BREAST CANCER TREATMENT
What is the treatment?
It depends on a few things:
Histology – the type of breast cancer cell. This will be listed on your pathology report. Most breast cancers start in the ducts, but about 10-15% can start in the lobules where milk is made.
Stage – how big is the tumor and has it spread to your lymph nodes?
Your breast size and overall health. Can the tumor be surgically removed and leave you with sufficient breast tissue to maintain your breast? If you need chemotherapy, are your liver/kidneys/heart in good enough shape to tolerate it? If you are obese, smoke, or have diabetes, your treatment options may change due to a higher risk of side effects.
How is radiation delivered?
Hopefully, you are a candidate for breast-conservation treatment.
This means that the tumor can be safely removed and the lymph nodes under your arm are “sampled” to ensure that no microscopic tumor cells have spread there. Alternatively, you may require a mastectomy, or removal of the breast and more lymph nodes. Pending your surgery, your Radiation Oncologist will typically offer you external beam radiation, meaning that you will lie on a treatment table while a machine called a linear accelerator or “linac” for short, rotates around you and delivers the radiation.
The radiation treatment itself is painless. You will not feel the radiation entering or leaving your body.
Treatment is around 15 minutes long. You may be positioned on your back or on your belly using a specific mold that is fitted to your body. Insert photo from Civco of prone breast board) If the lymph nodes near your sternum, above your collarbone, or under the arm need to be treated, your radiation plan may involve additional fields or take a little longer to deliver on the machine. Alternatively, if you have a small tumor, with no lymph nodes involved, you may be a candidate for a special type of radiation called brachytherapy. Dr. Gullett is certified in brachytherapy and uses the SAVI device made by Cianna Medical.
Breast cancer requires a certain dose of radiation to effectively eradicate microscopic tumor cells. It would be too dangerous to deliver that high dose all at once to such a large area, hence your treatments are given over the course of 3-6 weeks. You will receive a fraction of the dose daily, Monday through Friday, and meet with your Radiation Oncologist weekly to review side effects and assess your progress.
Other Treatment Options
About Breast Cancer
Roughly 12% (or one in eight) women living in the US will develop breast cancer at some point in her lifetime, making it the second most common cancer among women, with skin cancer being first. It is also the second cause of cancer-related deaths in women, after lung cancer. Due to advanced treatment options and perhaps awareness for the need to screen for breast cancer, the death rate has declined in recent years, which is encouraging.
This disease usually occurs when tissue cells in the breast mutate and continue reproducing, and cluster together, forming a tumor. When these irregular cells move to other parts of the breast, or spread (metastasize), throughout the body via the bloodstream or lymphatic system, the tumor is cancerous (malignant).
This is why early detection is so important with breast cancer; the sooner it is diagnosed and the less it’s progressed may provide a better outcome regarding treatment.
A genetic mutation in the DNA of breast cancer cells causes the disease, but it is not yet understood how or why this happens. A variety of factors influence a woman’s risk of developing breast cancer, some of which are inherited, or result from lifestyle and environmental influences. Others develop randomly over time. Even though not all variables that influence a woman’s risk are controllable, some risks associated with breast cancer may be preventable.
Key risk factors to be aware of, and then discussed with your physician, include:
Gender & Age. Women are at a higher risk of developing breast cancer after the age of 40, with women in their 70s at the highest risk.
Ethnicity / Race. While white women have a slightly higher risk of developing breast cancer, black & Hispanic women are more likely to die from breast cancer.
Family history. If a woman has a close blood relative with breast cancer, the risk of developing the disease increases. More specifically, the risk almost doubles for a woman whose mother, sister or daughter has breast cancer.
Body weight. After menopause, women who are overweight have an increased risk of developing breast cancer.
Estrogen. This hormone may be scientifically linked to an increased risk of women developing breast cancer, specifically for those who begin menstruating before the age of 12, as well as begin menopause after age 55. This is due to longer exposure to estrogen in the female body, which stimulates cell growth in the breast.
Changes/conditions of the breast. Women who have a history of breast lumps or dense breasts, have previously had breast cancer, or have certain non-cancerous conditions of the breast are at higher risk of developing the disease than those who have none of these conditions.
Additional factors to be aware of, and discuss with your physician, include alcohol consumption, pregnancy history, as well as a breast cancer gene mutation.
Signs & Symptoms
Signs and symptoms associated with breast cancer may include:
- Persistent lumps or thickening in or near the breasts, through menstrual cycles
- Changes is the size, shape, and/or contour of the breast
- Any mass or lump, which may be as small as a pea (can also feel hardened like a marble)
- Redness, or changes in the appearance of the skin, on the breast or nipple
- Changes in the appearance or feel of the breast
- Discharge of fluid from the nipple (may be clear or blood-stained)
It is important to understand your specific breast cancer diagnosis in order to also understand why and how cancer treatments will benefit you.
Questions to ask your doctor may include:
- What is the type of cancer I have?
- What is the stage of breast cancer I have?
- For this stage of cancer, what is the US standard of care?
Life After Breast Cancer
Depending on the type of breast cancer and the treatment you received will also determine your specific follow-up visits. Dr. Gullett is very passionate about helping you achieve and maintain a breast cancer prevention lifestyle, and she will discuss ways to help reduce the chances of your breast cancer recurring.
In Their Words
"From the moment I met her I knew that she had my best interest at heart. She clearly explained that I had different treatment options...She was with me every step of the way. So compassionate, understanding and knowledgeable. God truly blessed my circumstances when Dr. Gullett became my Radiation Oncology doctor. She is top notch!"
- Becky G., Google Review
"My daughter has stage 4 gliablastoma and had it not been for the care she received from Dr. Gullett and her staff she would probably not be with us now. I would highly recommend her, she is a wonderful caring doctor who does what is best for her patients. If you ever had the need for a Radiation Oncology doctor she would be my choice."
- Jackie K., Google Review
"Dr. Gullett is compassionate, knowledgeable and friendly. She listens and then develops a plan with you, taking into consideration what will work best for you. She suggested the Live Strong program at the YMCA, which was a wonderful program. Dr. Gullett is willing to think of healthcare in an expanded way, and to encourage the patient to do the same."
- Janette S., Google Review
“The staff was great. I would not change anything.”
“Dr. Gullett was fantastic. I cannot dream of better care. Nursing staff was terrific. I have already recommended Dr. Gullett to friends.”
“I was very pleased with my time here. Everyone was so nice.”
“I'm glad I had to come from Cleveland...I love Dr. Gullett. Thank you all so much.”
“Very professional. Always felt comfortable...especially with Dr. Gullett.”