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A Roadmap to Breast Cancer Care

Getting a mammogram is the first step to breast health. If an abnormality is found, the subsequent treatment options can seem daunting. This guide to breast cancer treatment at Texas Health hospitals can help ease concerns by helping you know what to expect.

1. After a screening mammogram reveals a potential abnormality, a patient is called in for additional tests to show magnified views of the area. Depending on the abnormality, a patient may have an ultrasound, a diagnostic mammogram with compression and magnification views, or a breast magnetic resonance image (MRI) to better determine if the mass is suspicious or benign.

2. If a biopsy is needed, the breast surgeon or breast radiologist may conduct a minimally invasive needle biopsy using ultrasound or stereotactic mammography for guidance. This office procedure involves a local anesthetic and utilizes a needle to obtain a tissue sample for testing. When a minimally invasive approach is not possible, an open biopsy may be conducted.

3. After a positive biopsy, the patient meets with a breast surgeon to review the imaging studies, pathology report and treatment options.

“The pathology report contains information such as the grade of malignancy or how aggressive the cells look under a microscope,” says Kory Jones, M.D., general surgeon and medical director of the Breast Program at Texas Health Arlington Memorial Hospital. “Staging of a patient’s breast cancer is determined by the size of the tumor, whether there is nodal involvement and whether there is metastatic disease. Breast cancer can be non-invasive -- also called in situ -- or invasive.”

4. After a meeting with the breast surgeon, the patient may have an opportunity to meet with a nurse navigator, who coordinates all aspects of cancer care, from additional imaging to consultations with oncologists and other specialists.

“As a nurse navigator, I am a resource for the patient throughout their treatment for breast cancer to provide them with reliable resources and to connect them to support groups and recovery programs,” says Shirley Harvey, R.N., nurse navigator at Texas Health Arlington Memorial.

5. Depending on the grade and stage of cancer and the patient’s preferences, the surgeon and oncologist recommend an individualized treatment plan. Surgical options include partial mastectomy -- also called lumpectomy -- followed by radiation therapy or mastectomy with or without breast reconstruction.

“The ultimate goal of cancer treatment is to remove the malignancy and to bring the risk of recurrence, in the breast or elsewhere, as low as possible,” says Mary Brian, M.D., breast surgeon at Texas Health Harris Methodist
Hospital Hurt-Euless-Bedford. “Chemotherapy, hormonal therapy and radiation therapy may be recommended to patients to achieve this goal. A multidisciplinary approach that involves a breast surgeon, radiologist, pathologist, medical oncologist and radiation oncologist for each patient facilitates the right treatment to achieve the best
possible outcome.”

To schedule a digital mammogram at a Texas Health hospital near you, visit TexasHealth.org/Breast.

(Fall/Winter 2010)

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