Answers for Breast Cancer Concerns

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Mar 26, 2013

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Florida - Southwest

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Q: If I have had a partial mastectomy(lumpectomy) for breast cancer, do I need to have post-operative radiation therapy?
A: After a patient has had a breast-conserving surgery, there is a risk of the cancer recurring within the same breast. Even if your surgeon does a great job and the margins are clear, there is a chance that residual microscopic cancer cells can be left behind. Radiation therapy has the ability to destroy those microscopic cancer cells, which vastly decreases the risk that the breast cancer can return.
Q: What are my options for radiation therapy after I've already had a partial mastectomy for breast cancer?
A: Radiation options depend on the stage of the cancer, specifically the size of the tumor and the number of lymph nodes involved. Most patients require external beam radiotherapy to the breast, and lymphatic drainage regions may be treated if cancer is detected in the lymph nodes. Certain patients with smaller cancers may qualify for MammoSite APBI (accelerated partial breast irradiation). With APBI a balloon device within the lumpectomy cavity allows radiation to treat from the inside, the length of treatment is only one week, and the side effects are mild.
Q: Why do I need to have radiation after my surgery (lumpectomy) for breast cancer?
A: Although surgery removes the visible tumor, there may be microscopic cancer cells remaining in the breast. Radiation treatment is given in order to eradicate these cancer cells. Radiation has been proven to significantly reduce the likelihood of cancer recurrence. For early-stage breast cancer (stage I and II), the chances of a cancer returning after surgery alone may be as high as 3050%. With radiation, this chance is reduced to less than 10%.
Q: My yearly mammograms showed a suspicious spot in my left breast and my doctor has ordered a biopsy. What does that mean?
A: A biopsy means the doctors will go in and take a small piece of the spot and look at it under the microscope to determine whether it is cancer or not. Doctors don't want to miss a cancer, so even slightly suspicious spots are routinely biopsied. In fact, 90% of all biopsies are negative, meaning the spot is not cancer.
Q: If my biopsy shows cancer, what happens next?
A: Your doctors will stage your cancer, meaning they will determine how far advanced it is. If your cancer is caught early, which is usually the case, you will have your choice of keeping your breast or having a mastectomy.
Q: I was diagnosed with breast cancer very recently and was told that I am a candidate for chemo-therapy. How will my doctors know that the chemotherapy that they have selected for my breast cancer will work for me to treat my specific breast cancer?
A: People often see breast cancer as one disease and treated only one way. In fact, breast cancer is a heterogeneous disease with different cells of origin, subtypes driven by various signals that promote tumor growth, with varying risks of recurrence. It is common for different medical oncologists to select different treatment protocols due to the vast number of available therapies for breast cancer. Upon completion of chemotherapy treatment, we will continue to follow you very closely with blood work, a physical exam and imaging to make sure the disease does not return.

Editors Note: This article was submitted by Janet Sperry, MD and Shemin Saferali, MD.

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