BREAST CANCER FAQs

Surgery to remove the tumor and preserve the remaining breast tissue is called a lumpectomy. Radiation treatment is given to destroy any remaining microscopic deposits of cancer in and around the site of surgery. The combination of lumpectomy followed by radiation therapy is considered equal or better than a mastectomy, which is a major surgery removing the entire breast. If radiation is not done following a lumpectomy, there is a high likelihood of cancer growing back in the breast and a lower survival.

Many women are surprised to learn that breast cancer research has already shown us that mastectomy offers no survival advantage (and may even be worse) compared to lumpectomy and radiation. Many women also do not appreciate that even the best possible reconstruction after a mastectomy can not match the excellent appearance of a breast treated with lumpectomy and radiation. We would be more than happy to educate you further about current breast cancer research during your consultation.

Yes, absolutely. Our mission is to educate women about this and improve their lives as a result. Mastectomy is disfiguring and totally unnecessary for the vast majority of women today. This is especially true since many women who are getting regular mammograms are uncovering tumors that can be easily removed while sparing the normal breast. Even women who are told they have ‘large’ tumors or cancerous lymph nodes can still spare their normal breast because of research demonstrating excellent results including survival and appearance, making a mastectomy ‘obsolete’ in all but the most extreme cases.

Side effects can include fatigue, skin irritation similar to a moderate sunburn, and mild to moderate breast swelling. These changes are temporary and can be treated by skin creams and/or medications. Tell your radiation oncologist or nurse about any discomfort you may feel, we will help you through it. Most women are surprised how quickly and easily they complete radiation.

Modern radiation involves computer controlled dose modulation that can actually reduce extremes in radiation in the breast and on the skin such that the dose is much more homogenous and you experience less skin burning. More importantly it allows for better heart and lung protection. The breast also has less areas of under dosing so tumor control is expected to be higher.

Accelerated partial breast irradiation is the delivery of radiation to only part of the breast over four to five days. By treating a smaller area of the breast, treatment can be completed in just one week.

Randomized clinical trials are being conducted to evaluate the effectiveness of this treatment, and until then, only women who are not candidates for the clinical trial should be considered for APBI off-study. Selected women who are at the lowest risk of recurrence (recurrence means the cancer coming back) may be offered APBI. Researchers at MD Anderson Cancer Center showed a higher rate of cancer recurrence using APBI, requiring a mastectomy. We await the results of more definitive studies being conducted throughout the world to get the final word on this. You can read about these various experimental techniques of APBI here. Randomized clinical trials are being conducted to evaluate the effectiveness of this treatment, and until then, only women who are not candidates for the clinical trial should be considered for APBI off-study. Selected women who are at the lowest risk of recurrence (recurrence means the cancer coming back) may be offered APBI. Researchers at MD Anderson Cancer Center showed a higher rate of cancer recurrence using APBI, requiring a mastectomy. We await the results of more definitive studies being conducted throughout the world to get the final word on this.