Breast cancer

While some women experience signs and symptoms in their breast, many women don’t have any symptoms at all. That’s why compliance with routine annual exams and regular mammograms is highly recommended. Should your mammogram determine abnormal results, your doctor may recommend an ultrasound, breast magnetic resonance imaging (MRI), lab work and/or a biopsy. In some instances, your doctor may also perform genetic testing to see if you have any genes that predispose you to breast cancer.

If you have an abnormal mammogram or a concern about a possible breast cancer, find your nearest GenesisCare center to find out what diagnostic tests and scans are available in your local area. Whatever your outcome, our expert team will support you throughout your treatment journey.

If you are diagnosed with breast cancer, talk to your team about your treatment options. Treatment will vary depending upon the type of breast cancer, location and if the cancer has spread.

In general, breast cancer treatment typically includes a combination of therapies, such as breast surgery, medical therapies (chemotherapy, hormone-blocking therapy, and/or immunotherapy) and radiation therapy. The first step in a breast cancer journey is often meeting with a surgeon who specializes in removal of breast cancer. This surgeon may recommend surgery as the first for treatment but, depending on the size and biologic makeup of your cancer, may also recommend chemotherapy with or without immunotherapy first.

Our expert team of breast surgeons are specially trained in surgical removal of benign (non-cancerous) and malignant (cancerous) tumors of the breast. There are different procedures used for breast cancer surgery and your surgeon will recommend the most appropriate one for you depending on what type of breast cancer you have and how advanced it is.

Lumpectomy

Also called “breast-conserving surgery,” is when only part of the breast surrounding the tumor or area of concern is removed. Typically, a lumpectomy is more appropriate if you have an early-stage breast cancer and the cancer has not spread to other parts of the body. Some of your lymph nodes under your arm may also be removed for further testing.

Oncoplastic breast surgery

Oncoplastic breast surgery combines the traditional methods of breast cancer surgery listed above while utilizing some specialized techniques to improve the cosmetic outcome of the surgery. This helps maintain a more natural look and feel of the breast, as well as reduce the amount of scarring. Some of the techniques our skilled oncoplastic breast surgeons perform include:

• Hidden scar technique, which places the incision from a lumpectomy in a location that is not visible and is not seen after fully healing.
• Local advancement flap, which takes tissue from the breast after a lumpectomy to reconstruct the original appearance of the breast. This is also called an “oncoplastic closure”.
• Bilateral breast reduction, which reduces the size of the healthy breast following a lumpectomy to the diseased breast so both sides match better.

Mastectomy

Mastectomy removes the tumor along with the entire breast. It is more commonly recommended if the tumor is larger (over 5 to 7 centimeters) or if you have multiple tumors in your breast. When both breasts are removed, it is called a bilateral or double mastectomy.

There are several types of mastectomies, which include:

• Nipple-sparing mastectomy, where only the breast tissue is removed but the nipple and areola are preserved.
• Skin-sparing mastectomy, where the breast tissue, nipple and areola are removed but most of the skin on the breast is preserved.
• Total mastectomy, which removes the entire breast, including the nipple, areola and most of the surrounding skin.
• Modified radical mastectomy, which removes the entire breast, including the nipple, areola and surrounding skin, as well as the lining over the chest muscles and lymph nodes underneath the arm (axillary lymph nodes).

Following a mastectomy, you may consider reconstructive surgery to re-build the breast.

Find your nearest GenesisCare center to find out what surgical options are available in your local area.

Systemic therapies (treatment that target the entire body) may be recommended before or after surgery to help with cure rates or reduce the changes of cancer returning. At GenesisCare, we offer a wide range of systemic drug therapies and the latest anti-cancer medications for the treatment of breast cancers. In some instances, your medical oncologist may order genetic or genomic testing to understand the makeup of your individual cancer and will discuss which treatment options are most appropriate for you.

Chemotherapy

Chemotherapy refers to drugs that destroy cancer cells. It may be used as a breast cancer treatment before or after surgery, and usually takes between three and six months to complete. Chemotherapy for breast cancer is usually given through the blood stream (intravenously / IV) at first, but in some cases may be given in pill form after surgery has been completed. The type of chemotherapy you’ll receive will also depend on your breast cancer stage, grade and the genetic or biologic make-up of your cancer.

Hormone or Endocrine therapy

Many breast tumors need a hormone, either estrogen or progesterone to continue to grow. Hormone or endocrine therapy for breast cancer works by blocking the appropriate hormones from binding to the cancer cells, or preventing your body from producing those hormones, in order to slow down the cancer growth. Hormonal therapy is usually provided as a pill but can also be an injection. It is also commonly used at the end of treatment to help reduce the risk of the cancer returning.

Immunotherapy

A relatively new type of treatment that is being used to treat some types of breast cancer is called immunotherapy. This category of medicines helps our own immune system recognize cancer cells as abnormal and in need of being cleared by the body. Depending on the stage of cancer, immunotherapy may be used together with other medicines (such as chemotherapy) or on its own.

Targeted therapy

Targeted therapy, also known as precision medicine, is a newer type of treatment that ‘targets’ cancer cells without affecting normal healthy cells. Targeted therapy seeks, attacks and blocks cellular activity that the cancer depends on to survive and grow. Targeted therapies help determine what DNA mutation is driving a cancer, based off of your tumor’s individual genomic and genetic make-up.

Clinical trials

Clinical trials examine how people respond to a new treatment and help identify possible side effects, while others compare existing treatments, test new ways to use or combine existing treatment, or observe how people respond to other factors that might affect their health. If you participate in a clinical trial, you may be one of the first to benefit from some of the latest treatment offerings, as well as open the door to new treatment pathways for future patients. Talk to your doctor to see what clinical trials are available to you.

Find your nearest GenesisCare center to find a medical oncologist who specializes in breast cancer treatment in your local area.

In addition to surgery and systemic therapies, radiation therapy is often administered after the breast cancer has been removed. Over the past several years, radiation therapy has advanced, allowing for a more targeted and precise approach that spares surrounding healthy tissue.

At GenesisCare, we use the latest-generation machines to deliver highly targeted radiation beams. The accuracy of these treatments, together with the expertise of our teams, helps our patients achieve the best possible outcomes. The type of breast cancer treatment your radiation oncologist recommends will depend on your diagnosis, if the cancer has spread to other parts of your body, your general health and personal preferences.

External beam radiation therapy (EBRT)

EBRT is delivered from outside of the body and aims an accurate x-ray beam from multiple angles directly toward the treatment site within the breast, chest wall or under the arm. It is typically performed on an outpatient basis, so there’s no hospital stay required, usually once a day over the course of a few weeks.

Accelerated partial breast irradiation (APBI)

APBI is a radiation therapy for some early-stage breast cancer patients that treats a smaller portion of your breast tissue than other radiation techniques. There are two different types of APBI:

• Breast brachytherapy, which is radiation given from the inside of the body. A catheter is inserted during surgery and afterwards, tiny radioactive seeds are guided into the catheters during treatment. Typically, breast brachytherapy is provided two times a day for up to five days. After treatment, the catheter is removed.
• EBRT, which is delivered from outside of the body. Unlike whole-breast EBRT, EBRT for APBI is delivered to only a portion of the breast and is usually given over a one to two-week period.

Intraoperative radiation therapy (IORT)

IORT is delivered at the time of surgery, allowing for a higher dose of radiation to directly target a tumor. It is typically used if you have an early-stage breast cancer and are undergoing a lumpectomy procedure. IORT is extremely precise and is given in one single dose instead of over the course of several weeks. Sometimes IORT is used on its own, and sometimes it is used before whole breast external beam radiation therapy.

3D-conformal radiation therapy (3D-CRT)

This form of radiation typically uses at least two beams that are shaped or modified by your radiation team to deliver a therapy that conforms to the desired treatment. The shaping of the beam is generally done by the medical dosimetrist or doctor to give you a personalized radiation plan.

Intensity-modulated radiation therapy (IMRT)

IMRT is an advanced external beam radiation therapy technique where the beams of radiation are precisely shaped to exactly match your tumor, which limits radiation exposure to adjacent healthy tissue.

Additional radiation services

At GenesisCare, we offer an advanced AlignRT® technology, which allows us to provide:

Tattoo-free radiation therapy through Surface - guided radiotherapy (SGRT)- Surface-guided radiation therapy uses sophisticated 3D camera technology to help your radiation therapy care team accurately position you for treatment each day. This technology monitors breathing position and any unintended movements you might make during the treatment which allows your treatment team to make sure your daily treatments are as accurate as possible. In many instances, we are able to do this without the use of tattoos for positioning. That means you aren’t left with a permanent visual reminder about your treatments in the future. The technology also monitors any unintended movements you might make during the treatment, and will pause the radiation until you are back in the correct position to reduce the amount of radiation reaching healthy tissues and organs.

Heart protection with deep inspiration breath hold (DIBH) - GenesisCare also uses surface-guided technology for deep inspiration breath hold, which is a breathing technique used during left-sided breast cancer treatment to help minimize exposing your heart to radiation during treatment. With AlignRT®, we monitor the position of your chest during treatment. Our team works to educate you on how to control your breathing pattern during treatment, so radiation is delivered only when you are in a deep inspiration, or when your heart is further away from the radiation beam.

If you struggle to be on your back or hold your breath, prone positioning radiation therapy may be another option to receive radiation therapy and protect the heart. In this instance, you may lie on your stomach to receive radiation. This position uses gravity to move the breast tissue away from the chest wall to safely deliver radiation therapy while minimizing dose to the heart.

Additional offerings

If you have been diagnosed with ductal carcinoma in situ (DCIS), an early-stage breast cancer where cancerous cells are found within the milk ducts, you may benefit for a risk assessment test to determine if radiation is appropriate for you after surgery. GenesisCare has partnered with PreludeDx to offer DCISionRT®, a simple lab test to determine the risk of the cancer spreading after surgery, to help women make an informed decision about their treatment plans.

There are several different radiation options and treatment durations available, and your radiation oncologist will work with you to personalize a plan that best meets your needs. Find your nearest GenesisCare center to find out what radiation options are available in your local area.

GenesisCare offers access the latest technologies, advanced treatments and personalized care that’s tailored to the you, without delay.

Cancer treatment and care is constantly evolving, and we offer the world’s latest evidence-based treatments that have been shown to benefit patients. By working together closely, our multidisciplinary teams of breast surgeons, medical oncologists, radiation oncologists and other healthcare specialists provide care that’s focused on you, not just your cancer, so you receive the best possible outcomes.

Our goal is to help you navigate through your cancer journey in the most positive way possible. That’s why as well as offering advanced and innovative treatment options, we also provide you with support and resources for your cancer journey—including advice about nutrition and exercise, expert help for managing side effects and information on local support groups.

Our centers are conveniently located throughout the United States, and each location has a dedicated Office Financial Counselor on hand to help you with your paperwork and answer your questions. We accept most insurance plans as well as Medicare Part B, which covers physician services, including radiation therapy.

References

1. American Cancer Society. Key Statistics for Breast Cancer. Available at: https://www.cancer.org/cancer/breast-cancer/about/how-common-is-breast-cancer.html [Accessed 7/26/2022]
2. Breast Cancer Research Organization. What to Know About Male Breast Cancer. February 11, 2022. Available at: https://www.bcrf.org/blog/male-breast-cancer-statistics-research/ [Accessed 7/26/2022]