Treatment: Breast Cancer
The Liggett Breast Center
Every day counts. Our team, and our treatment timeframe, is focused on you.
One in every nine women has a chance of being diagnosed with breast cancer within her lifetime. The statistic is startling. Fortunately, the solution is nearby. The Van Elslander Cancer Center’s Liggett Breast Center. Come to us for education, early detection, screening, risk factor assessment and, perhaps most important, timely treatment. When you are diagnosed with breast cancer, every day counts. Our revolutionary process enables you to review your options quickly with your entire cancer care team. This nationally recognized team of experts can then help you begin treatment within just days of your diagnosis.
Highlights at the Van Elslander Cancer Center
Whether you’re focused on surviving breast cancer, preventing breast cancer, or anything in between, we’re ready with an uncommon level of care. We believe every patient deserves the fastest and most comprehensive treatment available, and we have designed the Liggett Breast Center to provide it. Here’s how:
- A nurse navigator gives each woman entering the Breast Center individual assistance, assuring that no information, education, service or support is left to chance, including timely additional physician referrals or testing.
- Breast care services include screening, diagnostic mammography and stereotactic procedures.
- Our referral mechanism enables each patient with a suspicious mammogram to consult with a specialist within 48 hours.
- Our multidisciplinary physician team provides the optimal treatment regimen for the woman with breast cancer, providing important advantages for women who:
- Have recently been diagnosed with breast cancer.
- Have experienced a relapse of their disease.
- Have had abnormal mammograms, abnormal physical findings or symptoms of breast cancer.
- Have been referred by their family physician or another surgeon for a second opinion about their breast health and/or breast cancer.
- Have not received any form of treatment for their breast cancer, either proven or suspected.
How To Reach Us
To schedule a consultation, call (313) 647-3000 or toll free, 1-866-246-HOPE
Patients who have been diagnosed with breast cancer may come to the Van Elslander Cancer Center for a second opinion consultation. Second opinions are strongly recommended for all cancer diagnoses, so that you and your oncologist can choose the best treatment. Patients should ask their physicians to submit pathology materials for our review; each case receives a written evaluation.
If you are a Van Elslander Cancer Center patient and would like to obtain a second opinion, we can assist you as part of the University of Michigan Cancer Center Network. Because we are affiliated with their network, Van Elslander Cancer Center patients receive priority treatment.
Who’s On Your Team?
Our multidisciplinary approach to cancer care ensures that in a single visit, each patient receives a complete team of nationally recognized experts, including:
- Medical Oncologist
- Radiation Oncologist
- Plastic Surgeon (if patient requests)
- Radiology and pathology are also involved in the patient’s case but may not interact with the patient
- Oncology Nurse
- Genetic Counseling and Testing – Ideal for women who have a family history of breast cancer, genetic testing enables us to identify certain genes that place women at higher risk for breast cancer.
- Screening Mammography – A routine, annual mammography to maintain good health.
- Diagnostic Mammography – A more specific, specialized, concentrated view to zero in on a suspicious area.
- Ultrasound – A painless screening which can often help differentiate immediately between a cyst, calcification or dense tissue that was unclear in a mammogram.
- Core Biopsy – Insertion of a needle into a mass that can be felt in order to extract cells to send to pathology.
- Stereotactic Core Biopsy– A needle biopsy similar to a core biopsy (above), where a slightly larger sample of cells is extracted for review by pathology. For many patients, needle biopsies help eliminate the need for more invasive, uncomfortable and time-consuming surgical procedures.
- Sentinel Lymph Node Biopsy – A conservative alternative to surgery to remove a cluster of lymph nodes from under the arm, this procedure analyzes only the first one or two (sentinel) nodes to receive lymph from the tumor. If these nodes do not contain cancer, further lymph node surgery may not be necessary.
- Excisional Biopsy (offered at St. John Hospital and Medical Center) – An outpatient surgical procedure to remove suspicious tissue for further examination.
To determine how far the cancer has spread, your cancer care team uses a process of analysis known as staging. The stage of your cancer impacts your treatment and the prognosis for recovery. A number of different staging systems can be used to classify tumors. The TNM staging system assesses tumors in three ways: size of the primary tumor (T), whether it has spread to lymph nodes (N), and whether it has spread (metastasized) to other organs (M). Once the T, N, and M are determined, a number of I, II, III, or IV is assigned, with stage I being early stage and IV being advanced. In general, the lower the number, the less the cancer has spread. A higher number, such as stage IV, denotes a more serious case. Your doctor will review your test results and tell you the stage of your cancer.
The Van Elslander Cancer Center provides several options for treatment of breast cancer, all of which will be discussed with you by your multidisciplinary team. Treatments include:
- Radiation Oncology (also known as Radiation Therapy) – A specific area can be treated using external-beam delivery of radiation. Much like getting a regular x-ray, this painless procedure destroys cancer cells remaining in the breast, chest wall, or underarm area after surgery (it is also sometimes used to shrink a tumor before surgery). Each treatment lasts about five minutes; treatments are usually given for five days per week for about six weeks. Side effects can include temporary fatigue or swelling or a sunburn effect in the treated area. Radiation Therapy is available for select patients.
- Chemotherapy – Drugs are taken orally or injected into a vein to kill cancer cells. These drugs work through the bloodstream, treating the whole body, as opposed to radiation, which treats a specific area. Chemotherapy can be the main treatment for women whose cancer has spread outside the breast, or it can be given after surgery to reduce the chance of breast cancer recurring. Chemotherapy can also be used before surgery to shrink the tumor, making it easier to remove. Chemotherapy is given in cycles, with the total course lasting from three to six months. Temporary side effects may include fatigue, nausea and vomiting, loss of appetite, hair loss, mouth sores, changes in menstrual cycle, a higher risk of infection due to a shortage of white blood cells, or easier bruising or bleeding. Permanent side effects may include infertility and menopause.
- Hormone Therapy – Drugs such as tamoxifen and arimidex have been found to counter the growth of breast cancer cells. Tamoxifen is taken as a pill, usually for five years. Side effects can sometimes include night sweats, hot flashes, vaginal itch or discharge and diminished sexual interest. Several other hormonal drugs can also be used to treat breast cancer; side effects differ depending on the drug, so be sure to ask your doctor about any side effects.
- Surgery (offered at St. John Hospital and Medical Center) – Several types of surgery can be performed, including lumpectomy, partial mastectomy, simple or total mastectomy, modified radical mastectomy, axillary dissection or reconstructive surgery.
We designed the Liggett Breast Center to help you assess your best treatment options and begin fighting your cancer quickly. While at many centers, it can take up to ten weeks to begin treatment, our process helps you begin within a few working days:
- If a mammogram shows an abnormality, we will contact you to return for diagnostic services.
- We will conduct a biopsy, and our pathologists will determine whether the abnormality is cancer. You will get these results generally within two working days.
- If the results determine you have cancer, the Van Elslander Cancer Center offers a unique service: A nurse “navigator” will work with you to coordinate all activities from this point forward, providing you with a consistent, comforting and supportive advocate and point of contact. She is a breast cancer survivor herself and has extensive background in breast cancer and treatment options. This individual will ensure you receive all the consultations, exams, and treatments quickly and provide you with all the contact information you need, medical and psychological. From the time you receive your diagnostic results, she will ensure you have access to a consultation with a specialist within 48 hours (sometimes even the same day).
- The multidisciplinary team (see the Who’s on Your Team section, above) meets every week to review patients’ cases. This means that your case will be presented to this team at their next meeting (usually within 10 working days of the original diagnostic procedure), providing input of all the team members at once and access to information on any clinical trials for which you may be eligible. This is an enormously time-saving process; many patients have to wait weeks before all members of a cancer care team are available, which delays your plan of action and treatment.
- Once you have met with your multidisciplinary team, you and your doctor will develop the best plan for your treatment.
- Within a few working days, your treatment will begin.
Once you have received treatment, your surgeon will follow up with you to check your healing progress and address any concerns. From there, a medical oncologist will structure a schedule for follow-up care, which will start within about ten days, depending on your individual healing timeframe. Generally, chemotherapy will be conducted first, followed by radiation.
Your follow-up care can also include other services offered through the Van Elslander Center, including:
- The Healing Arts Center
- Support Groups
Reducing Your Risk
Here are a few of the ways the Van Elslander Cancer Center can help you prevent breast cancer:
- Screening (see the Specialized Services section, above): The earlier your breast cancer is found, the better your chances for successful treatment. According to the American Cancer Society, guidelines for early detection are:
- Annual mammograms for women 40 and over.
- A clinical breast exam every 3 years for women ages 20-39; every year after age 40.
- Breast self-examination (BSE) every month for women 20 and over.
Lifestyle choices: A Van Elslander Cancer Center nutritionist can consult with you about cancer-preventing lifestyle changes, such as reducing fat intake, reducing alcohol intake, not smoking and exercising three times each week. For further nutritional information, click here.
Risk assessment: Van Elslander Cancer Center staff can work with you to determine your personal risk for breast cancer. Risk factors include lifestyle, genetic factors (we offer genetic testing), family history, age, race and previous breast cancer.
Assess your risk now. Use this brief assessment to identify some prominent risk factors and calculate your chance of developing breast cancer within the next five years. According to the Susan G. Komen Foundation, over 180,000 women and 1,400 men will be diagnosed with breast cancer this year. If detected early, breast cancer has a five-year survival rate of over 95%.
The Van Elslander Center is one of only 13 facilities nationwide whose patients have access to all national clinical trials. In addition, qualified Van Elslander Cancer Center patients can participate in private trials sponsored by the University of Michigan Cancer Center Network.
Clinical trials are conducted to study promising new treatments that have shown potential value to patients. While there can be risks, these studies offer the most leading-edge treatment options and are often found to have great benefits to patients. Taking part in a clinical trial is up to you, and once you have joined the study, you are free to leave it at any time, for any reason.
Here are just two of the many clinical trials for currently available to qualified breast cancer patients at the Van Elslander Cancer Center:
- The Study of Tamoxifen and Raloxifene, or STAR trial, one of the largest breast cancer prevention studies ever, which evaluates the effectiveness of tamoxifen and raloxifene in reducing women’s risk of breast cancer.
- Two clinical trials involving sentinel lymph nodes, sponsored by the National Cancer Institute, comparing the effects of removing only one or a few lymph nodes to the standard practice of removing a much larger number of underarm lymph nodes.
For a list of current clinical trials, click here or call the National Cancer Institute at 1-800-4-CANCER.
Additional services available to Van Elslander Cancer Center patients include:
- Healing Arts Center – these services heal and strengthen your spirit, including massage, reflexology, mediation, yoga, music and art therapies and holistic assessment.
- Support Groups – Studies show patients who utilize support groups have improved healing rates. Among our support group activities is a “Look Good, Feel Better” clinic with a cosmetologist discussing makeover techniques, skin, hair and nail products.