Breast Cancer

We use 3D mammograms to effectively pinpoint the size, shape and location of potential breast abnormalities. Mammography is a detailed radiograph of the breast. It creates an image of the tissue inside the breast. Our care teams use mammography to identify lumps, tumors or other abnormalities that are too small to find by touch alone.

A screening mammogram is a routine test to look at breast tissue without any physical abnormalities or symptoms. This test can detect a cancerous or precancerous finding before a provider can find it during a clinical exam.

A diagnostic mammogram evaluates physical findings or symptoms that you or your doctor may have found. This test captures standard mammogram images as well as images focused on the area in question. To get a good picture, the imaging machine compresses the breast firmly to keep it from moving. In some cases, your care team may reposition your breast to take more pictures. If this occurs, don’t be concerned.

Some patients need other breast imaging tests, such as ultrasound or magnetic resonance imaging (MRI).

A breast MRI uses a powerful but harmless magnetic field to create an image of the body. This doesn’t involve X-rays or radiation. Your cancer care team may use this type of imaging in addition to mammography and ultrasound. If a breast MRI reveals an abnormality, your care team may recommend you have a focused ultrasound.

If your specialist can see an abnormality with ultrasound, they may perform a biopsy. If your specialist cannot see the abnormality with ultrasound, they may recommend an MRI-guided biopsy or other testing.

An ultrasound uses high-frequency sound waves to create pictures of the body. In some cases, the technician may perform ultrasound via the axilla (arm pit) to assess your lymph nodes. The ultrasound machine sends sound waves into your body and collects them after they bounce off tissues.

A computer collects these sound waves and creates an image of the tissues. Your radiologist then examines the images to determine the location and nature of abnormality.

A core biopsy is a minimally invasive procedure to determine the pathology (diagnosis) of an abnormality or finding from mammogram, ultrasound or MRI. A member of your care team uses a needle to get a small tissue sample. They then send the sample to the pathologist to examine it. Your care team will share the results of the biopsy within two to three business days.

Oncotype DX is a diagnostic tool that allows the medical oncologist to target therapy specific to your tumor and your needs. If you are sentinel node negative and have estrogen receptors in your tumor cells, your cancer care team may recommend this test. The oncotype DX test evaluates the 21 genes present in your cancerous tumor.

Your care team uses statistical methods to generate a recurrence score:

• If your recurrence score is low, you may only require endocrine therapy (Tamoxifen or Aromatase inhibitors). That’s because this treatment gives the greatest effect to reduce recurrence.
• If the recurrent score is high, your care team may recommend you have endocrine therapy plus chemotherapy. That’s because chemotherapy gives the greatest benefit, and adding endocrine therapy gives additional benefit.

Those who’ve had surgery (such as mastectomy) for breast cancer have many options for breast reconstruction. The best option for you depends on your personal medical history and preferences. Our plastic surgeon will work with our breast surgeons to coordinate your personalized surgical plan. Options include rearrangement of breast tissue, reduction in breast size and/or implant placement.

In addition to surgical treatment, having chemotherapy can help further decrease the chance of cancer returning in your breast or other areas of your body. There are certain drugs that our team considers to be standard for care. However, we offer clinical trials for those who meet certain criteria and wish to participate.

Our surgeons offer hidden scar surgery, an advanced approach to removing breast cancer or tissue at risk of breast cancer. The hidden scar approach allows your surgeon to make the incision in a location that is hard to see, so your scar is not visible when it heals.

Another prognostic test that we offer at BID Plymouth is growth factor receptor testing. If human epidermal growth factor receptor 2 (HER2) is present in the cancerous tumor, your care team may recommend targeted therapy using a new drug, Herceptin. Another name for immunotherapy is biological therapy.

Mastectomy with or without breast reconstruction is surgical removal of all breast tissue, including the nipple areolar complex.

Our care team typically uses radiation therapy along with breast conservation surgery. That’s because radiation therapy can help prevent cancer from recurring in the same breast.

Your care team may use sentinel node excision with either breast conservation or mastectomy procedures. Lymphatic mapping is a sophisticated method of identifying the first lymph nodes (usually 1-3) that drain the tumor. This is called the sentinel node. This procedure shows sentinel nodes in the axilla (arm pit) on the same side as the affected breast.

Your surgeon removes the sentinel node(s) and evaluates them at the time of the breast conservation surgery or mastectomy. A sentinel node that contains cancer cells indicates that your surgeon needs to remove more tissue. A sentinel node without cancer cells doesn’t require more extensive surgery.