Buying off the rack may be fine for clothes, but when it comes to treating breast cancer, a made-to-order approach can go a long way in improving your standard of care.
The first option for physicians is the right imaging tool needed to detect your cancer. Ultrasounds, mammograms and magnetic resonance imaging (MRI) are all used to find and examine abnormalities in the breast.
If a tumor is found, the next step is to meet with a team of medical providers. Whether at The Dyson Center for Cancer Care at Vassar Brothers Medical Center, Northern Dutchess Hospital or Putnam Hospital Center, breast cancer patients at Health Quest work with a medical oncologist, radiation oncologist and surgeon, among others. Together, providers and patients discuss treatment options as well as reconstructive surgery.
Taking the Stage
“Your treatment needs depend on multiple characteristics of your tumor,” says Dr. Angela Keleher, director of breast surgery and the Breast Center at Health Quest. “You need multidisciplinary care to focus on all aspects of the cancer and ensure each element of treatment is handled properly.”
Medical oncologists will help you decide if you need chemotherapy or medication used to treat cancer. These specialized physicians also work to order any blood work or scans that you need. Radiation oncologists discuss whether you need radiation for your tumor, and surgeons can help you decide on surgical treatment options as well as reconstructive surgery after a lumpectomy or mastectomy.
Needle in a Haystack
When a woman has a tumor that cannot be physically felt in the breast, surgeons usually locate the hard-to-find tumor with mammography, MRI or ultrasound, and mark the location with a wire that remains in the breast for several hours before surgery. The Dyson Center for Cancer Care at VMBC now offers seed localization, an alternative to the uncomfortable wire placement technique.
“With seed localization, we can place a tiny radioactive seed in the tumor up to five days prior to surgery,” says Keleher. “During surgery, we locate the seed with a probe so we know exactly where to place the incision. It’s much easier for the patient, and the seed is removed along with the tumor during surgery.”
Right on TARGIT
In 2000, Health Quest became one of only seven facilities in the United States to start trials on targeted intraoperative radiation therapy–A (TARGIT-A), a new technique for using radiation to treat breast cancer. Instead of an external radiation beam given over a broad area, TARGIT-A uses a targeted beam of radiation given during surgery in the location of the already-removed tumor.
“We know that if someone is to have a local recurrence of cancer, the reappearance is usually exactly where the first tumor was,” Keleher says. “The study showed that targeting radiation after a tumor is removed but during surgery was just as good as external-beam radiation of the entire breast.”
The results of the trial showed that for women who qualify, intraoperative radiation is an equally safe and effective option for treating cancer. Health Quest is now able to offer this specialized service in a clinical setting through the TARGIT-A trial. Women who are a good fit for TARGIT-A must be age 45 or older and otherwise in good health; your surgeon and radiation oncologist will discuss if you qualify for this treatment and help you further understand the risks and benefits.
Silicone or saline implants can, and do, meet the needs of many women who want breast reconstruction after a mastectomy. However, Health Quest also offers deep inferior epigastric perforator artery (DIEP) flap reconstruction, which uses tissue from the stomach to reconstruct the breast. Widely considered the most natural form of reconstructive surgery, no muscle is used in the procedure.
“We’re the only facility in the region to offer DIEP flap,” Keleher says. “We work with three physicians from New York City who are trained in plastic surgery and have additional fellowships in microvessel operations, and they only focus on these types of surgeries. After the operation, you stay in a private room with a dedicated nursing staff assigned to your care the whole time.”
To learn more about breast cancer care at Health Quest, visit www.health-quest.org/cancer.