Breast Cancer

Multidisciplinary tumor review board

When you are facing a breast cancer diagnosis, you can be assured that multiple specialists are looking at your case. Our multidisciplinary tumor review board brings together experts to collaborate on the treatment plan. This includes not only medical doctors, but also our nurse navigators, representatives from the Clinical Trials Office and genetics specialists.

The board discusses every breast cancer patient at Hollings at diagnosis. The board may also return to review a case after surgery and collaborate on a post-operative treatment plan.

Second opinions

Hollings offers the same high-quality services to people seeking second opinions about their treatment plan, including an assessment by the multidisciplinary tumor review board.

Genetic testing

Every woman who receives a breast cancer diagnosis at Hollings will receive genetic testing. There are many gene mutations known to be associated with breast cancer, although BRCA1 and BRCA2 are probably the best known. Having a gene mutation will affect how your doctor approaches the treatment plan. And if you do have a genetic mutation, we will recommend that family members (sisters, brothers, cousins, etc.) also get genetic testing and counseling. You will also be referred to the Hollings Hereditary Cancer Clinic for comprehensive follow-up to reduce future risk.

Fertility preservation

Chemotherapy can cause infertility, which can be temporary or permanent. If you want to become pregnant in the future and have been diagnosed with breast cancer, our doctors can connect you with fertility specialists who will help you to preserve your eggs before beginning treatment.

Our innovative researchers make groundbreaking advances in the fight against breast cancer that help save lives around the world. Areas of focus for our researchers include improving breast cancer prevention measures, developing new surgical techniques, and reducing health disparities.

Recent projects include:

• Discovering one way that triple-negative breast cancer becomes resistant to immunotherapy and testing methods to restore the effectiveness of immunotherapy.
• Testing whether targeting a specific protein could restore effectiveness of an antibody drug conjugate after the cancer has developed resistance.
• Working with community health workers to expand awareness and understanding of genetic testing to see if people have a higher likelihood of developing breast or ovarian cancer.
• Providing breast cancer patients with Boswellia extract as an oral supplement prior to surgery to see whether it has anti-tumor effects.

In addition, Hollings’ dedicated Breast Transdisciplinary Cancer Team brings together expertise from different disciplines in basic and clinical research for monthly meetings to collaborate on ongoing breast cancer research.

As South Carolina’s only NCI-designated cancer center, Hollings offers you clinical trials and treatments that aren’t available anywhere else in the state. These opportunities provide you with access to the latest medications, therapies, and surgical techniques that can improve your outcomes. Learn more about clinical trials at Hollings and see our current breast cancer clinical trials.

Breast cancer is generally defined by a scale of five stages:

• Stage 0 breast cancer. Stage 0 is a precancerous condition. You will probably be told that you have ductal carcinoma in situ, or noninvasive breast cancer. This means that cancer cells haven’t started to spread into nearby tissue.
• Stage 1 breast cancer. At this stage, the cancer has started to spread outside of the original site but remains small. It’s contained within either the lymph nodes or tissue in the breast.
• Stage 2 breast cancer. The cancer is larger and may be spreading into the lymph nodes.
• Stage 3 breast cancer. The cancer is now considered advanced. The tumor may have grown to the size of a small lime with cancer in the lymph nodes; the cancer may now be in the chest wall or skin; or the cancer may have spread to lymph nodes near the collarbone, breast bone or underarm area.
• Stage 4 breast cancer. This is also called metastatic breast cancer. The breast cancer has spread to other organs or tissues, like the brain, bones, lungs or liver.

Sometimes women don’t have any symptoms of breast cancer, which is why Hollings recommends annual 3D screening mammograms beginning at age 40 for women at average risk. Women who are at higher risk might need to begin screenings earlier or get screened more frequently. However, if you have any of the following symptoms, you should talk to your doctor:

• A lump or thickening in the breast or near the armpit
• Breast swelling or shrinking
• Red, flaking or dry skin
• Nipple or breast pain
• Nipple discharge
• New inverted nipple
• Skin puckering or dimpling

The five-year survival rate for breast cancer is more than 90%. That means that nine out of 10 women diagnosed with breast cancer will still be alive five years after their diagnosis.

Survival rates depend on the stage when the cancer was found and the type of breast cancer. Some types are more aggressive and have lower survival rates.

Women who are at average risk of breast cancer should get a 3D screening mammogram every year beginning at 40 years old. You can make an appointment for a 3D mammogram at MUSC Health yourself; you do not need a referral.

Women who are at higher risk for breast cancer might need screening at younger ages, more frequently or with different imaging techniques. Some high-risk factors include a family history of breast cancer or having gene mutations associated with breast cancer. Talk to your doctor about whether you should be referred to our High-Risk Breast Cancer Program.

It depends! If you still have breast tissue, then you still need annual screening mammograms. If you’ve had a mastectomy and no longer have breast tissue, you will still need regular follow-ups.

Doctors don’t usually talk about cures. Instead, they’ll say they want to get you to the point where there is “no evidence of disease.” In everyday terms, the majority of women diagnosed with breast cancer are still alive 10 years after diagnosis.

Breast cancer can occur in adults of any age. Most people diagnosed with breast cancer are between the ages of 65 and 74. Women at genetic risk or with a family history may be diagnosed at younger ages.

Some drugs to fight breast cancer are designed to interact with specific proteins or receptors. When someone is diagnosed with breast cancer, the cancer cells are checked for these proteins and receptors. Triple negative breast cancer doesn’t have estrogen receptors, progesterone receptors or the HER2 protein, so it tests negative for all three things.

Triple negative breast cancer tends to spread more quickly and is more difficult to treat.

About 5% to 10% of breast cancer cases are because of an inherited gene mutation.

People with certain inherited gene mutations, like the harmful BRCA1 and BRCA2 variants, have a much higher risk of developing cancer than people without those mutations. Genetic testing can tell you if you have those harmful variants, and the Hollings Hereditary Cancer Clinic can help you to decide on a monitoring and treatment plan.

Some breast cancers are caused by harmful genetic mutations. Most of the time, though, we don’t know exactly what caused a cancer.

We know that there are risk factors that contribute to breast cancer — like being overweight after menopause, being over the age of 55, having a family history of breast cancer or having dense breast tissue — but none of those risk factors means that you will automatically have breast cancer.

However, you can take action on the risk factors that you can control, like being physically active and maintaining a healthy weight, and you can make sure to get a 3D screening mammogram every year. Annual mammograms should start at age 40 for average-risk women. Women who are at higher risk might need to begin screenings earlier or get screened more frequently. Cancers that are caught early are more easily treated, and if you are otherwise healthy when you start cancer treatment, you’re likely to tolerate the treatment better.