Breast Cancer

Breast cancer in its early stages usually has few or no symptoms. Some types of breast cancer have no symptoms until they are quite large, so regular breast self-examination and mammograms are recommended for all women, although frequency depends on individual variables. Men can also get breast cancer. Those with higher risk should be mindful to self-check regularly. When doing a self-check, it’s important to look for:

• Lumps, swelling, or thickening of tissue in the breast or nearby, such as in the underarm.
• Skin distortion, skin irritation, or changes in the feel of the skin on or around the breast, including the areola and nipple. This could include dimpled, puckered, red, swollen, or scaly skin.
• Changes in the shape or size of the breast
• Nipple discharge, erosion, inversion or extra tenderness

Breasts are made up of a number of different types of tissue. When cancer is diagnosed, the specific type of cancer is determined by what types of cells have begun behaving abnormally.

• Ductal Carcinomas: The most common type of breast cancer. These begin in the lining of ducts in and around breast tissue and can sometimes be felt as a lump inside the breast tissue.
• Lobular Carcinomas: These occur in the lobules, which are milk-producing glands. These tumors can also sometimes be palpated and felt as lumps inside the breast. Lobular carcinomas are another common type of breast cancer.
• Paget’s Disease: This is a more rare form of breast cancer, occurring in the glands in or under surface skin, causing scaly red patches on the skin. Because Paget's disease often originates from breast duct cancer, the eczema-like cancer usually appears around the nipple.
• Inflammatory Breast Cancer: This is another rare form of breast cancer. It is also more invasive. Instead of a palpable lump or tumor, this type of cancer causes breast skin to appear red, with a thick and pitted texture.
• Triple Negative Breast Cancer: Also called “invasive ductal carcinomas.” With this form of breast cancer, the actual surfaces of the cells have a different protein structure than the cells of other cancers, which affects its treatment. These tumors also tend to grow and spread more quickly. Triple negative breast cancer is more often found in younger women and African-American women.

Breast tissue is surrounded by a dense network of lymphatic ducts through which cancerous cells can spread to other areas of the body. If unhealthy cells reach the lymphatic system, it’s more likely they will be able to spread to other areas of the body. When cancer cells spread beyond their organ of origin, the cancer is said to have “metastasized.” It’s therefore possible to have breast cancer in other body organs because the cells originally migrated from breast tissue.

Your treatment program will be specific to you. Upon diagnosis, a plan is mapped out, taking into consideration your age, overall health and health history, the type of breast cancer, how much the cancer has advanced, predicted course of the disease, tolerance for available procedures and medications, as well as the your preferences and opinions. You will be assigned one or more oncologists, as well as a fellowship trained surgeon in cases of breast cancer surgery.

Surgery

• Overview: Surgery is a common treatment for breast cancer. It’s done to remove as much of the cancer as possible.
• Sentinel Node Resection: Cancer often first spreads to nearby lymph nodes. So if you have swollen or enlarged lymph nodes, you may need a sentinel lymph node biopsy to remove your lymph nodes to check for cancer cells. 
• Mastectomy: This method removes the whole breast and most of the overlying skin.
• Breast-Conserving Mastectomy (BCS): Only the part of the breast is removed. Breast-conserving surgery may be used as part of a treatment plan for breast cancer. It is sometimes called a lumpectomy or a partial mastectomy.
• Skin-Sparing Mastectomy: The breast tissue, nipple, and areola are removed, but most of the skin over the breast is saved.
• Nipple-Sparing Mastectomy: All of the breast tissue, including the ducts going all the way up to the nipple and areola, is removed, but the skin of the nipple and areola are preserved.
• Reconstructive Breast Surgery:  Breast reconstruction is surgery to create a new breast in place of a breast that has been removed (mastectomy). A breast mound is created that comes as close as possible to the shape and look of a natural breast.

Radiation Therapy

• Overview: Breast cancer may not require surgery. Radiation Therapy is a minimally invasive procedure that’s used to shrink and destroy cancer cells. Radiation is often used along with other breast cancer treatments, like surgery or chemotherapy.
• Whole Breast Radiotherapy: Radiotherapy is a treatment for cancer most often used along with other treatments. It uses high-energy X-rays usually aimed at the whole breast. 
• Partial Breast Radiotherapy: This radiation treatment is used in smaller parts of the breast, after a tumor removal, to minimize reoccurrence.
• Intensity-Modulated Radiation Therapy (IMRT): This type of radiation treatment is given inside the body in the area of the cancer. It gives a higher dose of radiation to a small area for a shorter time. The radiation source may be put directly into the area of the breast tumor or put in through a small tube placed near the tumor.
• Brachytherapy: Brachytherapy is a type of internal radiation that is given inside the body as close to the cancer as possible. Internal radiation involves giving a higher dose of radiation in a shorter time span than with external radiation.

Medical Oncology

• Overview: INTEGRIS medical oncology is a dedicated group of medical oncologists specializing in diagnosing and caring for cancer patients with a variety of medicine options. These treatments are administered orally or intravenously depending upon the treatment plan developed by your multidiscipline cancer care team.
• Chemotherapy: Chemotherapy’s main method of function is to interfere with cancerous cells’ ability to develop and multiply. A patient may be prescribed a combination of a few types of chemotherapy, and it may also be prescribed in tandem with additional treatments, like radiation or surgery.
• Targeted therapy: Targeted therapy uses medicines that target specific parts of certain types of cancer cells, interfering with their ability to grow and survive. The therapies are specific to each person's cancer.
• Immunotherapy: This is a way to use the body's immune system to help treat or prevent many health problems. It may be used to treat or manage cancer.

At INTEGRIS, we offer a wide variety of support programs and services along with the Troy and Dollie Smith Wellness Center to help patients with breast cancer and their loved ones manage the physical and emotional effects of a cancer diagnosis and treatment.

Support services for breast cancer include:

• Integrative medicine clinic
• Mind, body therapies including acupuncture, massage, and yoga
• Research and clinical trials
• Nutrition consultations
• Pastoral care, spiritual support and relaxation techniques
• Resource Room
• Clinical social work services
• Counseling
• Patient navigation and survivor care planning
• Multi-disciplinary clinic coordination
• Cancer screenings
• Patient and family support groups