Breast Cancer Treatment Options

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Compassionate Care using the Latest Technology

Thanks to research and medical advances, men and women who face breast cancer now have many treatment options. They include surgery, chemotherapy, radiation therapy, hormone therapy, immunotherapy or, more often, a combination of therapies. The Swedish Cancer Institute offers all of these and tailors treatment to each individual for the most effective outcome.

Our treatment planning may include a "multidisciplinary tumor board." These groups of specialists meet regularly to discuss patient cases and personalized treatment options. This collaboration assures that your care will be based on the latest research and technology, and the best expertise.

At SCI, we will provide you with the best care team for your individual circumstances. Our breast cancer specialists are dedicated to providing compassionate care that is as seamless as possible. Your care team will coordinate appointments and procedures, and make sure you and your family get all of the support you need. SCI has a full array of support services, including our highly popular naturopathic care, counseling and help with finances.

If you are interested in breast reconstruction, SCI has experienced plastic surgeons specializing in both implant reconstruction and reconstruction using your own tissue. You can plan for breast reconstruction early in treatment, wait until later or choose not to have reconstructive surgery, if that is best for you. We even have expertise in achieving the best possible cosmetic outcomes for women who choose not to have reconstruction (often known as “going flat”). Our team of specialists is here to help you make the decision that feels right for you.

Surgery

Most men and women who have been diagnosed with breast cancer will undergo some type of surgery as part of their treatment. At the Swedish Cancer Institute, our breast surgeons have years of experience helping patients understand the surgical options, as well as the advantages and disadvantages of each approach.

Most patients will need surgery first, but some will benefit from chemotherapy or other treatments prior to surgery. Specialists on your care team will collaborate on the timing of various treatments so you can focus on taking care of yourself.

Depending on the location, tumor size, aggressiveness of the cancer and a patient’s personal preference, there are several surgical options:

Lumpectomy/partial mastectomy

The cancerous lump and a rim of normal tissue around it are removed. Some of the underarm lymph nodes also may be removed to determine if cancer cells are present. A lumpectomy is usually followed by radiation therapy.

Oncoplastic techniques

At the forefront of modern breast surgical care is "restorative" care.  For patients preserving their breasts, a variety of oncoplastic techniques are available at Swedish to yield the most natural appearing post-treatment breast(s) that can be achieved.  Our team of breast surgeons and plastic and reconstructive surgeons partner closely to hide scars, and to recontour the breast in a way that allows us to optimize cosmetic outcomes for our patients. 

Simple or total mastectomy

This is the removal of the entire breast, including the nipple and most of the skin of the breast. Lymph nodes from the underarm may be removed for evaluation. Radiation therapy usually will not be necessary after a total mastectomy.

Modified radical mastectomy (mastectomy plus armpit lymph node removal)

The entire breast is removed, as well as underarm lymph nodes, which will be evaluated for breast cancer cells.

Radical mastectomy

The entire breast is removed, along with the chest-wall muscles under the breast and the armpit lymph nodes. This surgery is rarely performed today.

Skin-sparing mastectomy

Most of the skin is left intact on the chest wall. The breast tissue is removed through a small incision with the goal of leaving less visible scars after reconstruction.  

Nipple-sparing mastectomy 

The entire skin envelope of the breast including the nipple-areola complex is left intact. The breast tissue is removed through a small incision with the goal of leaving less visible scars after reconstruction.  

Your surgeon will help you decide whether saving the breast skin and nipple areolar complex is right in your particular situation.

Sentinel node biopsy

The sentinel lymph nodes are the first lymph nodes that cancer cells are likely to spread to from the primary cancer. With a sentinel node biopsy, the surgeon identifies and removes these lymph nodes from the armpit. A pathologist examines the nodes under a microscope to determine if cancer cells are present. This procedure is typically done at the time of breast cancer surgery but the full pathology evaluation usually takes several days. Depending on the circumstances, if there are cancer cells in the sentinel nodes, your surgeon may recommend removing additional lymph nodes from the armpit.

Axillary reverse mapping

This is a newer technique that we are studying and utilizing at SCI (as part of a national cooperative group trial) designed to minimize risk of lymphedema caused by removal of axillary lymph nodes. We are excited to offer this highly specialized technique that we believe will significantly improve quality of life for many women after cancer treatment.

Radiation Therapy

At the Swedish Cancer Institute, radiation oncologists are part of the specialized team delivering personalized treatment for each breast cancer patient. Not every patient will need radiation therapy, but our experts are involved in treatment discussions to share their clinical expertise. Most patients receive post-lumpectomy radiation over four weeks.

Our radiation oncologists are extremely experienced in breast cancer treatment and have been thought leaders in the field by advancing technologies such as Active Breathing Coordinator and accelerated partial breast irradiation.

Radiation therapy involves using targeted, penetrating rays of energy, or radiation, to destroy cancer cells. Radiation therapy typically is used after surgery to kill any remaining cancer cells in the breast and possibly the armpit area.

The number of sessions needed depends on the type of treatment selected. Radiation therapy is available at multiple locations for the convenience of our patients.

We offer these advanced radiation therapies:

External beam radiation therapy

This is the most common radiation treatment. It is delivered by a machine called a linear accelerator, or linac.  It delivers short, targeted bursts of X-rays to the cancer. The Swedish Cancer Institute uses the latest technology to precisely target breast cancer and minimize radiation to normal tissue.

For patients with cancer in the left breast, we can minimize the radiation to the heart by incorporating the Active Breathing Coordinator, or ABC, with external beam radiation.

Each treatment session usually is about 30 minutes. Most patients will undergo treatment five days a week for about four weeks. Common side effects include fatigue and skin tenderness.

Accelerated partial breast irradiation (APBI)

Accelerated partial breast irradiation (APBI), commonly known as brachytherapy, is a method of delivering radiation directly to the surgical cavity to kill any remaining cancer cells and treat the tissue immediately adjacent to where the cancer has been removed. 

Accelerated partial breast irradiation therapy using external beam techniques also may be suitable for some patients.

Chemotherapy, Hormone Therapy and Immunotherapy

At the Swedish Cancer Institute, our highly-skilled breast oncologists continue to gain recognition as top doctors in the Seattle area. They are experts in the most advanced therapies for breast cancer, including chemotherapy, hormone therapy and immunotherapy.

Our experts are also leaders in research to develop new treatments. The Swedish Cancer Institute is one of the leading clinical trial sites in the western United States, offering access to novel breast cancer trials, some of which are only available here in the Pacific Northwest. Learn more about our research

Chemotherapy

Chemotherapy is the use of anti-cancer medications to kill or suppress cancer cells in the breast or throughout the body. At the Swedish Cancer Institute, our medical oncologists participate in regular meetings of a wide variety of cancer specialists who together determine the best course of treatment for each patient.

This may include chemotherapy. Some patients receive chemotherapy before breast surgery with the goal of shrinking the tumor and killing cancer cells. This is called neoadjuvant chemotherapy. Other patients may receive chemotherapy after surgery.

Our specialty pharmacists work with patients to ensure the proper use of chemotherapy medication, which is taken by pill or injected into the bloodstream.  Chemotherapy is a systemic treatment, meaning it reaches all parts of the body. Side effects may include nausea and hair loss, but our supportive treatments help minimize these conditions.

Chemotherapy may last for three to six months, or longer in some circumstances. Learn more about chemotherapy

We have multiple convenient locations for patients to receive treatment in Seattle, Ballard, Edmonds, Bellevue and Issaquah. Call 1-855-XCANCER for more information.

Hormone therapy

Some breast cancers are sensitive to the hormones estrogen and/or progesterone. For these cancers, anti-estrogen hormone therapy can slow the growth of breast-cancer cells. The medicine for this treatment is taken in pill form. When prescribed as a supplemental therapy for early-stage breast cancer, treatment generally lasts at least five years. Learn more about hormone therapy

Immunotherapy

This treatment is called immunotherapy, biological therapy or targeted therapy. Immunotherapy enhances the body's immune-system response to breast cancer. This treatment is administered intravenously. Learn more about immunotherapy