Breast Cancer

When breast cancer is spotted early, and is in the localized stage, the survival rate is 99%*, so if you’re 40 and over, or have other risk factors, it may be time to get tested for breast cancer. Talk to your doctor about your risk for breast cancer, and what level of screening and monitoring is right for you. We offer a community breast cancer screening program to find breast cancer at early stages, when it’s typically easier to effectively treat.

*According to the American Cancer Society 5-year tracked, survival rate based on the NCI-maintained SEER database.

Our High-Risk Prevention and Surveillance Program might be right for you if you’ve had cancer before, cancer is in your family, or you have breast biopsy test results showing an increase in risk. Contact us with questions. Through this program we offer:

• Formal clinical risk assessment
• Genetics evaluation
• Clinical examination
• Breast imaging, including mammogram, ultrasound and MRI optimally scheduled to detect cancer as early as possible
• Prevention strategies to reduce risk and ensure early diagnosis, such as lifestyle changes and preventive surgery in select cases

Many people undergoing breast cancer surgery express the strong desire to preserve the normal appearance of the breast as much as possible while removing all evidence of cancer. We offer several routes to ensure this occurs. For example, if a mastectomy is required, we offer breast reconstruction surgery along with a procedure designed to preserve the skin and nipple of the breast. We routinely partner with plastic surgeons who use leading-edge oncoplastic techniques to hide scars and save healthy breast tissue. Minimally invasive ablation of tumors with cryotherapy is another approach; this involves the application of extreme cold to destroy tissue.

This innovative approach enables the surgeon to pinpoint, with a high level of precision, the area of the breast that requires removal. Doctors place a tiny radioactive seed (a small metal object) in the breast prior to surgery. That seed then guides the surgeon in order to achieve precise removal through a hidden cosmetic incision. Accuracy and removal of all cancerous breast tissue dramatically reduces the likelihood of additional surgical procedures.

We offer intraoperative radiation therapy, an innovative, high-tech approach in which the patient receives targeted radiation treatment during surgery. While other cancer centers often recommend mastectomy as the best course for people who develop a second local occurrence after previous breast cancer treatment, we use IORT as an alternative—which provides a second chance at breast conservation. We also perform lumpectomies with IORT, which often succeed in conserving breast tissue.

Other state-of-the-art radiation treatment options we offer at The New York Proton Center and elsewhere include:

• Intensity modulated radiation therapy (IMRT): X-ray and proton beams of varying intensity and shape deliver radiation that matches your tumor’s exact shape and size.
• Deep inspiration breath hold (DIBH): Radiation is synchronized with deep breathing to protect the heart muscle.
• Prone breast radiation treatment: This treatment requires that you lie on your stomach on a specially designed table allowing the breast to hang freely below your body.
• Partial breast irradiation: We treat a specific location on your breast with precise radiation beams, highly-advanced implanted pellets and, in some cases, both.
• Proton therapy: High-energy beams of positively charged electric particles (protons) provide precision treatment to tumors while sparing surrounding tissues.

Sometimes, surgery for breast cancer leads to fluid build-up due to damage to the lymph nodes. This is called lymphedema. We’re sensitive to this risk and work to limit the likelihood it happens, through measures such as:

• Avoiding lymph node removal when possible
• Axillary reverse mapping, a technique that limits lymph node surgery and preserves the axillary nodes that drain the arm
• Careful monitoring of lymph node surgery patients with bioimpedance spectroscopy, a non-invasive tool to spot early increases in arm volume
• Adopting LYMPHA, (LYmphatic Microsurgical Preventive Healing Approach) a procedure where a lymphatic vessel is re-attached to a vein branch in the axilla to preserve lymph drainage and reduce risk of lymphedema

There are different kinds of breast cancer:

• Non-invasive (in situ) breast cancer: Cancer forms in the milk ducts and does not spread to other breast tissue.
• Invasive ductal carcinoma: Cancer forms in the cells lining the ducts. This is the most common form of breast cancer in women and men.
• Invasive lobular carcinoma: Cancer cells grow in the lobes or lobules, sometimes in both breasts.
• HER2 positive breast cancer: HER2 is a protein found in some breast cancer cells. Too much of the HER2 protein makes cancer grow.
• Hormone-receptor positive breast cancer: The cancer cells include protein receptors that bind with estrogen or progesterone hormones. The cancer cells need these hormones to grow.
• Triple negative breast cancer: These cancer cells have no receptors for estrogen and progesterone. They do not make any (or too much) of the HER2 protein.
• Paget’s disease: Abnormal cells grow beneath or on the surface of the nipple.
• Inflammatory carcinoma: This rare type of cancer causes the breast to become red, swollen and warm.