October is Breast Cancer Awareness Month but for women, awareness needs to be a year-round thing.
October is Breast Cancer Awareness Month but for women, awareness needs to be a year-round thing. Although the majority of breast cancers occur in women over 50, 9% of this year’s 255,000 cases will be in women in their 20s and 30s, according to the Centers for Disease Control. The importance of early detection cannot be over emphasized.
“I skipped my annual mammogram screening last year because of Covid,” said Willow Grove artist Yolanda Ward, 66. “When I went to the Women’s Center at Chestnut Hill Hospital this August, they saw something in my mammogram that required another screening. They explained that I have dense breasts which are more difficult to diagnose. After the second mammogram, they did an ultrasound. Something wasn’t right.”
Within days, the Women’s Center scheduled a consultation for Ward with Amanda Woodwarth, MD, FACS, Regional Director of Breast Services and surgeon at Chestnut Hill Hospital, who performed an outpatient biopsy. “I was diagnosed with breast cancer and could have gone to Fox Chase Cancer Center or Penn’s Abramson Cancer Center, but I chose Chestnut Hill Hospital because I have full confidence in their breast cancer team,” Ward said. Her next step will be treatment at Penn Radiology Oncology at Chestnut Hill Hospital. Ward was lucky. Her cancer was caught early.
Advances in breast cancer have reduced the need for mastectomy. “In addition to traditional mammograms, we have become much better with screening for breast cancers by using 3D mammograms, AKA tomosynthesis and MRIs for women who are at increased risk,” Woodworth said. “This catches cancers when they are much smaller and, if there is a small tumor, this typically does not require mastectomy.”
“When I am discussing treatment options with patients, the first thing I look at is the tumor size or span of disease to breast size,” said Woodworth. “If there is a relatively small tumor size to breast size, the patient is a great candidate for breast conservation therapy. If there is a larger size of a tumor or span of disease, the woman may be a candidate for breast conservation therapy by using the latest surgical technique called oncoplasty. This is using plastic surgery techniques to removed cancers and recreate the shape of the breast.”
“The next thing I look at is the patient’s genetics,” said Woodworth. “We are able to get genetic testing for most women who are diagnosed with breast cancer now. If they are found to carry a genetic mutation, this puts them at a very increased risk of developing a second breast cancer. While they are not required to have a mastectomy, many women may choose to have one at that point,” she said.
Only 10% of breast cancers are in women with genetic mutations; the majority are in women with no family history of breast cancer, all the more reason to get regular screenings and perform breast self exams.
“When Penn Radiation Oncology took over management of the radiation center at Chestnut Hill 19 years ago, they quickly expanded the facility and placed state-of-the-art equipment at Chestnut Hill,” said William T. Grizos, MD, Medical Director, Penn Radiation Oncology, Chestnut Hill Hospital. Members of his team include radiation therapists, a nurse skilled in radiation treatment, patient's service representative, social worker, and nutritional support.
“In the last several years, our technology has been replaced and upgraded including our CT scanning and imaging capabilities,” said Grizos. “The major benefit for our patients is that they can receive state-of-the-art cancer care in their community, minimize effects on their daily lives, and reduce the stress that cancer treatment may cause. They can continue to work and take care of their families without having to travel to Philadelphia for daily treatments and can be assured they are receiving the best care possible.”
“We are very focused on limiting potential side effects short-term and long-term. We are also reducing overall treatment times from six and half weeks to four weeks, so that the patients are finished sooner and can get on with their lives, while maintaining excellent cure rates,” said Grizos.
“The vast majority of breast cancer cases, from early stage to locally advanced malignancies, are generally treated with external beam radiation,” he said. “We provide 3D radiation therapy along with Intensity Modulated Radiation Therapy (IMRT). IMRT radiation is very precise and allows us to minimize radiation to uninvolved organs and maximize the radiation dose to cancer cells. By sparing normal structures, we are able to drastically reduce possible side effects of radiation treatment.”
Breast reconstruction may delay healing of tissues. “It is important before radiation is started to allow breast tissues enough time to heal, so that excellent results can be achieved with minimal side effects, and with long-term cosmetic results,” said Grizos.
Grizos also factors in other patient-related medical problems such as cardiovascular disease or diabetes, which may affect their response to treatment.
“A great advantage of being part of Penn Radiation Oncology is that we have access to incredible technology,” he said. “Penn is a leader in proton therapy and if the patient would benefit, we can get them evaluated with proton experts very quickly. If appropriate, they can receive the care at the Penn Proton Center, and after completion can continue follow-up locally in Chestnut Hill.”
Lower Your Risk
According to the National Breast Cancer Foundation, you can lower your risk of breast cancer by making healthy lifestyle changes:
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