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Breast with tumor and sentinel lymph nodes identified
At Mayo Clinic, breast cancer treatment may include surgical removal of tumors, radiation therapy, chemotherapy and reconstructive surgery.
At Mayo, breast surgeons and plastic surgeons work together to provide the best care for each patient with breast cancer. The multidisciplinary team may also include experts from internal medicine, medical oncologists, radiation oncologists, physical therapists, psychologists, geneticists and nurses.
If surgery is the most appropriate treatment option, breast surgeons remove the cancer and specialists from the departments of pathology and radiology evaluate the tissue immediately. They report results directly to the surgeon. On-site communication and contact allow the surgeon to verify the tumor's margin (edges) and other details with the pathologist while the surgery is still under way.
Mayo Clinic offers a full range of the latest surgical techniques and procedures to treat patients with breast cancer. Mayo surgeons perform more than 750 operations for breast cancer each year. Research shows that patients who are treated for breast cancer at high-volume medical centers (centers that treat many patients with a specific disease) have better outcomes than patients treated at medical centers that perform the treatment less frequently.
Mayo Clinic's state-of-the-art research facilities and equipment also help ensure the most appropriate diagnosis and treatment for patients with breast cancer. Learn more about research at Mayo Clinic, including clinical trials for new surgical approaches to breast cancer treatment.
At Mayo Clinic, surgeons provide individualized information and work with patients to help determine the appropriate treatment and provide timely surgical care. Surgical options for breast cancer treatment include:
Some patients may also be evaluated for prophylactic mastectomy, a procedure that may prevent or reduce the risk of developing breast cancer.
Mayo Clinic physicians may use frozen section evaluation of tissue during breast cancer surgery to determine whether all of the cancer has been removed. Mayo Clinic's unique frozen section pathology laboratory provides rapid, accurate microscopic analysis of tissue while the patient is in surgery. Mayo surgeons know if they have achieved negative margins (removed all the cancer) while the patient is still in the operating room. Frozen section analysis may prevent the need for patients to undergo additional surgery.
Localization may be used to pinpoint the location of a breast tumor that appears on a mammogram but cannot be felt. In localization, a radiologist uses either mammography or ultrasound to insert a fine wire into the tumor site. The surgeon then follows the wire to locate and remove the targeted area.
As an alternative, a radioactive seed (a metal capsule that contains a small amount of radioactive material) the size of a grain of rice may be placed at the tumor site. The seed may be placed a day or more before the operation. The surgeon locates the seed with a handheld Geiger counter and removes the targeted area.
If breast cancer is invasive (spreading into healthy tissue), it usually spreads first to the axillary lymph nodes in the axilla (armpit). When an invasive cancer is found in the breast, the surgeon will recommend removing some axillary lymph nodes to confirm whether the cancer has spread.
Surgeons at Mayo Clinic use several procedures to evaluate lymph nodes:
Breast reconstruction after cancer surgery is an option for most women undergoing mastectomy. Surgical options offered at Mayo Clinic include reconstruction with implants and autologous reconstruction (using the patient's own tissue), including:
Mayo specialists may recommend chemotherapy (treatment using drugs) following surgery to kill cancer cells that may have spread outside the breast. The drugs are usually administered intravenously (into a vein).
Chemotherapy may be recommended before surgery if the breast tumor is large, the lymph nodes are involved or the tumor is attached to the chest wall muscles.
Chemotherapy may also be recommended in cases of inflammatory breast cancer.
Most patients receive chemotherapy after they have healed from the operation and before they receive radiation. Mayo physicians choose the chemotherapy drugs and sequence of treatment based on the details of each patient's tumor characteristics.
Mayo Clinic researchers conduct many clinical trials clintrials.html to find drug combinations and treatment sequences that result in improved outcomes for patients with breast cancer. Mayo specialists often talk with eligible patients about participating in clinical trials.
Radiation therapy involves the use of high-energy X-rays to kill cancer cells and shrink tumors. Patients who undergo radiation therapy consult with a radiation oncologist before treatment begins. Radiation may be recommended if:
The term hormone therapy refers to the use of drugs that either block estrogen from reaching cancer breast cells or reduce the amount of estrogen the body produces to help reduce the risk of cancer recurrence.
Hormone therapy is most effective for patients whose tumor cells express (produce) the estrogen receptor. Hormone therapy is not recommended for patients who have tumors that are estrogen negative.
For premenopausal patients with tumors that are estrogen receptor or progesterone receptor positive (sensitive to hormones), medications or removal of the ovaries may also be recommended to prevent cancer recurrence.
Mayo Clinic researchers conduct many clinical trials on hormone therapy. Mayo specialists often talk with eligible patients about the opportunity to participate.
Mayo Clinic recommends CYP2D6 gene testing and discontinuation of drugs that potently inhibit the CYP2D6 enzyme for postmenopausal patients about to begin tamoxifen therapy for breast cancer. Hepatic metabolism by (the liver's effect on) CYP2D6 converts tamoxifen into a more potent form of the drug, endoxifen.
Mayo Clinic offers many experimental therapies, including lapatinib and trastuzumab or Herceptin therapy, which is often used to treat breast cancers that produce an abnormal amount of human epidermal growth factor receptor 2 (HER2).
Mayo Clinic offers patients with breast cancer the opportunity to participate in its Familial Cancer Program, which helps identify people at higher risk for breast cancer related to family history.
In the program, a team of doctors, genetic counselors and nurses evaluate patients and their families to determine potential cancer risk. The team develops a customized cancer screening plan for families at increased risks of developing cancer. Consultations are offered to patients who have been diagnosed with cancer and to family members who have not had cancer.
Mayo Clinic's Women's Cancer Program helps patients understand and manage breast and gynecological malignancies. Multidisciplinary teams of physicians and other professionals in the women's cancer program work to:
Nimaat Al Azzah came to Mayo Clinic nine years ago for treatment of breast cancer. Visit the Sharing Mayo Clinic blog to read about her experience of care and survival.
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