Getting regular screening tests is one of the best ways to lower your risk of breast cancer. Screening tests can find breast cancer early when it's most treatable.
One of the most important screening tests every woman should schedule is a mammogram. A mammogram is an X-ray of the breast. It is a safe, effective way to detect cancerous tumors and other abnormal breast conditions. Mammograms can locate a tumor before it can be easily felt and while it is easy to treat.
During a mammogram, a technician will X-ray each breast twice, once from above and once from the side. To do this, each breast must be compressed between two flat plates so an accurate image can be taken. This can be uncomfortable, but it only lasts a few seconds. If any abnormalities show up on the mammogram, a doctor may recommend more tests and maybe a biopsy (removal of a small amount of tissue) to check for cancer.
Mammography at Springfield Clinic includes both screening and diagnostic mammograms with CAD, MRI of the breast with CAD, and breast ultrasound.
Springfield Clinic Radiology offers state-of-the-art digital mammography.
- Lowest mammography radiation dose in the Springfield area
- Digital images for more accurate diagnoses
- Shorter exam times and faster results
- Images interpreted by Clinical Radiologists, SC
- Member of the National Consortium of Breast Centers
The visit to your breast surgeon will include a review of your pathology and mammogram results. At that time, the physician will explain a plan of care which will likely include either a lumpectomy or mastectomy with lymph node biopsy or lymph node removal.
There will be a lot of information given to you at this time and some decision making will be required on your part at this visit.
The following is a list of terms that you may hear at this appointment.
Sentinel Lymph Node Biopsy: A procedure in which dye is injected to identify the sentinel lymph node. This node would then be removed and checked for any evidence of cancer. At times there may be more than one node
Lumpectomy: A medical procedure in which only the tumor and a small section of normal breast tissue are removed, leaving the breast virtually intact.
Mastectomy: The surgical removal of a portion of or all of the breast.
Simple Mastectomy: The surgical removal of the breast tissue with the structures in the axilla (or armpit) undisturbed.
Modified Radical Mastectomy: The surgical removal of the breast tissue, and some lymph nodes under the arm and the lining of the chest muscles.
Radical Mastectomy: The surgical removal of the breast, all of the lymph nodes under the arm and lymph nodes under the chest muscles.
Questions to ask your Breast Surgeon:
- What kind of breast cancer do I have?
- Is there only one area or more than one?
- What does “grade” mean?
- What does “stage” mean? Can you tell from the biopsy report or will you wait for the pathology from surgery?
- What is the best approach to remove my cancer?
- If I have to have a mastectomy, am I a candidate for reconstruction?
- Do you remove any lymph nodes during surgery?
- What happens if cancer is found in my lymph nodes?
- How long does it take for the pathology to come back?
- Will I have a drain in after surgery? If so, how long does it stay in?
- What restrictions will I have after surgery?
- How long will I need to be off of work?
Breast reconstruction can be a very rewarding procedure for a woman who has lost her breast due to cancer or other conditions. The course of breast reconstruction may take a few weeks or up to several months and may entail more than one operation. Reconstruction may be done at the time of the mastectomy or at a later date. Many factors will be considered when choosing the type and timing of reconstruction such as:
- Stage of your tumor
- Need for postoperative chemotherapy or
- Other medical problems
- Medicines that you are taking
- Smoking, etc.
Essentially, there are three types of reconstruction: tissue expander/implant reconstruction, reconstruction using your own tissues or a combination of the two. Your surgeon will work with you to determine which type of reconstruction will be best for you.
Types of Reconstruction
Tissue Expander: This is an expandable shell that is placed under the chest muscle during surgery. Saline or IV fluid is injected into a port in the tissue expander every one to two weeks. The shell expands and allows your own tissue to expand and grow to accommodate a breast implant, similar to the gradual expansion of a woman’s abdomen during pregnancy. After expansion your chest may feel full or tight but that sensation usually subsides in 1-2 days. Expansion continues until the appropriate size is attained then removal of the tissue expander and placement of a permanent implant occurs. Alteration of the opposite breast to improve symmetry and nipple/areolar reconstruction may occur at this time as well.
Saline Implants: This type of breast implant has a soft shell and is filled with normal saline or IV fluid to create a breast.
Silicone Implants: This type of breast implant has a soft shell and is filled with silicone. Silicone implants today have changed immensely from the implants of the 1980’s and feel more natural than saline. Extensive research regarding the safety of silicone gel implants has occurred and based on those safety studies, silicone gel implants were approved by the FDA in November 2006.
Latissimus Dorsi reconstruction: This procedure takes tissue (skin, fat and muscle) from your back just below the shoulder blade and is tunneled to the chest to reconstruct the breast. A tissue expander or single staged implant may be required as well. This procedure may entail a longer hospital stay and a longer recovery period than the tissue expander alone.
TRAM reconstruction (Transverse Rectus Abdominis Myocutaneous Reconstruction): This procedure takes tissue (skin, fat and muscle along with its blood supply) from the abdomen and tunnels it into the chest to reconstruct a breast. This method will require a hospital stay and the recovery period is slightly longer than the latissimus dorsi reconstruction.
DIEP reconstruction (Deep Inferior Epigastric Perforator Reconstruction): This procedure moves tissue (skin and fat) with its blood supply and involves a microsurgical procedure but leaves the abdominal muscles intact. The Free TRAM or free muscle sparing TRAM are similar to the DIEP flap but varying amounts of muscle are taken as well as skin and fat. The operations require hospitalization and the recovery period is about the same as the TRAM reconstruction.
Much information will be given to you during your first visit. The plastic surgeon and his/her staff will be available to answer your questions to help you decide which treatment option would be best for you.
Your plastic surgeon will see you at regular intervals during your recovery to monitor your progress, answer your questions and provide you with support.
Questions to ask your Plastic Surgeon:
- What types of breast reconstruction are available?
- Which type would I be a candidate?
- Can reconstructive surgery be done at the same time as the mastectomy?
- Can reconstructive surgery be done at a later date if I don’t have it done with my mastectomy?
- Is reconstruction covered by my insurance?
- How long will I be in the hospital?
- Are there any long term considerations with breast implants?
- Do you have before and after photos of previous reconstructions?
Chemotherapy can be used to treat several types of breast cancer. In determining a treatment plan, your oncologist will take into consideration your type of breast cancer, the stage and whether or not it has positive or negative receptors for estrogen, progesterone or HER-2/neu. These factors affect the length of treatment as well.
Chemotherapy may cause you to lose your hair. Ask your oncologist if the type of chemotherapy you are going to receive will cause you to lose your hair. If it does you may want to obtain a wig before your treatment begins so you can match hair color and style. Some women prefer to go without a wig and wear a soft hat or turban.
This choice is a personal decision for you to make.
Your Energy and Appetite
If nausea or poor appetite becomes a problem you should let your physician know. As the chemotherapy works to rid your body of cancer cells it also takes a toll on your energy level and appetite. It is important for your immune system and energy level to keep a regular diet with healthy food choices.
Questions to ask Oncologist:
- Do I need to have genetic testing?
- Do I need to have chemotherapy?
- What side effects can I expect from chemotherapy?
- How many treatments will I need?
- How long will the treatments take?
- Are there other medications that are given with the chemotherapy?
- Will chemotherapy affect fertility?
- What follow up tests will I need after my treatments are finished?
Following mastectomy, lumpectomy or breast reconstruction, patients with breast cancer may benefit from physical therapy. Springfield Clinic Physical Therapy offers treatments including, but not limited to:
- Range of motion of the affected shoulder(s)
- Education regarding lymphedema identification as well as lymphedema precautions and treatment
- Scar mobility
- Postural correction
- Exercise prescription during and following cancer treatment
Impairments Associated with Cancer Treatment
Scar Adhesion - occurs after surgery
Therapy intervention can include:
- Scar mobilization
- Prevention of adhesions
- Manual stretching
Lymphedema – occurs after removal of lymph nodes
Therapy intervention can include:
- Manual lymphatic drainage
- Compression bandaging
- Skin care
Impairments Associated with Breast Reconstruction
- Scar adhesions or immobility
- Weakness of core muscles
- Shoulder impairments
- Back pain or instability
- Poor posture
- Therapy intervention can include:
- Scar mobilization and desensitization
- Strengthening of core muscles
- Active and Passive Range of Motion
- Postural correction and strengthening
Exercise during and following cancer treatment can be beneficial to your overall health and promotes:
- Physical function
- A decrease in fatigue
- Psychological well-being
- Prevention of nausea and weight gain
- Healthier lifestyle
Some types and stages of breast cancer will require radiation therapy.
This service is provided at Memorial Medical Center or St. John’s Hospital. The radiation therapist will review your reports and formulate a treatment plan. Your skin will be marked with a dye to ensure that the radiation is delivered to the exact area every time. It is important that you do not wash these markings off.
You will be given additional information by the radiation therapists concerning the skin markings, skin care and changes to the skin from radiation.
Radiation therapy treatments will usually take place 5 days per week for up to 6 weeks. The treatment does not take more than 30 minutes per day. It is important that you attend these appointments as they are scheduled.
Questions to ask about Radiation Oncologist:
- Why has radiation therapy been recommended as part of my treatment?
- How do you ensure the radiation targets the same area each time?
- How often will I have the treatments?
- What happens if my marks fade or wash off?
- What skin changes will occur and what do I need to do to care for the skin changes?
- Are there any short term side effects of radiation therapy?
- Are there any long term side effects of radiation therapy?
- Will I be able to drive myself to my treatments?
Some women undergoing chemotherapy treatment for breast cancer may experience a side effect of nausea and vomiting. Some will experience this despite the best anti-nausea medicine we have available.
Windie McKay, DC at the Springfield Clinic Chiropractic Department performs acupuncture treatments to help alleviate this undesirable side effect of chemotherapy. In many randomized trials of acupuncture combined with anti-nausea medications, the nausea and vomiting were significantly reduced.
Being diagnosed with breast cancer can be a stressful time. Multiple physician visits, surgeries and treatments can take a toll on your body. Sometimes it may be necessary to take a little time for yourself, to relax and begin to heal the mind, body and spirit.
The Springfield Clinic Chiropractic Department offers two licensed massage therapists. Springfield Clinic Chiropractic massage therapists may provide Neuromuscular Therapy. Neuromuscular Therapy is a style of bodywork that works with soft tissue targeted at specific points, often where trigger points have formed in the muscle. This treatment works to release the point of tension in the muscle.
Although it is not necessary to have a physician referral to see our Springfield Clinic Chiropractic specialists it is suggested that you obtain clearance from your physician prior to beginning any type of alternative or integrative therapy.