Step by Step

Proceso Paso a Paso

This Step by Step Process guide is designed to be used with a health care provider who specializes in breast cancer i.e. radiologist, surgeon, plastic surgeon, medical oncologist, radiation oncologist, nurse breast specialist etc. Although this information is intended to give you an idea of what steps usually follow a breast cancer diagnosis, your treatment path will be tailored to your individual situation.

The information on this page will make more sense when additional data is gathered. The additional data may come from a breast MRI, pathology markers/breast panel i.e. ER/PR (estrogen and progesterone receptor) status, lumpectomy or mastectomy pathology, etc.

Radiologist

  • Biopsy - Ultrasound, Stereotactic
  • Breast MRI and possible further biopsies


Surgeon - Consultation

  • Lumpectomy/Breast conserving therapy - is based on size and location of abnormal tissue and personal preference. Usually followed by radiation therapy.
  • Needle Localization - performed day of surgery usually with a lumpectomy
  • Mastectomy - is based on size and location of abnormal tissue and personal preference. Radiation therapy may still be indicated.
  • Skin sparing mastectomy
  • Axillary lymph node dissection
    • Sentinel node procedure (removes fewer lymph nodes and is available if there is no known spread to the lymph nodes)

Plastic Surgeon - Consultation may be recommended

  • Cosmetic results with lumpectomy
  • Breast reconstruction options with mastectomy
  • Nipple reconstruction

Medical Oncologist - Consultation

  •  Risk Assessment (Genetic Consultation/Testing may be recommended)
  •  21 Gene Assay Test - indicates risk of recurrence in node negative, ER* positive patients
  •  Tamoxifen (pre or post menopausal); Arimidex, Femara or Exemestane are Aromitase Inhibitors (post-menopausal only) for patients who's cancers are ER or PgR* positive
  •  Neo-adjuvant chemotherapy - before surgery to shrink tumor
  •  Adjuvant Chemotherapy - after surgery
  •  Clinical trials
    *ER- Estrogen receptor, PgR- Progestrone receptor

Radiation Oncologist - Consultation may be recommended

  • Radiation Therapy
  • Whole Breast Radiation - 5 days/wk for 5-6 weeks
  • Brachytherapy
  • Catheters placed in breast and connected to radiation 2x day for 5 days
  • Balloon placed in breast, radiation instilled 2x day for 5 days
  • Partial Breast Radiation
  •  Radiation to tumor site and surrounding tissue, Clinical Trials ongoing

Post Surgery Physical Therapy - Consultation

  • Scar tissue and soft tissue cording management
  • Arm range of motion and strengthening
  • Lymphedema precautions
  • Lymphedema assessment and treatment

Complementary and Integrative Medicine Suggestions

  • Support groups
  • Nutritional counseling
  • Psychosocial counseling
  • Acupuncture, Massage
  • Yoga, Tai Chi, Pilates
  • Exercise programs
  • Art or Music Therapy

Do What Makes Your Heart Sing :)