  • Breast-conserving surgery: Also called lumpectomy, this surgery removes the part of the breast containing the cancer and some surrounding normal tissue. With this technique, the breast looks as close as possible to how it did before surgery. Most patients who choose breast-conserving surgery also will need radiation.
  • Mastectomy: In this surgery, the entire breast is removed. There are several different types of mastectomies. You and your surgeon will choose the option that is best for you. Mastectomy may be combined with various forms of breast cancer surgery.
  • Lymph node surgery: If breast cancer spreads, it typically goes to nearby underarm lymph nodes first. To determine whether cancer has spread, the nearest lymph node to the cancer is often removed so a pathologist can evaluate it for cancer cells. Lymph node evaluation is also an important part of breast cancer staging.

All types of surgery for invasive breast cancer will involve sampling lymph nodes in the armpit on the side of the cancer to determine if cancer has spread to the lymph nodes. Centegra offers a lymphedema screening program after lymph node surgery to monitor for development of lymphedema or swelling of the arm.

Following surgery breast cancer patients at Centegra are referred to physical therapy for range of movement exercises to optimize healing.

Chemotherapy

Advances in chemotherapy treatment and infusion therapy have significantly changed the way patients experience this type of cancer treatment. Physicians called medical oncologists specialize in the use of medications or drugs to treat cancer. Medical oncologists develop a personalized treatment plan for every breast cancer patient and work with other specialists to provide complete care.

Chemotherapy can be injected or taken in pill form. Some patients may elect to have a small port placed under the skin of the chest to facilitate administration of intravenous chemotherapy.

Hormonal Therapy

Hormonal therapy involves giving medication in pill form that decreases the level of hormones or blocks their action. In breast cancer, hormonal therapy typically targets estrogen, which is made mainly by the ovaries. Taking an anti-hormone medication may decrease the risk of breast cancer recurrence by up to 50 percent.

Radiation Therapy

Radiation therapy involves irradiating the breast after surgery to decrease the chance that the cancer returns by up to 60 percent. Radiation oncologists use sophisticated computer programs to target the tissue to irradiate while protecting healthy organs in the vicinity from the radiation field.

  • External beam radiation therapy: Advanced treatments — including tomotherapy, image-guided radiation therapy and intensity-modulated radiation therapy — pinpoint the location of tumors with sub-millimeter accuracy. Centegra offers tomotherapy, which is highly regarded as the best way to use radiation as a cancer treatment and protect surrounding healthy tissues.
  • Internal radiation therapy: This type of treatment allows doctors to treat cancer from inside the body. One way Centegra provides internal radiation therapy is through an applicator known as the SAVI™ Accelerated Partial Breast Irradiation device. This device is placed inside the breast to deliver radiation treatment where it is needed the most. Also known as breast brachytherapy, this protects healthy breast tissue and reduces complications.

Reconstructive Breast Surgery

A woman who has surgery to treat breast cancer might choose to have additional surgery to rebuild the shape and look of her breast. There are many reconstructive options available, and women should talk to their surgeon about which would be best for them before their breast cancer surgery.

Lymphedema

Lymphedema is a potential side effect of breast cancer surgery or radiation in which the lymph system is damaged or blocked. If lymph fluid does not drain properly, it can build up in the fatty tissues under your skin and cause swelling. For breast cancer patients, it usually occurs in the arm and hand, but also can affect the breast, underarm, chest, trunk and back.

Lymphedema signs and symptoms 

  • Swelling of part or all of your hand, arm, chest, breast or underarm area
  • Feelings of heaviness or tightness in the hand, arm, chest, breast or underarm area
  • Decreased flexibility in nearby joints, such as the shoulder, hand or wrist
  • Aching, tingling or discomfort in the hand, arm, chest, breast or underarm area
  • Recurring infections
  • Hardening and thickening of the skin

Early detection and screening

At Centegra, non-invasive lymphedema index or L-DEX testing is used for the early detection of lymphedema. L-DEX measurements are made by passing a low-level electrical signal through your limbs to measure the amount of fluid in your tissues. The whole process takes just a few minutes. Before any surgery, L-DEX testing is done to get a base reading, and this is repeated at your follow-up visits with the breast surgeon for up to five years.

Lymphedema can occur months or years after cancer treatment. If you have signs or symptoms of lymphedema, tell your physician right away. The more time passes, the more likely it is that lymph fluid will build up in the tissue where it can cause lasting damage.

If your L-DEX measurements become abnormal at any point, you will be referred for a thorough assessment and treatment plan from a lymphedema specialist.

Lymphedema treatment 

At Centegra, lymphedema specialists — occupational and physical therapists with advanced training and certification — see patients to treat lymphedema. Complete decongestive therapy is the gold standard for treatment of advanced lymphedema.

Complete decongestive therapy starts with an aggressive treatment aimed at getting the extra fluid out of your body to reduce visible swelling and other lymphedema symptoms. Your lymphedema specialist may recommend manual lymphatic drainage, compression garments and exercise.

  • Manual lymphatic drainage uses light touch to move excess lymph and fluid out of the tissues and back into the lymphatic vessels. This is much gentler than traditional forms of massage.
  • Compression garments create working pressure when you use your arm, which will help move fluid out of the tissues and into the vessels of the lymphatic system. The compression garment helps prevent fluid from flowing back into the limb and softens the tissue under the skin.
  • Exercise, under the supervision of lymphedema specialist, can play a role in reducing lymphedema flare-ups. Your therapist will design a customized plan to meet your individual needs and current fitness level, taking care to start slowly, build strength slowly and not overstress the affected area.

Self-care for lymphedema 

To reduce the risk of lymphedema returning or worsening in the future, you can:

  • Protect your arm, hand, chest or other affected body area from inadvertent cuts and injury
  • Learn the signs and symptoms of infection
  • Set and stick to an exercise and weight control plan