What is Breast Cancer?
In normal breast tissue, cells are continually dividing and dying as part of the natural process of tissue renewal. When the DNA of some cells is damaged, those cells may begin to divide uncontrollably, creating a lump in the breast.
Some of these lumps, or tumors, are benign (non-cancerous) and do not damage surrounding tissue. Benign lumps can be cysts or formed from fibrous tissue, which cause no threat to the breast and typically require no intervention beyond the diagnostic biopsy.
Tumors that grow uncontrollably and invade the healthy tissue around them are malignant (cancerous). A malignant tumor is what is known as breast cancer. The two most common forms of breast cancer are lobular and ductal. These cancers usually begin in the milk lobules, tiny sacks that produce milk, or in the ducts that transport milk to the nipple. If not removed, malignant tumors can spread through the breast, into the lymph nodes under the arm and into other organs.
Lymph nodes are part of the lymphatic system, which runs throughout the body and normally helps the body fight disease. When cancer invades these nodes, however, the lymphatic system can spread the cancer cells to other parts of the body. Cancers can also spread directly through the blood vessels. The process of spreading cancer to other organs is called metastasis.
Breast Cancer Diagnosis
In the United States, breast cancer is the most common cancer in women and is the second leading cause of cancer related deaths. Nearly 40,000 women will die of breast cancer each year. At IU Health Arnett Cancer Centers, we focus on prevention and early detection of breast cancer.
There are a variety of means for detecting breast cancer. Our advanced detection technologies include:
- Digital mammography: A more accurate form of mammography.
- Breast MRI: A proven form of three-dimensional imaging that is the most sensitive for detecting breast cancer.
- Breast ultrasound: Imaging that allows real-time viewing of tissue within the breast.
Breast Cancer Treatment Options
We are focused on personalized comprehensive cancer care. IU Health Arnett Cancer Centers comprise a highly specialized, multidisciplinary team of doctors including:
- Breast surgeons
- Medical oncologists
- Radiation oncologists
- Plastic surgeons
Our team of experts evaluates the unique genetic features of each breast cancer for the most effective personalized treatment plan.
Our breast surgeons are experts in preserving the natural appearance of the breast utilizing advanced techniques such as lumpectomies through very small incisions. If a mastectomy is necessary, the nipple can be spared and a new breast reconstructed. Because we specialize in breast cancer, we have the expertise to treat cancers that are rare and aggressive. Our surgical expertise offers treatment for tumors sometimes considered too difficult to treat.
There are three general levels of cancer treatment:
- High risk. At this stage, you don’t have breast cancer but for various reasons are at high risk to develop it. You will be watched closely, with clinical breast exams, annual mammograms and possibly breast MRI to detect breast cancer at its earliest development. Genetic testing to check for mutations that cause breast cancer may be needed.
- Early stage. At this stage, the cancer is small and treatment is highly successful. There is no hurry, so you and your doctor have time to consider all treatment options.
- Late stage. With late stage cancer or recurring cancer, treatment begins with an honest conversation about realistic options. Even at this stage, our intense, multidisciplinary approach to treatment yields many good outcomes and an improved quality of life. Clinical trials, not available elsewhere, that offer new therapies for treatment of advanced breast cancer may be an option.
Treatment for breast cancer is personalized for the most effective therapy. Treatment techniques used at IU Health Arnett Cancer Centers focus on surgical and nonsurgical procedures that maximize the aesthetic and natural appearance of the breast. These techniques include:
- Lumpectomy: Lumpectomy removes the cancer through a very small incision and conserves the appearance of the breast. If a large amount of breast tissue requires removal, the breast can be reshaped through plastic surgery techniques to retain a natural appearance.
- Mastectomy: Mastectomy removes the breast, with or without preservation of the skin and nipple. Advanced forms of mastectomy allow recreation of a natural appearance with reconstruction surgery.
- Sentinel node biopsy: This form of biopsy removes only the lymph nodes under the arm that are most likely to harbor cancer. This focused surgery provides information to personalize cancer treatment and reduces the complications of nerve damage or arm swelling (lymphedema).
- Reconstruction surgery: Reconstruction reshapes the breast following mastectomy and can be immediate or delayed. Advanced reconstruction techniques include one-step implant placement and tissue flaps from your own body. A new breast can be recreated at the time of mastectomy or delayed after a mastectomy. There are many options for reconstruction. An implant can be placed as a one-step procedure at the time of mastectomy or as a staged procedure after a temporary expander. Tissue from the back, gluteus or abdomen can also be used to recreate a breast. Based on your body shape, current medical condition, type of breast cancer surgery and your personal preference, our plastic reconstructive surgeons can discuss which reconstruction option would be best for you. The opposite breast can also be contoured for a balanced appearance.
- Chemotherapy: Chemotherapy destroys cancer cells with drugs.
- Radiotherapy: Radiation is included as part of breast cancer treatment to reduce the risk of tumor recurrence within the breast. Several forms of radiation are available and consultation with a radiation oncologist can help determine the best option for you.
- External beam breast radiation treats the entire breast by a once daily treatment of about 15 minutes over a course of five to six weeks. This can begin within three weeks of surgery or completion of chemotherapy.
- Accelerated partial breast irradiation is a focused form of radiation that targets the lumpectomy site and reduces damage to the surrounding normal breast tissue. A special catheter is placed about one to three weeks after surgery in the lumpectomy site. This highly focused radiation can shorten the course of treatment to five days.
- Hypofractionated radiotherapy is a newer type of treatment that delivers a lower total dose of radiation with fewer, larger fractions of radiation over a shorter time of three weeks.
- Hyperfractionated radiation therapy involves lower doses of radiation given more frequently to reduce the side effects of treatment.
- Hormonal therapy. Hormonal therapy uses drugs to block the body’s hormone effect on tumor growth.
Breast Cancer Specialists
Breast Cancer Surgeons
Roger G. Bangs, MD, FACS
Richard C. Berg, MD, FACS
Bamidele A. Adesunloye, MD, MS, FACP
Thomas I. Jones, MD, FACP
Vijaya Kakani, MD
Ajita Narayan, MD, PhD
Song-Chu “Arthur” Ko, MD, PhD
Matthew Orton, MD
Ayaz Shaikh, MD, FRCSC, FACS
Phyllis Martin-Simmerman, MD
Indiana University Health Arnett cancer experts provide you with the latest therapies, address your unique needs and questions and guide you through the healthcare system to ensure your treatment and patient experience are as smooth as possible.
Our experts also work closely with Horizon BioAdvance to give you access to additional clinical trials and leading edge treatments close to home. Horizon BioAdvance, an independent biomedical research company based in Lafayette, offers clinical and research support to patients and physicians.
As part of IU Health Cancer Centers, IU Health Arnett strives to bring quality care to patients through highly advanced technologies, the latest clinical research and the clinical expertise of the largest team of cancer specialists and innovators in the region. Connected through Indiana University Health Melvin and Bren Simon Cancer Center and the IU School of Medicine, IU Health Cancer Centers provide you with innovative treatment options and specialized care to meet your needs.