Breast Cancer Treatment Approaches

City of Hope is at the forefront of breast cancer treatment. For women needing medical intervention, we take a comprehensive and aggressive approach to treatment offering state-of-the-art surgical, medical and radiation therapies, including many that are not yet available to the general public, and our supportive care and long-term follow-up programs help women and their families manage the process of treatment and recovery.
 
Surgery
City of Hope offers the latest advances in the surgical management of breast cancer provided by specialty-trained breast surgeons. The scope of surgery is determined by the size and extent of the breast cancer.
 
  • For patients with small tumors and early-stage breast cancer, breast-conserving surgery is a treatment option providing optimal cancer surgery while achieving excellent cosmetic outcomes. Our surgeons specialize in nipple-sparing mastectomies, in which the entire appearance of the breast is preserved. This technique can be used for appropriate patients with breast cancer or as “risk reduction” surgery in patients who are at very high risk for developing breast cancer.
  • For patients with larger tumors, chemotherapy can sometimes be given before surgery to shrink the tumor, which can help make breast conservation an option.
  • Patients who are not candidates for breast conservation or who elect to undergo a total mastectomy with removal of all breast tissue may still have reconstructive surgery, either immediately or at a later time.
 
Reconstruction can be performed either using implants or the patient’s own tissue during reconstructive procedures to create the most natural breast possible. Our surgeons also specialize in secondary reconstructive surgery when initial procedures prove unsatisfactory. A new method developed by the Breast Cancer Program at City of Hope to recreate the nipple and areola is providing better cosmetic results with minimal scarring.
 
Medical Oncology
Medicines that slow or stop the growth of cancer cells are often included in a patient’s treatment plan because these drugs travel through the bloodstream, and are able to kill any small cancer cells that have leaked into the blood that may eventually take root in other parts of the body. We offer the best treatments available and are constantly investigating promising new treatments, including novel chemotherapies, endocrine therapies, and immunotherapies to help save the lives of our patients.
 
  • Patients with small tumors or early-stage breast cancer may receive chemotherapy alone, neoadjuvant chemotherapy, which is treatment given before surgery to help shrink the tumor, adjuvant chemotherapy, which is additional treatment given after surgery to “mop up” microscopic disease, or hormonal therapies (medication given after surgery).
  • Patients with large primary tumors may be considered for neoadjuvant treatment. Patients with more advanced disease may also be candidates for new strategies developed to slow the spread of cancer. These may include combinations of standard drugs, investigational and targeted therapies or other options.
 
Radiation Oncology
Radiation therapy is often used in treating breast cancer. It may be employed as a stand-alone treatment for early stage cancer, or in combination with surgery and other treatments in more advanced cases, to help reduce the chance of the cancer recurring.
 
Radiation therapies available at City of Hope include advanced partial breast irradiation techniques. These focus radiation only on the affected area, rather than the entire breast. Radiation therapy is a standard part of treatment for patients who have a lumpectomy for small invasive breast cancers and non-invasive cancers. Some mastectomy patients may also receive radiation therapy. We also offer new investigational treatments for appropriately selected breast cancer patients.
 
  • External Beam Radiation Therapy
    External Beam Radiation Therapy is the most common form of radiation therapy, where radiation is directed at the tumor from outside the body.
  • Intensity Modulated Radiation Therapy (IMRT)
    IMRT targets tumors with pencil-thin “beamlets” of radiation. By sculpting the radiation to precisely match the tumor’s contours, a higher dose can be delivered to the cancer while avoiding unnecessary exposure of healthy tissues. Treatment with IMRT may also minimize certain side effects.
  • Intra-operative Radiotherapy (IORT)
    At City of Hope, we also offer appropriately selected breast cancer patients radiation therapy delivered in the operating room. We are one of a select number of cancer centers to provide IORT .  This advance enables many women to receive their entire course of radiation on the same day as their surgery, rather than stretching out radiation treatment over six to eight weeks. Learn more about IORT.