Breast cancer: Personalized care tailored to your needs

• Benign: Normal breast tissue

• Atypical: Different from normal breast tissue but not cancerous

• Malignant: Cancerous cells
  

• In situ: Cancer cells are confined within the structures of the breast

• Invasive: Cancer cells have moved outside the structures of the breast (ducts and lobules) and into surrounding breast tissue

• Grade 1: Low grade, most like normal cells

• Grade 2: Medium grade

• Grade 3: High grade, cells are significantly different from normal cells

• ER positive: The cancer cells grow in response to estrogen

• PR positive: The cancer cells grow in response to progesterone

• HER2/Neu amplified: The cancer cells grow in response to human epidermal growth factor receptor proteins

The pathologist will review lymph nodes removed during a sentinel lymph node biopsy or an axillary dissection and will report the number of nodes found to have cancer cells.

This is also known as lumpectomy or partial mastectomy. It involves removing your cancer and some healthy tissue around it (to ensure a negative margin) while preserving your breasts shape and contour. Survival with this surgery is the same as surgery to remove your breast (mastectomy). The UW Health breast team uses oncoplastic techniques to ensure the breast has the best appearance after your surgery.

Factors we consider when deciding if you’re a good candidate include:

• The size of your cancer compared to the size of your breast

• Your preferences

• Your ability to safely receive radiation therapy after surgery if recommended

This is surgery to remove the whole breast. Occasionally, we can save the skin and nipple of your breast and you might choose to have breast reconstruction surgery at the time of your mastectomy.  You will be referred to one of our expert plastic surgeons to discuss the best options for reconstruction, tailored to you. 

A sentinel node surgery is done to look for cancer in the node (or nodes) where breast cancer cells that break away from a tumor are likely to travel to first. This sentinel nodal excision often takes place at the time of your breast cancer surgery. Surgeons locate your sentinel node by injecting a dye or dyes into your breast. They watch to see which nodes the dye reaches first. They then remove that node or nodes so pathologists can examine them for cancer. If they find cancerous cells, you may or may not need to have more lymph nodes removed. Most women only need two or three sentinel nodes removed.

This is a procedure that involves removing many lymph nodes from under your arm (typically more than 10, though the number can vary). This type of surgery is less common than sentinel lymph node surgery, but is the best option for some women who have many lymph nodes with cancer in them.

The DIEP flap procedure uses fat and skin from your lower abdomen to create a breast which is as natural looking as possible. It results in a “tummy tuck” at the same time. This reconstruction avoids using the muscle of your belly or rectus muscle to avoid damaging your core strength

We can rebuild your breast with implants filled with saltwater or silicone which may be placed behind or in front of your chest muscle/pectoralis muscle

Two-stage reconstruction: This involves first stretching the skin and muscles of your chest. We use an expander that’s like an implant, but it’s only temporary. Over time, we fill the expander with a saltwater solution though a tiny port beneath your skin. Once we reach your desired breast size, we remove the expander and place the implant.

One-stage reconstruction: With this procedure, we rebuild your breast without the expansion process.

This procedure involves tunneling muscle, skin and fat from your back under the skin near your armpit. We move it to the site of your mastectomy. There, we use the tissue to rebuild a natural-looking breast. We may also place an implant as part of this procedure.

After reconstruction, we offer procedures to make your breast look like it has a natural nipple and areola. The areola is the colored area of skin that surrounds the nipple.

Surgical nipple reconstruction: We usually do this procedure several months after breast reconstruction. It involves raising a flap of tissue on your new breast. The surgeon then shapes it to look like a nipple. Tattooing the area around the nipple gives it a more natural appearance.

Breast tattooing: Tattooing can be done after a nipple reconstruction to color the area of the areola. We also offer 3D tattooing, which can be done without a surgical nipple reconstruction.

After breast cancer surgery, one breast might have a different size and shape than the other. We offer procedures to lift your unaffected breast and reduce or increase its size. The goal is to help both breasts look similar.

If you’re considering reconstructive surgery, contact us to schedule an appointment with one of our surgeons.

This operation combines breast conservation therapy (lumpectomy and radiation) with a breast reduction. This operation is a safe method for reducing the size of the breast at the time of the lumpectomy. Advantages include obtaining symmetry prior to radiation therapy and relieving the symptoms of overly large breasts (back pain, shoulder pain, bra strap grooving, etc.).

These medications block or decrease levels of hormones that can spur cancer growth if your cancer is estrogen or progesterone sensitive or positive.

About one in five breast cancers depend on human epidermal growth factor receptor 2 (HER2) to grow. HER2 targeted therapies can help stop the growth of these cancers.

This class of medications is used in combination with endocrine therapy in certain individuals. They block a part of the cell cycle that is important for resistance to endocrine therapy.

This class of medications is used for the treatment of breast cancers which arise in those with BRCA1 or BRCA2 mutations.

This class of medications include the PD-1/PD-L1 inhibitors. They are currently only used for some individuals with triple-negative breast cancer.

UW Health providers are on the cutting edge of research and are evaluating through clinical trials new drugs for breast cancer.      

This treatment gives high doses of radiation to the cancerous area of your breast over a short period of time. It involves placing small, thin tubes called catheters directly into your breast. We then pass radioactive seeds or pellets into the tubes. They stay there for about 10 minutes before we remove them. In most cases, we do this treatment twice a day for five days.

This treatment involves delivering radiation from a machine. We aim the radiation so that it precisely conforms to the exact place your tumor was. This limits exposure to healthy nearby tissue.

We use this for breast cancer that hasn’t spread beyond your breast or nearby lymph nodes and that was treated by removing your tumor rather than your entire breast. It involves delivering radiation to your breast five days a week over three to four weeks.

IMRT delivers radiation from several different angles. We’re able to change the size, shape and strength of the beams. This helps us match the size, shape and location of the area we’re treating. It also helps us limit how much radiation the healthy tissue receives.

IGRT uses CT scans and MRIs to identify parts of the breast needing treatment. We offer this treatment with IMRT. It allows us to deliver radiation with great precision.

We provide this treatment while you lie on a table on your stomach. We aim the rays at your breast through an opening in the table. Prone breast radiation may be helpful if you have larger breasts. It can reduce radiation exposure to your heart and lungs. 

On these studies, you receive standard of care, but a sample will be collected or a test done such as a PET scan, biopsy or blood test.

As a major research center, we are testing the most recently discovered medications or new combinations of existing medications. These studies are offered most commonly offered in the setting of metastatic cancer.

On these studies, everybody gets the promising new surgery, medicine or radiation type in addition to the standard-of-care treatments.

All UW patients receive the best standard-of-care treatments. These trials test if the treatments can be improved by modifying one part of the treatment — adding, subtracting or replacing. For these studies, you and your provider will not select the treatment, but both will be scientifically and ethically reasonable, as judged by your provider and independent review teams.

Another research project is focused on people who live for years or decades with metastatic breast cancer. We are trying to learn how "outliers" survive and thrive even when the breast cancer is not cured. We are recruiting people with metastatic breast cancer to participate in this project. For more information, visit the Outliers website.

One of the most unpleasant side effects of cancer treatment can be hair loss. Hair loss is caused because chemotherapy targets quickly dividing cells, including hair cells.

At UW Health, we offer scalp cooling caps. These are silicone caps that are cooled to a very low temperature by using circulating cooling fluid. Worn during and after chemotherapy treatments, they reduce blood flow your hair follicles and can help reduce or prevent hair loss. Cooling caps can be used in cancer patients who have solid tumor cancers and are most effective for patients receiving taxane chemotherapy. Cooling caps cannot be used in patients with leukemia or for anyone who cannot tolerate extremely cold temperatures.

We work with Paxman Scalp Cooling to make cooling caps available to our patients receiving care in our Breast Center. If you are interested in cooling caps, please speak to your oncologist to see if cooling caps is an option for you. Our staff will work with you to schedule the equipment. You will then work directly with Paxman to complete sign-up and payment.

The UW Clinical Genetics Center helps people with concerns about their personal or family history of cancer. Counselors assess your risk and offer guidance on steps you and your family can take to protect yourselves.

Many women have sexual health concerns when they're dealing with cancer. The WISH Program offers support and can direct you to resources that can help.

After breast cancer treatment, you might wonder "What comes next?" and "How do I stay healthy?" The UW Health Breast Cancer Survivorship Program has answers to these and any other question you may have. Our goal is to give you suggestions for staying healthy — now and in the future.

This group is offered in Northern Illinois to provide ongoing support to patients diagnosed with breast cancer, patients currently undergoing treatment and patients who have completed treatment.

Educational topics could include lymphedema, reconstructive surgery, integrative health, psychological well-being and more. Educators will rotate and include nurse navigators and UW Health providers.

The group meets online starting at 5:30 p.m. on the third Wednesday of the month.

Ready to join us? Email jortgiesen@swedishamerican.org for your personal invitation.