Frequently Asked Questions About Breast Cancer
I was just diagnosed with breast cancer. Is mastectomy my only option?
The majority of women are diagnosed with early stage breast cancer. For women with early stage disease, lumpectomy and radiation is as good an option as mastectomy. In fact, several studies have shown that 80% of women with early disease are well suited for breast conservation. Dr. Morrow, a leading surgeon at Fox Chase, recently published a study showing that 75% of women diagnosed with breast cancer can be treated with lumpectomy and radiaton. If your surgeon has recommended mastectomy, be sure to ask WHY.
There are 5 reasons to consider mastectomy...more than 1 cancer in the breast, being in the first or second trimester of a pregnancy, diffuse calcifications in the breast that can not be excised, and a genetic predisposition to breast cancer. Prior radiation may exclude a women from breast preservation unless she is a candidate for brachytherapy.
What is Breast Conserving Therapy?
Breast conserving therapy is a term used to describe a successful treatment of a woman's breast cancer that does not require mastectomy or the loss of her breast. By excising just the diseased portion of the breast (i.e., the cancer) and then giving radiation, we are able to get the same rates of cure without the disfigurement of mastectomy. Click here for more information.
Why do I need to go through radiation if the cancer has been removed?
Several studies have looked at the results of women treated with lumpectomy alone. All of the studies show a high rate of recurrence for invasive breast cancer treated with lumpectomy alone.
Is Radiation Therapy Safe?
Radiation has been used successfully to treat patients for more than 100 years. In that time, many advances have been made to ensure that radiation therapy is safe and effective. Before you begin receiving radiation therapy, your radiation oncology team at ABCS will carefully design your plan to make sure that you receive safe and accurate treatment. The medical phycisist in the center works with the radiation oncologist to develop an extensive safety and quality assurance plan to ensure that every patient receives the right treatment in the safest possible way, each and every time.
Treatment will be carefully planned to focus on the cancer while avoiding healthy organs in the area. Throughout your treatment, members of our team check and recheck your plan. Special computers are also used to monitor and double-check the treatment machines to make sure that the proper treatment is given.
If you undergo external beam radiation therapy, you will not be radioactive after treatment ends because the radiation does not stay in your body. However, if you undergo brachytherapy, tiny radioactive seeds will be implanted into your body either temporarily or permanently.
Your radiation oncologist will explain any special precautions that you or your family may need to take for a short time following treatment.
Is Brachytherapy effective?
It is regarded as a safe and effective alternative to standard external beam treatment for many patients with breast cancer; overall patient survival with either approach is going to be similar. The primary reason a woman would select breast brachytherapy over standard external beam radiation is time: external beam radiation requires over six weeks of daily treatment, but breast brachytherapy can be completed in one week.
Am I a candidate for Brachytherapy?
To be a candidate for breast brachytherapy, a patient must have:
- Invasive breast cancer or ductal carcinoma in situ (DCIS) 3 cm or less in size.
- Node negative of no more than three positive lymph nodes of the axilla (armpit area). For patients with 3 or fewer positive nodes, we insist that the tumor has not penetrated the capsule of a lymph node (medical term: extranodal extension). We believe that patients with more than three nodes involved, or with extranodal extension, should consider comprehensive external beam radiation therapy to the breast and lymph node areas instead of brachytherapy.
- Clear surgical margins of at least 1 mm.
- Unicentric breast cancer (no other areas of the breast with cancer).
- A negative pregnancy test or no possibility of pregnancy.
- A time interval of no more than 6 weeks from lumpectomy or re-excision surgery, or breast ultrasound or CT evidence for a clear lumpectomy cavity edge for target volume definition.
How do I know if Brachytherapy is right for me?
After reviewing our information on our website, all of us at Arizona Breast Cancer Specialists invite and encourage you to come visit us to see if brachytherapy is right for you.
What if my doctor doesn't recommend Brachytherapy?
If you have an early-stage breast cancer (Stage 0, 1 or 2), with limited or no lymph node involvement, you may be a candidate for brachytherapy. Give us a call to see how your cancer fits within the Guidelines. Please click here for our Contact Information.
Does Brachytherapy hurt?
Because a local anesthetic is used and mixed with sodium bicarbonate, there is none of the usual initial burning pain that can occur with this procedure. This local anesthetic also contains small amounts of epinephrine, which stops bleeding from small blood vessels; there is very little bleeding from this brachytherapy.
Most patients have NO pain and NO bleeding with catheter insertion that follows the anesthetic injection. Patients are awake during the procedure, talking with our physicians and listening to music. Most are surprised when it is all over. The local anesthetic wears off in 6 hours and for any soreness or pain that persists, we provide pain medications and mild sleep aids. After one day, however, many patients do not require anything more than Tylenol for the pain.
What are the side effects?
Redness, bruising and mild breast pain are the most common side effects, but do not occur in all patients and usually go away after a short period of time.
You should be able to go back to work soon after your last treatment, as long as you don't do any heavy lifting or strenuous work. Breasts will be tender for a few days especially in younger women who have more nerve endings.
Will my insurance cover Brachytherapy?
Brachytherapy is usually covered by the majority of insurance companies, but is is always best to check with your insurance company for details. You can also call us for assistance or if you have questions.
How soon after Brachytherapy can I start chemotherapy?
It is best to wait 2 to 3 weeks after Brachytherapy treatment before starting chemotherapy.
Will I lose my hair?
How many women have been treated with Brachytherapy?
Tens of thousands of women have been treated since the early 1990's with brachytherapy.
What do other women say about Brachytherapy?
All of our patients who have been treated with brachytherapy are very pleased with the process because there is so little pain and because of the short timeframe required for the treatment. Click here to read what our patients say about brachytherapy and about our practice!