“Breast cancer treatment is not ‘one size fits all.’ Every cancer is different, and with recent advancements in genetic testing and tumor pathology, we can tailor therapies to the biology of each woman’s individual cancer, which means better results and fewer treatment-related side effects.” Anthony Dragun, MD Board Certified Radiation Oncologist Floyd Memorial Cancer Center of Indiana Assistant Professor & Vice-Chairman of Radiation Therapy University of Louisville School of Medicine “There are many different combinations of drugs and therapies that can be utilized based on the type of breast cancer present and the patient’s personal preferences. Having a say in treatment choices makes women feel empowered during a time when everything else feels out of their control.” Yosoda Devabhaktuni, MD Board Certified Medical Oncologist/ Hematologist Floyd Memorial Cancer Center of Indiana
Watch Floyd Memorial’s Pink Glove Dance video in honor of breast cancer awareness. Visit floydmemorial.com/cancer to view.
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Individualized, Minimally Invasive Treatments Have Become Standard of Care for Breast Cancer At the Floyd Memorial Cancer Center of Indiana, our multidisciplinary team of breast cancer experts focuses on providing each patient with the most up-to-date, advanced care available. From diagnosis in our Women’s Imaging Center, an American College of Radiology Breast Imaging Center of Excellence, to surgery, treatment and rehabilitation in a comprehensive program that is on its way to becoming the first American College of Surgeons’ Nationally Accredited Breast Center in Southern Indiana, patients who choose Floyd Memorial for their breast cancer care are in great hands. Treatment planning with a multidisciplinary panel of experts At Floyd Memorial, a multidisciplinary panel of breast cancer experts review cases and make treatment recommendations for every breast cancer patient. This gives patients access to input from multiple specialists at one time, simplifying the treatment planning process, and providing several viable options to choose from, each tailored to their unique needs. It includes representation from: • Medical oncologists • Radiation oncologists • General surgeons • Plastic and reconstructive surgeons • Pathologists • Radiologists • Physical therapists • Dietitians • Social workers • Oncology nurses • Diagnostic imaging technologists Minimally invasive breast conservation surgery Julie Hutchinson, MD, board certified general surgeon with Floyd Memorial Medical Group-Surgery, explained that utilizing minimally invasive surgery whenever possible is the standard of care for breast cancer today. “Breast conservation surgery is the best option we can offer for patients with early stage, non-aggressive breast cancer. It’s the least invasive approach with a shorter, less painful recovery while still achieving a symmetrical, pleasing cosmetic result,” said Dr. Hutchinson. She continued, “There are a lot of myths out there about breast conservation (lumpectomy), versus total breast removal (mastectomy). Many women think that
their breasts will no longer be symmetrical after lumpectomy, but we actually incorporate some aspects of plastic surgery into the procedure, such as re-centering the breast and the nipple to ensure that the breasts still align well.” “The biggest myth that I encounter is that choosing lumpectomy over mastectomy means there’s more of a chance the cancer will come back,” added Dr. Hutchinson. “This is not true. Recurrence rates for lumpectomy with subsequent radiation therapy are equivalent to mastectomy. And just because mastectomy is chosen doesn’t mean radiation won’t be necessary. It depends on the size of the tumor and the number of lymph nodes involved. I would encourage anyone who is facing breast cancer surgery to consider all of their options before deciding on breast conservation or removal. I see a lot of patients who have their mind set on mastectomy before knowing the particulars of their specific cancer, and it leads to unnecessarily invasive procedures and long recoveries.” Shortened radiation treatment timeframes are another trend making lumpectomy an excellent choice for women today. Anthony Dragun, MD, board certified radiation oncologist with the Floyd Memorial Cancer Center of Indiana, noted, “The rationale behind the push for early detection in breast cancer is to give women options for treatment that leave as little of an impact on their body as possible. Long-term evidence shows that the overwhelming majority of women diagnosed with early stage breast cancer will not have a recurrence with lumpectomy and radiation. With advancements in radiation technology such as Floyd Memorial’s newest linear accelerator, we can reduce treatments from six weeks to as few as possible, making it more tolerable and accessible to patients.”
“It is a myth that having a mastectomy eliminates the chance of recurrence while lumpectomy does not. Studies show that cancer is no more likely to come back in patients who have undergone lumpectomy with radiation than in patients who have had total mastectomies. They are equivalent treatments.” Julie Hutchinson, MD Board Certified General Surgeon Floyd Memorial Medical Group-Surgery
Genetic analysis leads to more targeted treatments and reduced recurrence rates Tailored therapy based on the biology of each woman’s individual cancer is the new standard in breast cancer treatment today. Genetic analysis of tumors allows for tailoring of chemotherapy and radiation therapy based on the genetic makeup of the tumor and the level of aggressiveness that the makeup is known to demonstrate. As Dr. Dragun explained, “Two of the biggest issues in the battle against cancer are over treatment and under treatment. When you don’t know how the cancer will behave, you risk giving patients with aggressive cancer too little treatment, or those with slow-growing disease too much. Genetic analysis gives us a window into the biology of each patient’s specific disease, so that we can tailor their treatment to exactly what’s needed.” Yasoda Devabhaktuni, MD, board certified medical oncologist/hematologist with the Floyd Memorial Cancer Center of Indiana,
added, “Systemic treatment after breast cancer surgery, be it a lumpectomy or mastectomy, benefits some patients in terms of decreasing the chance of cancer recurrence. Breast cancer has a wide range of pathology and there is no one chemotherapy that fits all patients. Knowing the tumor’s genetic makeup allows us to make treatment decisions and gives the woman help making informed decisions as well.” She continued, “Through pathological and genetic testing we can determine if the cancer is hormone receptor positive or was growing independent of hormones. After systemic chemotherapy some patients will benefit from anti-hormonal treatment for a total of five to seven years. Anti-hormonal treatment is the standard, but choosing systemic chemotherapy treatments involves putting together multiple factors before deciding if the patient will benefit from treatments, and there is no ‘one treatment fits all’ approach in this setting.”
Schedule Your Mammogram at Floyd Memorial’s Women’s Imaging Center The Diagnostic Breast Center is open extended hours with evening and Saturday appointments available. Call (812) 949-5570 for an appointment.
Services offered include: • Digital mammography featuring complimentary soft mammopads • Breast MRI • Stereotactic breast biopsy
Breast Cancer Nurse Navigator Guides Patients Along Path to Recovery No one should fight cancer alone. And at the Floyd Memorial Cancer Center of Indiana, our breast cancer nurse navigator is right by your side through the entire journey. Her services are offered free of charge, she can help you ask the right questions and more importantly, remember and understand the answers. She’ll help you develop a treatment plan that you feel comfortable and confident with. And then she’ll take care of all the details, like coordinating appointments and explaining procedures and treatments. So you can focus on getting well, not making to-do lists.
“Breast cancer treatment can be very involved and overwhelming. My goal is to be my patients’ advocate and point person from the moment of diagnosis, so they never feel lost or unsure of their next step. Knowing someone is there to help guide them along the way is important, because they should be focused on winning the battle, not fighting it.” Kristy Helm, RN, OCN, Breast Cancer Nurse Navigator Floyd Memorial Cancer Center of Indiana
• Ultrasound guided breast biopsy • F irst in Southern Indiana to be recognized as an American College of Radiology Breast Imaging Center of Excellence
Breast cancer patient Lori Fitzsimmons and Breast Cancer Nurse Navigator Kristy Helm, RN, OCN, discuss treatment options.
Mastectomy vs. Lumpectomy: Which is the Best Decision for You? Mastectomy Lumpectomy Aggressive breast cancer
Non-aggressive breast cancer
Advanced disease with multiple tumor sites in breast
Early stage disease with one tumor site
Large tumor size
Small tumor size
Two to three surgeries with inpatient hospital stays
One outpatient surgery
Total surgical and recovery timeframe of eight to 12 months with possible concurrent radiation therapy depending on lymph node involvement
Two to four week surgical recovery followed by one to six weeks of radiation therapy
Major invasive surgery
Minimally invasive surgery 7