An interdisciplinary approach involving a board certified plastic surgeon, oncologist, oncology surgeon and Internal Medicine may all be a part of developing the treatment plan. The good news is that breast cancer can usually be detected at an early phase and the earlier the treatment, the less invasive the treatment plan, as noted by Cancer.org:  

Stage O:

Breast cancer is categorized in the 0 stage when the cancer has not spread out of the affected area. While a total mastectomy (breast removal) may be the call to order, radiation is rarely required. An alternative is a lumpectomy (partial breast removal) when the tumor is less than 4 four cm with or without radiation.

Stage I and II:

Stage I and II is characterized by a tumor less than 5 five cm and the lymph nodes may or may not be involved. Treatment may be a modified radical mastectomy and radiation may be required in some cases. Alternatively, a lumpectomy, radiation and axillary lymph node excision (when necessary) may be performed. If the lymph nodes are not involved, the sentinel approach may be used which is less invasive than axillary node excision with an incision 2-3two to three inches long, along with possible radiation to select lymph nodes. Chemotherapy may also be administered to prevent the risk of reoccurrence in all types of treatment plans. 

STAGE IIIA and Operable IIIC

STAGE IIIA and Operable IIIC is characterized by a tumor that is greater than 5 five cm with lymph nodes involvement or a tumor less than 5 five cm with the lymph nodes under the arm involved. Operable IIIC is any size tumor that spreads to more than 10 lymph nodes which may involve the breast area, neck and/or collarbone.  Treatment in both stages may consist of modified radical mastectomy followed by radiation. Conversely, a lumpectomy, radiation, chemotherapy, axillary lymph node excision and radiation may be performed.

Stage IIIB and Stage IIIC Inoperable

Stage IIIB consists of any size tumor that spreads to nearby tissue, muscles, ribs and possibly lymph nodes. Stage IIIC inoperable consists of any size tumor that has spread to the lymph nodes in the breast, neck and collarbone areas. While there is no surgery for inoperable Stage IIIC, those in stage IIIB may qualify for Modified radical mastectomy that may require nearby tissue removal. In both stages, treatment plans include radiation for breast area and possibly surrounding areas, axillary lymph node removal and usually chemotherapy.

Stage IV is characterized by cancer that has spread to other organs. Treatment may involve surgery and/or radiation, possibly lymph node treatment and chemotherapy.

Special Considerations for Hormone-Receptor-Positive Cancer

Women in any stage with hormone-receptor-positive cancer will receive hormonal therapy, as well.  Targeted drug therapy may be used for women with certain cancers, such as those with a large volume of proteins regulated by estrogen receptors. There are a number of targeted drugs that may be used to target select tumors, cancer cells or proteins.  Adjuncts to treatment may be acupuncture, meditation and yoga.

Reconstructive plastic surgery is usually performed following cancer treatments which involves the placement of breast implants.  If you have breast cancer, it is wise to visit a plastic surgeon soon after diagnosis so that the plastic surgeon can be a part of the development of your plan with your oncologist.   

Quality of Life Following Breast Cancer Treatment and Reconstruction

Breast reconstruction following cancer treatment can certainly improve the appearance of the breasts and this may play a significant role in a breast cancer survivor’s self- image, self- esteem and confidence.    Recently, researchers learned more about the role of personality traits in breast cancer survivors and how these traits may affect quality of life.  The January issue of Plastic and Reconstructive Surgery® reported on the results of the study led by Silvio Bellino, MD at the University of Turin, Italy. The study participants were comprised of nearly sixty women who underwent mastectomy and immediate breast reconstruction.  Researchers gave these women a series of psychological tests to identify trends in personality traits and the comparison to quality of life. All in all, breast reconstruction did vastly improve quality of life, but there were some interesting comparisons. 

The two groups of personality types that held the highest quality of life scores were those who tended to be socially inhibited and insecure, as well as, those who tended to be more self-serving and aggressive.  Also, having breast reconstruction immediately following mastectomy tended to reduce the psychological burden on the patients.  The conclusion of the study is that it may be wise for certain personality types of breast cancer patients to undergo counseling to prevent depression and improve social relations throughout treatment.  Of course, the best news is that there are options available to vastly improve the appearance of the breasts following breast cancer treatment. 

Next Visit, Breast Reconstruction

It is important to recognize that medications and medical procedures are associated with benefits and risks that should be discussed with your physician. It is important to recognize that all information contained on this website cannot be considered to be specific medical diagnosis, medical treatment, or medical advice. As always, you should consult with a physician regarding any medical condition. Your Health Access disclaims any liability for the decisions you make based on this information.