Breast Cancer Quality Indicators
Multiple Treatment Options
Breast cancer treatment can be complex and requires close communication and coordination among highly-trained multispecialty team members. Guidelines published by the National Comprehensive Cancer Network (NCCN) state that there are a variety of treatments and that patient participation is a major part of the decision-making process (2007: Breast Cancer NCCN Clinical Practice Guidelines for Patients).
Treatment decisions for breast cancer are based on the presence of metastases (cancer spread), involvement of axillary lymph nodes, characteristics of the primary tumor, patient comorbid conditions, patient age and menopausal status, and hormone receptor status (ER, PR, and HER2/neu) (2007: Breast Cancer NCCN Clinical Practice Guidelines for Patients).
The American Cancer Society states that most women with breast cancer will have some type of surgery. The type of surgery and/or other treatments should be made after careful consideration and education. Types of surgical treatments for breast cancer include: lumpectomy, breast-conserving surgery (lumpectomy and radiation therapy), mastectomy (partial or skin-sparing), and lymph node removal. In addition, women may decide to have breast reconstruction at the same time as the mastectomy, or at a later time (2007: Breast Cancer NCCN Clinical Practice Guidelines for Patients).
Breast conserving surgery (BCS) with radiation (BCSR) requires a collaborative effort between surgeons and radiation oncologists. Studies have demonstrated the role of multidisciplinary consultation in the decision to use BCSR and other treatment options (Cancer, February 2004: 100(4); 701-709).
Does UVa offer multiple treatment options to women diagnosed with breast cancer?
Yes. Our board-certified surgeons have specialty training in breast surgery and are committed to providing the latest and most proven treatment and reconstruction options. These include: sentinel node biopsy; lumpectomy; partial, modified or radical mastectomy; and breast reconstructive and plastic surgery.
For select patients with or at-risk to have an inherited susceptibility to breast and other cancers, the proven or suspected genetic status may also govern treatment decisions.
