Breast Cancer Diagnosis & Treatment

Screening tests and exams help detect breast cancer earlier when it’s easier to treat. There are several types of breast screening including mammograms, self-exams and clinical breast exams. Beginning at age 19, women should perform regular breast self-exams and have a clinical breast exam by a Mercy doctor or Mercy OB/GYN annually. Clinical breast exams help detect lumps, pain or other changes in the breast and are an important part of early detection.

Breast Cancer Screening Guidelines

The American College of Obstetricians and Gynecologists (ACOG) recommends the following screening guidelines for breast cancer:

• Annual mammograms are recommended for women between the ages of 40 - 74 and who have no family history of breast cancer.
• Women with a family history of breast cancer should start screening before age 40.
• Healthy women ages 75 and older should continue to get mammograms if they’re in good health and are expected to live 10 years or longer.

Imaging Methods

Imaging is used to diagnose as well as evaluate the stage and extent of breast cancer. Three imaging methods are used to find breast cancer:  mammography, ultrasonography and breast magnetic resonance imaging (MRI).

• Mammography - in addition to screening mammograms, Mercy provides 3D mammography, which provides more detailed breast images at several angles. It’s especially effective for women with dense breast tissue and other risk factors.
• Ultrasonography - also known as a breast ultrasound, this exam may be used along with mammography or MRI
• Breast MRI - a breast MRI is used to help determine the extent of breast cancer. Not every patient diagnosed with breast cancer needs a breast MRI.

A breast biopsy is performed when cancer is suspected during a mammogram, clinical breast exam or other imaging tests. Mercy offers several types of biopsy to detect breast cancer.

If you have a strong family history of breast cancer or you’ve been diagnosed yourself, your Mercy doctor may recommend genetic counseling or testing. Breast cancer genetic testing lets you know if you’ve inherited genes linked to breast cancer risk.

Local therapy treats a specific (local) area of breast cancer without affecting the rest of the body. Local treatment for breast cancer typically includes surgery, which is sometimes followed by radiation therapy to the breast and nearby lymph nodes.

Breast Cancer Surgery

The most common form of treatment for breast cancer is surgery. There are two main types of surgery to remove breast cancer breast-conserving surgery and mastectomy. Mercy also offers breast reconstruction procedures that can be performed at the same time as lumpectomy or mastectomy in some cases.

• Breast-conserving surgery (BCS) - BCS surgery, also referred to as lumpectomy, quadrantectomy, segmental mastectomy or partial mastectomy, involves removing breast cancer while leaving as much healthy breast tissue as possible.  This type of surgery is generally followed by radiotherapy and/or other therapies.
• Mastectomy - is the surgical removal of the breast, including the breast tissue and nearby tissue in some cases. There are several different types of mastectomies that depend on the amount of tissue that is removed and how the surgical approach.
• Lymph node surgery - is a procedure to remove lymph nodes to determine whether or not cancer has spread beyond the breast, such as to nodes under your arm or around your collarbone and neck. There are two main types of surgery to remove lymph nodes:  sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND).

Radiation Therapy

Radiation therapy uses high-energy rays to destroy cancer cells and is used in many different situations for women with breast cancer. There are two main types of radiation often used to treat breast cancer:  external beam radiation therapy (EBRT) and brachytherapy.

Systemic therapies are medicines that travel throughout the body to treat cancer and can be administered orally or directly via the bloodstream. Different types of drug treatment may be used depending on the type of breast cancer. Systemic treatments for breast cancer include chemotherapy, hormone therapy, targeted therapy and immunotherapy. 

Chemotherapy

Chemotherapy is used to treat all stages of breast cancer, including recurrent and metastatic breast cancer. Not all breast cancer patients will benefit from chemo, however, there are several cases when it may be recommended such as before surgery (neoadjuvant chemotherapy), after surgery (adjuvant chemotherapy) and for advanced breast cancer.

Hormone Therapy

Hormone therapy, also known as hormonal therapy, hormone treatment and endocrine therapy, slows or stops the growth of hormone-sensitive cancers. It does by hormone production or interfering with hormone receptors on cancer cells. It is more targeted than chemotherapy. For example, anti-estrogen therapy blocks the estrogen stimulation of cancer cells.

Targeted Cancer Therapies

Targeted cancer therapies are treatments that target and act on specific molecules (molecular targets) that help cancer grow and spread. Targeted therapies are very focused and work differently than chemotherapy treatments for breast cancer. An example of targeted therapies used is anti-HER2 therapies which target the HER2 protein on cancer cells.

Immunotherapy

Immunotherapy also called biologic therapy, is the use of medicine to help the immune system recognize and attack cancer cells. It can work in different ways, either by boosting immunity or changing how it functions. Immunotherapy can be used to treat some types of breast cancer but not all.