The Breast Cancer Program at CentraState Medical Center in Freehold offers state-of-the-art services, expertise, and technology for detecting, diagnosing, treating and helping patients recover from breast cancer. Because our focus is on the whole patient, not simply the disease, we also offer guidance on maintaining breast health, screenings to detect cancer early, and complementary therapies to support self-healing and emotional well-being for those who are undergoing treatment.
Our multidisciplinary, integrated approach assures patients and their family’s continuity of care and the convenience of finding everything under one roof in the friendly, attentive environment of a community-based medical center. Because our focus is on the whole patient, not simply the disease, we also offer guidance on maintaining breast health, screenings to detect cancer early, and complementary therapies to support self-healing and emotional well-being for those who are undergoing treatment.
The Breast Cancer Team
The breast cancer team is led by an outstanding group of board-certified physicians specializing in surgery, radiation oncology, and medical oncology. Trained at leading academic medical centers, these doctors combine their expertise to evaluate and treat all stages of the disease. The team also includes Magnet-designated nurses credentialed in chemotherapy and certified in cancer care and other professionals focused on patients’ physical, emotional and spiritual needs.
Acute Diagnosis and Staging of Breast Cancer
If screening tests indicate that you could have cancer, the next step is to have a biopsy. During this test, cells from the area of concern are removed so they can be studied in the lab. There are several types of biopsies. Your physician will determine which one is best for you. Biopsies are performed at CentraState’s Women’s Health Center by specially trained radiologists or surgeons and an all-female team of nurses and clinicians.
- Stereotactic Needle Biopsy (STNB)—STNB is a core biopsy that uses X-rays and computer coordinates. It offers a groundbreaking alternative to standard, open surgical biopsy. STNB procedures are performed in an outpatient setting using local anesthesia. During this procedure, small samples of tissue are removed for analysis using a hollow needle. This revolutionary diagnostic procedure is less invasive, less painful, and less costly than traditional surgical biopsy.
- Breast Needle Localization—Prior to surgery, a radiologist localizes the area in the breast to be biopsied by inserting a guidewire. The guidewire "hooks" around the area to be biopsied. The patient is then immediately transported to the Operating Room, where the surgeon makes an incision following the guidewire and accurately excises the targeted tissue.
- Ultrasound-Guided Breast Biopsy—This type of biopsy is useful when suspicious changes are detected through mammograms and ultrasounds, but no abnormality can be felt during an exam. The minimally invasive procedure involves no exposure to radiation, is performed in an outpatient setting, and takes less time than a traditional surgical biopsy.
- Sentinel Lymph Node Biopsy—A sentinel lymph node biopsy is a way of pinpointing the first few lymph nodes into which a tumor drains (called the "sentinel" node.) This helps doctors remove only those nodes that are most likely to contain cancer cells since the sentinel nodes are the first place cancer is likely to spread. This may help to alleviate the need for additional nodes to be removed if the sentinel node is negative.
Lab results are analyzed to determine if the tissue is benign (non cancerous) or cancerous. If it is cancer, then the biopsy can help to tell what type of cancer it is and whether or not it is invasive. Other clinical tests may be needed to determine the stage (extent) of the cancer. For example, is it confined to the breast or has it spread. Once the stage is determined, an appropriate treatment plan can be developed.
Individual Breast Cancer Treatment Options
Each patient receives an individualized treatment plan developed by the breast cancer team. The plan is based on your unique age, life expectancy, health status, lifestyle and personal preferences; the severity of the breast cancer and whether it is a recurrence of a pre-existing cancer; and the potential complications or side effects of each therapeutic approach.
The Breast Cancer Program offers these leading treatments for breast cancer: surgery, radiation therapy, and chemotherapy.
Breast Conserving Surgery
- Lumpectomy: This surgery removes only the breast lump and some normal tissue around it.
- Partial (segmental) mastectomy or quadrantectomy: This surgery removes more of the breast tissue than a lumpectomy.
Radiation treatment is usually given after both of these surgeries. If chemotherapy is also going to be used, the radiation may be put off until the chemo is finished. Also, in both lumpectomy and partial mastectomy, if cancer is found at the edges of the tissue that was removed, the surgeon may need to go back and take out more tissue.
For most women with stage I or II breast cancer, breast-conservation therapy (lumpectomy/partial mastectomy plus radiation therapy) works as well as mastectomy. Survival rates of women treated with these two approaches are the same.
Mastectomy is surgery to remove the entire breast. All of the breast tissue is removed, sometimes along with other nearby tissues.
- Simple (also called total) mastectomy: In this surgery, the entire breast is removed, but not the lymph nodes under the arm or the muscle tissue beneath the breast. Sometimes both breasts are removed. For some women who are planning on having reconstructive surgery right away, a skin-sparing mastectomy can be performed. In this procedure, most of the skin over the breast (other than the nipple and areola) is left intact. This can work as well as a simple mastectomy. Although this approach has not been used for as long as the more standard type of mastectomy, many women prefer it because there is less scar tissue and the reconstructed breast seems more natural. Another option for some women is the nipple-sparing mastectomy. This procedure is more often an option for women who have a small early stage cancer near the outer part of the breast, with no signs of cancer in the skin or near the nipple.
- Modified radical mastectomy: This surgery involves removing the entire breast and some of the lymph nodes under the arm.
- Radical mastectomy: This is a major operation where the surgeon removes the entire breast, underarm lymph nodes, and the chest wall muscles under the breast. This surgery is rarely done now because modified radical mastectomy has proven to work just as well. It may still be done for large tumors that are growing into the muscles and under the breast.
- Reconstructive or breast implant surgery: After having a mastectomy (or some breast-conserving surgeries) a woman may want to have the breast mound rebuilt. These operations are done to restore the way the breast looks. If you are having breast surgery and are thinking about having breast reconstruction, you should talk to a plastic surgeon before your operation.
Radiation Therapy for Breast Cancer
Radiation therapeutic approaches for breast cancer include:
Radiation therapy is administered by CentraState’s Radiation Oncology Department.
Chemotherapy for Breast Cancer
Chemotherapy uses medicines that kill or halt the growth of cancer cells. This approach is generally used in three ways:
- Adjuvant chemotherapy: Chemotherapy is given to patients after surgery whose cancer does not appear to have spread.
- Neoadjuvant chemotherapy: Chemotherapy is given to patients before surgery to help shrink large cancers so they are small enough to be removed by lumpectomy instead of mastectomy.
- Chemotherapy for advanced breast cancer: Chemotherapy can also be used as the main treatment for women with cancer that has already spread outside the breast and underarm area at the time it is found, or if it spreads after the first treatments.
Chemotherapy is offered through CentraState Medical Center’s Pharmacy Department and administered by Magnet-designated nurses credentialed in chemotherapy and certified in cancer care.
Chemotherapy infusion treatment is offered at the Jean Mehr Infusion Therapy Center located in CentraState’s Medical Arts Building.
Some patients may be eligible to participate in clinical trials in which they receive an emerging breast cancer treatment before it becomes publicly available
Complementary, Supportive Services
Patients may find dealing with the emotional and physical effects of breast cancer to be stressful, even isolating. To help them cope, we offer an array of supportive services such as wellness programs and support groups.