Breast Cancer Treatment

Radiation Therapy for Breast Cancer

Hypofractionated (shorter) courses of external beam radiation therapy are more convenient, equally effective, and have less skin toxicity than traditional courses of conventionally fractionated radiotherapy (six to seven weeks). For patients requiring whole breast radiotherapy, we routinely offer three to four weeks of hypofractionated treatment. For patients with small, lymph node negative breast cancers, we offer accelerated partial breast irradiation (APBI) which can shorten the duration of radiation to just five days.

Our Radiation Oncology team utilizes a radiotherapy technique specifically for patients with left-sided breast cancer where radiation delivered to the heart is a major concern. The Deep Inspiration Breath Hold technique requires patients to hold their breath as the chest is expanded and the heart is pushed down and away from your chest wall. This process helps to minimize the dose of radiation to your lungs and heart during your daily treatment. Deep Inspiration Breath Hold is the most efficient way to minimize this risk.

Learn more about radiation oncology at Hollings.

Surgery for Breast Cancer

The team at Hollings includes surgeons who specialize in breast cancer. Most treatment plans for breast cancer will include surgery of some type. Your doctors will work with you to determine the surgery that will be most effective for your situation and that you will be most comfortable with. Some options include:

Lumpectomy

A lumpectomy is surgery to remove the tumor and some of the surrounding tissue. There are three ways this can be accomplished:

Seed localization. A magnetic “seed” — really a stainless-steel device about the size of a grain of rice — is placed at the tumor or lymph node as a marker for the doctor during surgery. The seed can be placed ahead of time.
Wire localization. A small wire is threaded into your breast to mark the tumor or lymph node. The wire extends outside of your breast, so this procedure is performed the same day as surgery.
Non-localized. If the tumor is palpable — the surgeon can feel it with her fingertips — then a lumpectomy could be done without a marker.

Mastectomy

A mastectomy is the total removal of the breast. There are a few ways this is done, depending on the specifics of your cancer and whether you would like breast reconstruction after treatment.

Complete mastectomy. This option removes the nipple, areola (the colored area around the nipple) and all the extra skin. With this option, our fellowship-trained breast cancer surgeons and plastic surgeons work together in the operating room. After the breast surgeon performs the mastectomy, the plastic surgeon will create a smooth, flat closure.
Skin-sparing mastectomy. This option removes the nipple and areola but leaves extra skin to make room for breast reconstruction.
Nipple-sparing mastectomy. This option leaves the nipple and areola as well as extra skin for breast reconstruction. Here again, the breast surgeons and plastic surgeons work together, with the breast surgeon performing the mastectomy and the plastic surgeon performing a nerve graft to improve nipple sensation after surgery.

Sentinel Lymph Node Procedure

If you have an invasive breast cancer (the cancer has started to spread beyond the original site), then a sentinel node procedure might be appropriate. Because cancer can spread through the lymphatic system, this procedure looks for and removes the lymph node that’s at greatest risk of having cancer. This procedure is done at the same time as surgery to remove the cancer.

Hidden Scar©

This is a minimally invasive option to leave the smallest possible scar. It can be an option for lumpectomies or mastectomies, depending on the specifics of your cancer. We have a Hidden Scar-certified surgeon who can perform your surgery.

Learn more about surgery at Hollings.

Breast Reconstruction

The MUSC Health Advanced Breast Reconstruction Program provides expert care and multiple options after your surgery to remove the cancer.

Flap procedures: MUSC Health surgeons offer DIEP, TRAM and LD flap procedures. These procedures take tissue from another part of your body, like your belly, and rebuild your breasts.
Lymphedema microsurgery: Fellowship-trained plastic surgeons who specialize in microsurgery and supermicrosurgery can perform lymphoveneous bypass or lymph node transfer to help ease lymphedema, a painful swelling of the lymphatic system that can sometimes happen after breast surgery.

Chemotherapy for Breast Cancer

Chemotherapy drugs destroy cancer cells. Chemotherapy might be given before surgery, to shrink a tumor; after surgery, to kill any remaining circulating cancer cells that are too small to see; or instead of surgery.

Chemoprevention means taking chemotherapy drugs as a way to prevent cancer before it starts. This option is for women who are at high risk for breast cancer.

Immunotherapy for Breast Cancer

Immunotherapy helps your immune system to fight cancer. Cancer cells can prevent T-cells, part of your immune system, from doing their job. Immune checkpoint inhibitors prevent the cancer cells from suppressing T-cells. This type of therapy is approved for certain types of breast cancer.

Targeted Therapy for Breast Cancer

Targeted therapies are drugs that seek out a specific receptor, protein or other marker on the cancer cells. Your doctor will test your cancer tissue to see if it has any of the markers for which targeted therapies exist.

Hormone Therapy for Breast Cancer

Hormone therapy for cancer will block your body from producing hormones or interfere with how hormones act in your body. For cancers that feed off hormones to grow, hormone therapy can shrink a tumor before surgery, reduce the chances that a cancer will return or treat advanced breast cancer.