Dr. Lerna Ozcan, a fellowship trained breast surgeon at Lowell General Hospital and Medical Director of the hospital’s Breast Care Center of Excellence, answers common questions about breast cancer, your risk for the disease, and discusses the latest surgical advances in treatment.
Breast Cancer Treatment Frequently Asked Questions
Breast cancer occurs as a result of abnormal changes in the genes responsible for regulating the growth of cells in the breast tissue. This results in an uncontrolled growth of these cells, which can form a tumor. Tumors can be benign and not pose a danger, or malignant, where they can invade nearby tissues or spread to other areas of the body. Breast cancer is a malignant tumor that arises most commonly in the milk ducts which drain milk from the lobules to the nipple. Milk lobules are milk producing glands, and tumors arising in these tissues are the second-most common form of breast cancer. Other forms of breast cancer also exist and make up the minority of cases.
Breast cancer treatment consists of local and systemic therapies. Local treatments include surgery and radiation. Systemic therapies travel through the blood stream and include hormonal therapy, chemotherapy drugs and immunotherapy, depending on the type of breast cancer. Surgery includes removal of the malignant tumor in the breast as well as lymph node surgery to evaluate for possible spread to the lymph nodes.
No, the overall goal of surgery is to remove the cancer as well as some surrounding normal tissue. There are two surgical treatment options: breast conserving surgery (also called a lumpectomy) or a mastectomy in which the entire breast or both breasts are removed with or without lymph node surgery.
Long-term research shows that lumpectomy followed by radiation is an appropriate option for the majority of patients with early-stage breast cancer and does not have worse outcomes. Surgeons are therefore able to offer lumpectomy safely in patients who are candidates for breast conservation. It’s important to know your options so you can talk about them with your doctor.
It has certainly been more in the spotlight due to celebrities coming forward and is strongly considered and recommended for women with a high lifetime risk of breast cancer. These are patients with genetic mutations, such as BRCA gene mutations as seen in Angeline Jolie. It is generally not recommended for women of average risk of breast cancer.
For patients having a mastectomy, a plastic surgeon can reconstruct the breast at the same time, or you may choose to do it at a later time. Advanced surgical options include nipple-sparing mastectomy in appropriately selected patients or nipple reconstruction with very authentic looking nipple tattoos. For lumpectomy patients, rearrangement of your own breast tissue at the time of surgery or fat-grafting at a later date can result in great cosmetic outcomes.