Breast Cancer Treatments at Scripps Health in San Diego
Breast cancer treatments are as unique as patients. Treatments vary based on the location, size and stage of a breast cancer, but one thing is certain: specially trained nurse navigators will be there with you at Scripps Health. A multidisciplinary team of physicians, nurses and health professionals collaborate to develop a care plan to treat breast cancer. Treatments may include:
Scripps offers genetics counseling services for patients and families. Although most cancers are not clearly linked through genes passed from one generation to the next, a small portion of cancers are inherited, according to the American Cancer Society.
Breast-conserving surgery (BCS) involves partial removal of the breast, depending on size and location of tumor. BCS surgery is typically followed with radiation treatments. A BCS procedure is technically known as a partial mastectomy but most often BCS surgeries are described three ways:
- Lumpectomy is removal of a lump.
- Quadrandrantectomy is removal of a quarter portion of the breast.
- Segmental mastectomy is removal of cancer and some adjacent tissue.
The entire breast is removed in a mastectomy. All breast tissue — and sometimes adjacent tissues — are removed in this surgery. Types of mastectomies include:
- Simple mastectomy is when only the breast is removed and not lymph nodes under the arm. This surgery is also known as a total mastectomy.
- Modified radical mastectomy is when a simple mastectomy is combined with removal of most of the lymph nodes under the arms.
- Radical mastectomy involves the removal of breast and most lymph nodes under the arms, as well as the muscle wall beneath the breast. It is only required when cancer has spread to the muscle wall.
Lymph node surgery
This surgery may be required to help physicians stage the cancer. Results of this surgery affect treatment and outcomes. If lymph nodes under the arms (axillary) contain cancer cells, the chances of their spread into other parts of the body though the bloodstream are higher. There are two primary ways lymph nodes are checked:
- Axillary lymph node dissection involves the removal of 10 to 40 lymph nodes most commonly during breast-conserving surgery or a mastectomy. The surgery can also be performed separately.
- Sentinel lymph node biopsy is the injection of a radioactive substance and/or a blue dye into the breast to identify any spread of cancer. Cancerous sentinel lymph nodes are removed. If they are cancer-free, additional lymph node surgery usually is not required.
- Reconstructive or breast implant surgery is performed by a plastic surgeon to help restore the shape and size of the breast after a mastectomy or certain types of breast-conserving surgeries. Patients seeking reconstructive surgery are encouraged to speak with a plastic surgeon before having breast cancer surgery.
Breast cancer radiation therapy
Our renowned experts offer state-of-the-art radiation technology to treat all types of cancer, including cancer of the breast. Radiation therapy for breast cancer can be organized in two main categories: external beam radiotherapy and brachytherapy.
- 3-D conformal radiotherapy allows physicians to visualize a patient’s anatomy in 3-D though use of advanced computer software to match the radiation dose to the shape of the tumor while minimizing exposure of surrounding healthy tissues and organs
- Proton therapy uses a controlled beam of protons to target and destroy tumors with unprecedented accuracy. Unlike other forms of radiation, the precise delivery of proton energy limits damage to surrounding healthy tissues.
- Intraoperative electron beam radiation therapy (IOERT) is performed during breast surgery (versus multiple radiation sessions over a 4 to 6 weeks post-surgery) and promises greater convenience and shorter treatment times for patients undergoing a lumpectomy. Scripps Health will become the first health-care provider in San Diego to offer this type of radiation therapy in 2014 at Scripps Memorial Hospital La Jolla.
- High-dose rate (HDR) brachytherapy is a method where radiation is administered internally by placing radioactive sources directly in the body through catheters or small plastic tubes. HDR Brachytherapy is given as a sole treatment or in conjunction with a shortened course of external radiation therapy.
Chemotherapy treatment is the use of drugs (administered orally or intravenously) to attack cancerous cells directly or indirectly. The aim is to destroy cancer cells or slow their growth.
Scripps Health offers chemotherapy in several locations throughout San Diego County, including Scripps hospitals, outpatient infusion centers, or in Scripps-affiliated physicians’ offices. All infusion treatments are managed by physicians and nurses specially trained in oncology.
Scripps Health nurses administering chemotherapy have completed extensive training and education through the Oncology Nursing Society. Many Scripps clinical pharmacists have advanced training in chemotherapy preparation and treatment. A team of multidisciplinary professionals — including special breast cancer nurse navigators — works collaboratively to provide patients the highest quality of care and comfort.
New medications and advancements in chemotherapy allow most patients to receive their infusion therapy in an outpatient setting. Each visit to a Scripps Health infusion center includes a nurse assessment to determine how a patient is tolerating treatment. The assessment includes recommendations, educational materials and consultation with a pharmacist if needed.
Chemotherapy and other infusion treatments can produce physical symptoms that may be controlled through medication, nutrition and relaxation techniques. Nurses and pharmacists at all Scripps infusion centers work with patients to help manage any symptoms.
Scripps Health physicians and scientists are actively involved in research and studies to provide greater understanding of cancer biology and enable a faster availability of new treatments to patients.
If you are interested in participating in clinical trials, please discuss with your physician clinical trials options and potentially appropriate matches.