Breast cancer

Breast cancer risk factors

According to the American Cancer Society, the following risk factors that you cannot change may indicate a higher risk for developing breast cancer:

• Being born female — Breast cancer is much more common in women than men.
• Age — Most breast cancers are found at age 55 or older.
• Gene mutations — The most common gene mutations that may lead to breast cancers are BRCA1 and BRCA2.
• Family history — Having a first-degree blood relative with breast cancer nearly doubles your risk
• Race and ethnicity — Your race may affect your likelihood to develop breast cancer or affect the type of cancer you have.
• Being taller — Taller women have a higher risk than shorter ones.
• Dense breasts — Dense breasts increase your risk of breast cancer and they can also make seeing cancers on mammograms more difficult.
• Certain benign breast conditions — Some noncancerous conditions may increase your breast cancer risk. If you have atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH) or lobular carcinoma (LCIS) you have a higher risk.
• Early menarche — Starting your period earlier, especially before age 12, may increase risk slightly.
• Radiation therapy at a young age — If you've had radiation therapy for other cancers as a teen or young adult, you have a greatly increased risk for developing breast cancer.
• Diethylstilbestrol (DES) exposure — If you have taken diethylstilbestrol (DES) during pregnancy, or if your mother took DES while pregnant with you, you may have a slightly higher risk.

Breast cancer screening

Early detection of breast cancer allows for the best possible outcomes. This is why our hospitals offer breast cancer screenings and a variety of breast imaging services, including mammography and breast magnetic resonance imaging (MRI).

The breast cancer specialists of Sarah Cannon recommend an annual screening mammogram for women 40 to 74 years old. Your breast cancer screening strategy should be discussed with your physician, as women at high risk of developing breast cancer may need to begin screening earlier.

Diagnosing breast cancer

If a breast imaging exam shows a mass that cannot be designated as noncancerous, our doctors perform a breast biopsy. Breast biopsies are necessary because they help determine if a breast mass is noncancerous (benign) or malignant (cancerous). They also allow us to accurately diagnose and stage breast cancer.

We provide two types of nonsurgical biopsies: stereotactic breast biopsies and ultrasound-guided breast biopsies.

Multidisciplinary breast clinics

We understand receiving a breast cancer diagnosis can be overwhelming. When you first are diagnosed with breast cancer, you usually have to make many appointments — with oncologists, surgeons and for imaging scans — all while getting used to the idea that you have cancer.

That’s why we have designed multidisciplinary clinics for our breast cancer patients. We arranged it so you only have to make one visit and all your appointments can be done on that day. From one comfortable location, you will visit with the medical oncologist, breast surgeon and radiation oncologist and begin to create your personalized care plan. You will also meet a nurse navigator who will be your go-to guide for resources, scheduling, communication with doctors and support. Then, while you are still at the clinic, the doctors get together and work out a plan for you.

By doing it this way, everything can be organized for you and you can rest in the fact that your treatment is in the hands of the region’s best experts who are supported by a global cancer network.

These multidisciplinary breast cancer clinics are available at HCA HealthONE Swedish, HCA HealthONE Centennial, a part of Aurora, and HCA HealthONE Sky Ridge. HCA HealthONE Mountain Ridge also offers a version of this program.

Call askSARAH at (303) 325-3225 to talk about connecting with a team of cancer doctors at a location near you.

Breast cancer specialists

This specialized team reviews your case to collaborate and develop a comprehensive care plan specific to you.

Members of our multidisciplinary breast care team include:

• Breast cancer nurse navigators
• Breast ultrasound technologists
• Digital mammography technologists
• Genetic counselors
• Medical oncologists
• Pathologists
• Radiologists
• Surgical oncologists

Treatment options for breast cancer

What methods we use for your treatment will depend on your overall health, the cancer's stage and the type of breast cancer. You will most likely receive a combination of treatments.

You'll also have access to additional services including targeted therapy and precise cancer staging with analysis of lymph node involvement, and complementary therapies like scalp cooling for hair loss prevention. The type of treatment that is right for you will depend on your specific diagnosis.

Radiation treatment

We offer advanced, specialized radiation treatment options for breast cancer. Your radiation oncologist will help determine which radiation therapy technique will be effective for your type of breast cancer.

Whole breast radiation therapy

This technique involves external beam radiation therapy that uses radiation from high-energy X-ray beams to kill cancer cells or slow their growth. This treatment covers the entire breast, as well as the chest wall and lymph node areas, as needed. Whole breast radiation therapy is typically completed during a period of six to seven weeks.

Prone breast radiation therapy

This form of radiation is performed while the patient lies face down on a specialized table fitted with a breast board to enhance comfort. Aside from the different positions, radiation then continues as normal.

Partial breast radiation therapy

This therapy uses external beam radiation targeting only the small area of the breast where a tumor has been surgically removed. Partial breast radiation therapies significantly reduce the amount of time needed to complete the treatment. They also help limit and prevent radiation exposure to healthy tissue and organs close to the breasts, including the lungs, heart, ribs, muscles and skin.

Accelerated partial breast irradiation

This is external or internal beam radiation targeting only the small area where a tumor has been surgically removed. This form of radiation is typically completed with five consecutive daily treatments.

Breast brachytherapy

This form of radiation treats breast cancer from within the breast where a tumor has been surgically removed.

Deep inspiration breath hold

This is a specific breathing technique used during radiation treatment. When a breath is taken in and held, it pulls the heart farther away from the chest. This is beneficial for patients with left-sided breast cancer and reduces potential damage to the heart caused by radiation exposure.

Hypofractionated radiation therapy

This radiation treatment uses higher doses over fewer sessions. It still destroys cancer cells and, for some people, may be used as a follow-up treatment.

Intraoperative radiation therapy

This treatment allows for the delivery of a concentrated, single dose of radiation delivered directly to the tumor site during breast cancer surgery. Typically, no further radiation therapy will be needed following intraoperative radiation therapy.

Medical oncology therapies

Our medical oncology specialists may use a range of treatment options depending on your breast cancer.

Chemotherapy

Chemotherapy is a type of treatment that uses a drug or combination of drugs to treat cancer. The goal of chemotherapy is to stop or slow the growth of cancer cells. These medications may be used in conjunction with other therapies to treat breast cancer.

Biological therapy/immunotherapy

These therapies use man-made proteins that are made from naturally-occurring organisms or those in a lab, to alter the growth and replication of a cancer cell by interfering with its specific biological pathways. This stops cancer from growing and spreading.

Hormonal therapy

The hormones estrogen and progesterone can stimulate the growth of some breast cancers—which are called hormone-sensitive or hormone-dependent breast cancers. Hormone therapy is used to stop or slow the growth of these tumors.

Surgical treatment options for breast cancer

If you have breast cancer, you may need some form of surgery based upon your cancer type and medical history. We provide surgical treatment options to remove as much breast cancer as possible, see if your cancer has spread, relieve symptoms of advanced cancer and restore breast shape after the cancer has been removed. We will help you understand all of your options so you and your surgeon can make the right choice for you.

Surgeries we offer to treat breast cancer include:

• Lumpectomy
• Lymph node removal
• Mastectomy
  • Double mastectomy
  • Modified radical mastectomy
  • Skin-sparing mastectomy
  • Simple mastectomy
  • Total mastectomy

Breast reconstruction after breast cancer surgery

Breast reconstruction surgery helps restore the shape of your breasts following a mastectomy or lumpectomy. Reconstruction may take place immediately following your surgery or years later. Not all women opt for reconstruction. Talk to your surgeon about reconstructive surgery before your mastectomy or lumpectomy to determine the treatment plan that is right for you.

Our surgeons perform many variations of breast reconstruction surgery, including:

• Breast implant removal
• DIEP flap
• Implant-based reconstruction
• Reduction lumpectomy free-flap reconstruction
• Transverse rectus abdominis (TRAM) flap reconstruction
• Latissimus dorsi flap reconstruction

For some, breast reconstruction surgery may occur at the same time as breast cancer surgery. This will depend on your individual risk factors and diagnoses.

Rehabilitation for breast cancer

We offer rehabilitation services for breast cancer patients. Rehabilitation focuses on specialized treatment protocols for patients after breast surgery, as well as during and following chemotherapy and radiation therapy. It also helps reduce symptoms that women may experience due to treatment. We also offer prehabilitation services to help you improve your functional capability before surgery or other procedures.

Features of our breast cancer programs

We provide individualized, innovative breast care and breast cancer services. Our care teams work individually with you to schedule consultations with specialists — such as breast surgeons, radiation oncologists and medical oncologists. They will discuss your diagnosis and collaborate to develop your individualized plan of care.

Breast tumor conference

Our breast tumor board meets weekly to discuss your treatment plan. This is central to your care and engages all disciplines to determine the best possible care plan for you.

Clinical trials

Our doctors remain on the forefront of breast cancer research, clinical trials and therapeutic and registry trials.

You can search for breast cancer trials on the Sarah Cannon website.

Complementary services and therapies

You benefit from a variety of additional services, including oncology rehabilitation, nutrition support, cancer exercise, acupuncture and assistance with cosmetic changes when dealing with hair loss.

Genetic counseling

To help you manage your breast health and detect cancer early, we meet with you for genetic testing and counseling and to discuss risk reduction strategies.

Nurse navigation

Specialized services in nurse navigation are at the heart of our breast cancer program. Our nurse navigators act as advocates, educators, support systems and connectors between you and your providers throughout the care journey.

Oncofertility

We have oncofertility experts who help you with fertility options when facing cancer-related and genetic risk-related infertility. We will develop an individualized plan of care that is based on type and extent of cancer.

Patient education

We educate you through many channels, including consults with our physicians, meetings with a nurse navigator and detailed patient guidebooks.

Second opinion services

We understand the importance of an accurate breast cancer diagnosis. For this reason, our breast program provides compassionate, thoughtful second opinion services. We work with you to help you understand all testing, results and treatment options.

Support services

There are many facets to the cancer journey, which is why we help patients by providing access to financial counseling, advanced care planning, social workers and support groups.

About HCA Healthcare Sarah Cannon Cancer Network

Fighting cancer takes a team

HCA Healthcare Sarah Cannon Cancer Network delivers you exceptional cancer care through cutting-edge, specialized treatments, multidisciplinary collaboration and care that is tailored to you. Our teams of passionate caregivers and global oncology experts across the United States and United Kingdom offer services and expertise that extend across many types of cancer. Together with the full support of HCA Healthcare – a leading provider of cancer care and research – we’re with you and your family from diagnosis through survivorship.

askSARAH helpline

Have cancer questions? We can help. askSARAH is a dedicated helpline for your cancer-related questions. Our specially trained nurses are available 24/7, and all calls are confidential. Contact askSARAH at (303) 325-3225.