More than 182,000 American women are diagnosed with breast cancer each year. It is the most common cancer among women in the U.S. and worldwide.
Over the past decades, researchers have made great strides toward understanding the biology of breast cancer. Physicians are using this new information to develop an array of targeted therapies and other approaches for treating the disease. These advances have helped women with breast cancer experience fewer side effects from treatment and live longer.
Patients receiving treatment for breast cancer at NewYork-Presbyterian are cared for by a multi-disciplinary team of physician-scientists who meet regularly to discuss research, review patients' cases, and plan courses of treatment. These collaborations are important. They allow our patients to receive comprehensive care and have access to emerging treatments, typically available in clinical trials.
Early-stage breast cancer may not cause any symptoms. That is why it is so important for women to get regular mammograms, physical examinations, and to perform monthly breast self-examinations.
When breast cancer does cause symptoms, they may include:
Most women discover they have breast cancer through a mammogram. It is vital for all women to have mammograms after age 50, and for some women to begin screening at age 40. For women with a strong family history of breast cancer, it could be important to begin screening even earlier.
A physical or imaging exam can bring an abnormality to light, but a diagnosis of breast cancer cannot be confirmed without a biopsy. Doctors perform breast biopsies in different ways:
When breast cancer is diagnosed, doctors may order additional tests, such as MRI and/or CT scanning, to determine the extent (stage) of cancer growth. Pathologists also examine breast cancer tissue to see if it contains receptors for estrogen, progesterone, and/or the HER2 receptor. These tests help doctors determine which treatment would be most effective.
The most effective treatment for most breast cancers is often a combination of surgery, radiation, chemotherapy and/or hormonal therapy. Therefore, coordination between breast surgeons, plastic surgeons, medical oncologists, radiation oncologists, pathologists, radiologists, and nurses is important to achieve the best outcome. At our Centers, a team of social workers and nutritionists also support patients during and after their treatment.
Surgery to remove the cancer is the first course of treatment for most women with breast cancer. Eradicating the tumor with removal of minimal tissue is the surgeon's primary goal, but we also consider how a woman's breasts will look and feel after surgery. Our reconstructive surgeons are involved from the beginning of a woman's care to ensure that she has the best possible cosmetic outcome.
Medical oncologists have a spectrum of anti-cancer drugs for treating breast cancer. The field of breast oncology is rapidly changing, with frequent new discoveries and forms of treatments. The drug, or combination of drugs, chosen to treat a patient depends on the stage of a woman's disease and the biology of her tumor. For example, a tumor may contain HER2 receptors, a protein found on the surface of tumor cells in about 20 percent of patients. Many women with HER2-positive breast cancer respond best when treated with the drug Trastuzumab.
Radiation therapy can be an effective treatment for many forms of breast cancer. Our radiation oncologists treat breast cancer with both external beam radiation therapy and more targeted techniques that include: three-dimensional conformal radiation therapy and intensity-modulated radiation therapy. Targeted techniques provide oncologists with unparalleled precision. Physicians can pinpoint and shape radiation beams to the contours of the patient's tumor, while sparing the surrounding healthy tissue.
Doctors often treat women whose breast tumors contain receptors for estrogen and/or progesterone with drugs that reduce the production of these hormones. Patients may continue to take these drugs for several years after they complete other treatments to reduce their risk of recurrence.
Some 7 to 10 percent of breast cancers develop as a result of an inherited genetic mutation. Our Centers offer genetic counseling and testing to women with a family history of breast cancer. This allows patients to make informed decisions about how to reduce their risk.
For more information about cancer prevention at NewYork-Presbyterian, please see the nypcancerprevention.org.