Millions of women go for mammograms yearly and many agencies are working to make it possible for all women to have the tests.
Many of these ladies grumble about it, but make the appointment and happily cross it off their to-do list for another year.
But, what if the result is not what’s expected? That word “cancer” can alter a person’s life forever.
One in eight women today will receive a breast cancer diagnosis. There have been many advances in the last 20 years in both diagnosis and treatment. There have even been connections made between diet, smoking, exercise and heredity, as they relate to the risk of breast cancer.
It has been well-established that doing regular breast checks, having a clinical exam at least every two years, and enduring the yearly mammograms starting at age 40 are the best ways to find cancer early. But, what if you should get a diagnosis of breast cancer?
The shock is profound, as related by anyone I spoke to about the diagnosis. Once a person has received the news that she has breast cancer, the brain has begins to process it and the questions begin.
“Will I lose my breast?”
“How bad is it?”
“What choices do I have?”
Recently, Barb, a friend of mine, received the news that her mammogram was positive for breast cancer. I learned about the options for treatment from her descriptions.
There are several ways of treating breast cancer. Sometimes the entire breast is removed, but other times only the lump and a little surrounding tissue are removed. Sometimes, the surgeon must remove lymph nodes, too. There have been many modifications of the surgery over the year, but usually surgery is followed by chemotherapy or radiation.
Radiation can be aimed at the breast externally or internally. Internal radiation, called brachytherapy, involves placing radioactive seeds or pellets into the breast tissue next to the the tumor site. External radiation is the method of radiating from outside the body.
In Barb’s case, she was eligible for a treatment known as the MammoSite Radiation Therapy System, usually reserved for a cancer that is not beyond stage one.
On the day of surgery Barb started out at the Mount Nittany Physicians Group Breast Care Center. The physicians and staff there inserted a guide wire into her breast to aid the surgeon in finding the precise location of the tumor. Mammography or ultrasound will guide the placement of the wire.
Next, she went to the CT scan area, where small amounts of a radioactive substance will be injected to pinpoint where the sentinel nodes are located. This is to help during surgery, where a gamma probe is used to refine the location of the nodes to be biopsied and/or removed.
Barb then proceeded to the Medical Treatment Unit, where nurses prepared her for surgery.
Radiologist Dr. Jerome Derdel says about 30 percent of breast cancer patients are eligible for the MammoSite treatment that Barb received. There are clear parameters for this treatment.
A patient must be 50 years of age or older, and the tumor must not be larger than two to three centimeters, which is about 1.25 inches. There must be clear margins — no cancer showing anywhere around the lump when it is removed. The tumor must be estrogen-receptor positive. This becomes important in the follow-up care, as drugs may be given that help to prevent recurrence.
“Of course, you need to be in an area where there are qualified and trained surgeons to place the MammoSite tube. At the time of surgery, a temporary balloon tube is placed. The patient goes home and, after four days, when the pathology reports are all back, she returns. Each time the patient comes in during the treatments, a scan is done to make sure the balloon hasn’t moved,” Derdel said.
“A permanent MammoSite tube is placed after about four days and the patient goes to radiology. The radioactive pellet is placed through the tube for the predetermined time and then removed. The radiology oncologist works with the radiation department to calculate the measurements needed to place the MammoSite tube precisely.
“The patient has two treatments, twice a day for five days, and that completes the series. The balloon tube is then removed,” Derdel explains.
Some of the advantages of this type of treatment for breast cancer are that it is breast-saving, is a shorter treatment course, is less likely to cause nausea, and is less likely to damage surrounding tissue than if the entire breast is radiated.
The patient is seen afterward at regular intervals. Most women receive follow-up drugs to help prevent a recurrence of cancer. The follow-up appointments are to monitor for infection or radiation effects, such as redness or skin breakdown.
There are many variables concerning the choice of a treatment for breast cancer and only the patient and her doctor can fully discuss those. The message is clear that there are many more breast cancer survivors today. You do not necessarily have to lose your breast, and there are good facilities in the area with state-of-the-art equipment to carry out the needed procedures.
Dr. Theodor Kaufman is the only surgeon in State College at the present time that places the MammoSite tubes. Many people from the surrounding areas come to Mt. Nittany with their tubes in place to have the radiation done here because of the equipment and trained individuals such as Neil Holter, who operates the machine that delivers the pellets.
My friend Barb says the nurses were very good at explaining everything as she went through the treatments, as were the doctors. As Barb says: “Not a walk in the park, but I would still choose it as a treatment.”
