City of Hope offers the latest advances in the surgical management of breast cancer provided by specialty trained breast cancer surgeons. Removing tumors surgically is a common treatment for breast cancer. The scope of surgery is determined by the size and extent of the abnormality.
At City of Hope, our nationally recognized oncologic surgeons specialize in less –invasive, breast-conserving techniques such as lumpectomy for early stage cancers, as well as other options for larger tumors that offer better outcomes for breast reconstruction.
For patients with small, early-stage breast cancer, breast-conserving surgery is the preferred treatment option. For patients with larger tumors, chemotherapy can sometimes be given before surgery to shrink the tumor, which can help make breast conservation an option. Patients who are not candidates for breast conservation or who elect to undergo a total mastectomy with removal of all breast tissue may still have reconstructive surgery, either immediately or at a later time.
Tissue-sparing techniques used during an initial surgery can be combined with transplantation of a patient’s own tissue during reconstructive procedures to create the most natural breast possible. Our surgeons also specialize in secondary reconstructive surgery when initial procedures prove unsatisfactory. A new method developed at City of Hope to recreate the nipple and areola is providing better cosmetic results with minimal scarring.
Medicines that slow or stop the growth of cancer cells are often included in a patient’s treatment plan. Our Breast Oncology Team provides both standard therapy and access to clinical trials of new, leading-edge breast cancer therapies. These cover the full spectrum of breast cancer, from premalignant conditions to advanced metastatic disease.
Standard chemotherapies are those considered by medical experts to be the best treatments available, as proven by previous studies. However, as a Comprehensive Cancer Center, City of Hope seeks to continually improve treatments for this disease. We constantly investigate promising new treatments, including novel chemotherapies, hormonal or anti-estrogen therapies, and immunotherapies.
Patients with small tumors or earlier-stage breast cancer may participate in clinical trials of adjuvant chemotherapy (medication given after surgery). Patients with locally advanced, large primary tumors may be considered for a neoadjuvant protocol (medication given before a primary surgical treatment). And patients with more advanced disease may be candidates for new strategies developed to slow the spread of cancer. These may include combinations of standard drugs, investigational and targeted therapies, or other options.
Radiation therapy is often used in treating breast cancer. It may be employed as a stand-alone treatment for early stage cancer, or in combination with surgery and other treatments in more advanced cases, to help reduce the chance of the cancer recurring. Radiation therapies available at City of Hope include advanced, partial breast irradiation techniques. These focus radiation only on the affected area, rather than the entire breast.
Radiation therapy is a standard part of treatment for patients who have a lumpectomy for small invasive breast cancers and non-invasive cancers. Some mastectomy patients may also receive radiation therapy.
IMRT targets tumors with pencil-thin “beamlets” of radiation. By sculpting the radiation to precisely match the tumor’s contours, a higher dose can be delivered to the cancer while avoiding unnecessary exposure of healthy tissues. Treatment with IMRT may also minimize certain side effects.
This is a form of brachytherapy, in which a radiation source is implanted into the affected area to treat it from within. The process begins with the insertion of a balloon catheter into the breast. Twice a day for five days, a tiny radioactive seed is guided into the balloon and allowed to irradiate the area where the tumor was removed, to kill any remaining cancer cells. The radiation is left in place for several minutes. After the course of treatment is completed, the balloon is removed.