Treatment Options

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Treatment Options for Breast Cancer

Florida Hospital Cancer Institute (FHCI) is committed to providing those with breast cancer the latest and most effective treatments available. From our highly advanced surgical suites and clinical trial programs to our experienced team of breast cancer doctors, surgeons, nurses and specialists, FHCI is one the leading breast cancer treatment centers in the United States.

Treatment options cover a broad range of therapies, from surgery, chemotherapy and radiation therapy, to targeted and hormonal therapy. Our physicians work with our clinical research team to offer eligible patients the opportunity to participate in clinical trials. Patients can also find more information at www.FloridaHospitalCancer.com.

Breast Cancer Surgery

Rest assured that the medical specialists at the FHCI will explore every option available for the treatment of your cancer, and if surgery is an option, know that our physicians are highly experienced.

Breast cancer can be approached through a mastectomy (removal of the entire breast) or a lumpectomy (also referred to as a wide excision, partial breast excision or segmental resection).

There are three types of mastectomies. A simple mastectomy involves removal of the entire breast as well as some of the lymph nodes under the arm. In a modified radical mastectomy, the entire breast, many of the lymph nodes under the arm, the lining over the chest muscles, and in some cases a small portion of the chest muscle itself, may be removed. Finally, there is a double mastectomy, which involves the removal of both breasts.

In a lumpectomy, the cancer is removed as well as a small rim of normal tissue around it known as the "margin". Often, your surgeon may also recommend that some of the lymph nodes under the arm be removed if they contain cancer cells. In order to minimize the extent and possible side effects associated with removing these axillary nodes, doctors have developed a sentinel node biopsy procedure where a radioactive dye is injected into the lymphatic system of the breast. A pathologist uses the test results to determine if there is any evidence of a tumor in the sentinel nodes. If so, the axillary nodes may be removed during the lumpectomy.

Depending on the preferences of the patient, additional surgeries may be needed to reconstruct the breasts following a mastectomy. One of our plastic surgeons will review options with you to determine the best course for reconstruction, which can include tissue expanders with placement of implants or one of several special flap rotations. The decision of which reconstruction is best for you depends on the type of breast cancer treatment you're receiving and your unique physiology. In many cases FHCI's breast cancer surgeon and your plastic surgeon collaborate on your reconstructive procedure.

Radiation Therapy

An option for treating breast cancer locally is radiation therapy. A radiation oncologist at FHCI will utilize beams of high-energy rays to destroy cancer cells that are left behind in the breast, chest wall or lymph nodes following surgery. The radiation source can either be external or internal. Internal radiation involves the use of radioactive materials known as "seeds" that are placed in the area where the tumor was removed. New techniques have allowed the radiation to be delivered very precisely, with little damage to the surrounding healthy tissue.

Chemotherapy

Often, the highly skilled medical oncologists with the Florida Hospital Cancer Institute Breast Care Program will recommend the use of specially designed drugs to kill cancer cells. Known collectively as chemotherapy, these drugs are either administered through a vein or given orally.

Most often chemotherapy is given after surgery to rid the body of any residual tumor cells. This is referred to adjuvant therapy. However, it can also be given before surgery in the hope of shrinking a large tumor so that a mastectomy or lumpectomy can be accomplished more easily, this is referred to as neoadjuvent therapy. This decision is based on a number of factors and FHCI's medical oncologists will be happy to explain the options to you. While chemotherapy for breast cancer has been a standard practice for the last 30 years, new drugs are emerging from labs worldwide and FHCI is constantly adding them to their arsenal through clinical trials.

Hormonal Therapy

It has been known for a long time that many breast cancers are responsive to and grow in the presence of estrogen. By keeping the hormone away from the breast cancer cells, the cancer's growth can be slowed. It's best for patients who have tumors that have estrogen and/or progesterone positive receptors available. By blocking these receptor sites on the tumors, the hormone can't signal the breast cancer cells to grow.

Blocking the effects of hormones can be accomplished by removing the ovaries if you're still pre-menopausal or administering drugs such as tamoxifen or aromatase inhibitors. Each method of reducing the effects and levels of estrogen has its own unique properties and your individual circumstances will direct which approach, if any, is best.

Targeted Therapy

Doctors at the Florida Hospital Cancer Institute are working closely with the world's leading researchers to develop new therapies which will provide more specific information for treatment options. This idea of more personalized treatment planning is now possible with more genes and proteins being discovered which can lead to more specific, specialized therapy. This area of research and treatment is commonly referred to as targeted therapy and includes drugs such as Herceptin, Avastin and Tykerb.