Breast Cancer Care

Advanced axillary surgery techniques can be used to prevent the accumulation of lymphatic fluid (lymphedema) that leads to swelling. Two such procedures are reverse lymphatic mapping, which allows surgeons to identify lymph nodes that can be preserved during surgery, and lymphovenous bypass surgery, which enables surgeons to reestablish lymphatic drainage.

Aesthetic flat closure mastectomy is a surgical technique in which breast skin and fat are rearranged after a mastectomy, resulting in a smooth, flat, chest-wall contour. This can be performed at the time of mastectomy, or later.

Axillary lymph node dissection involves the surgical removal of groups of lymph nodes under the armpit and examining them to determine whether cancer is present.

Excisional breast biopsy is a surgical procedure to diagnose breast cancer. A suspected tumor or abnormality is completely removed from the breast and tested for cancer cells.

Excisional breast biopsy using targeted localization techniques uses tools or instruments to help the surgeon identify the exact location of a growth or abnormality before removing it entirely. The tissue is then tested for the presence of cancer cells.

Lumpectomy, also known as partial mastectomy, is a procedure in which only cancerous tissue is removed from the breast. This option allows the patient to keep most of their breast.

Mastectomy with immediate reconstruction is a surgical procedure that involves removing and reconstructing the breast during the same procedure. Surgeons may use an implant or tissue from another area of the body.

Nipple-sparing mastectomy is a surgical procedure that removes breast tissue underneath the nipple and areola but leaves those areas and the surrounding skin intact.

Oncoplastic lumpectomy is a surgical procedure that involves removing a tumor in the breast while making the result look as natural as possible. Surgeons may move tissue or perform other cosmetic procedures to hide the visible effect of the surgery.

Sentinel lymph node mapping and biopsy is a minimally invasive procedure that involves the use of a mapping technique to identify and remove the first lymph node(s) to which cancer cells are most likely to have spread from the primary tumor.

Skin-sparing mastectomy is a surgical procedure in which the skin of the breast is left intact, but all breast tissue, including the nipple and sometimes the areola, is removed.

Risk-reducing mastectomy is a mastectomy that is performed to prevent breast cancer from developing in patients with a higher-than-average risk of the disease. In some cases, the nipple and areola may be retained for breast reconstruction.

Total mastectomy is a surgical procedure to remove all breast tissue, including skin, nipple and areola.

Active Breathing Coordinator™ (ABC) is a radiation therapy support system that turns the radiation beam on and off in response to the breathing cycle of the patient for optimal treatment.

Accelerated partial breast irradiation (APBI) is a localized radiation therapy to kill cancer cells that may have been left behind following a lumpectomy. It focuses the radiation on a very narrow margin of normal tissue around the surgical site, as opposed to the entire breast, and a higher dose of radiation is given over a shorter time than in standard whole-breast irradiation.

Brachytherapy is an approach to delivering radiation treatment from a source implanted inside the body. These sources may be placed either permanently or temporarily at the tumor site.

By delivering radiation directly into a tumor, this technique spares the surrounding normal tissue any exposure to radiation and the side effects that it may bring.

This advanced procedure requires a sophisticated facility and equipment, along with highly specialized physicians and support. It is available at some Providence locations.

Hypofractionated whole breast radiation therapy is a treatment that uses larger doses of radiation to the whole breast for a shorter period of treatment.

Intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) are advanced types of radiation therapies. IMRT uses advanced technology to manipulate the radiation beams to conform to the shape of a tumor. VMAT is a subtype of IMRT in which the machine actively delivers radiation beams while moving in an arc around the patient.

This method of radiation delivery offers next-generation capabilities. The arc-based therapy provided via VMAT delivers high doses of radiation to more focused areas, reducing side effects and the overall treatment time for the patient. This treatment is particularly effective at treating several types of cancer while at the same time reducing toxicity and harm to vital organs.

This procedure is one of several new ways to deliver radiation therapy. It requires a sophisticated facility and equipment, along with highly specialized physicians. It is available at some Providence locations.

Intraoperative radiation therapy (IORT) is the delivery of radiation directly to tissues that are accessible during surgery. It is typically used when the cancer is difficult to remove and there is an expectation that there may be microscopic disease remaining. Because this radiation treatment is delivered surgically, healthy organs or tissue can sometimes be moved out of the way or shielded from the radiation to minimize toxicity.

Stereotactic radiation (SABR/SBRT) is a group of treatments that includes stereotactic body radiation therapy (SBRT) and stereotactic ablative radiation (SABR) – both of which are adaptations of stereotactic radiosurgery (SRS) – for the treatment of targets in the body, but outside the brain. Similar to SRS, these techniques deliver very high doses of radiation using sophisticated motion management and patient immobilization techniques.

The number of radiation treatments is minimal and may range from one to five treatments delivered over one to two weeks.

This procedure is one of several new ways to deliver radiation therapy. It requires a sophisticated facility and equipment, along with highly specialized physicians. It is available at some Providence locations.

Stereotactic radiosurgery (SRS) is the delivery of high-dose radiation treatment to a target using special patient immobilization techniques and sophisticated imaging to confirm highly accurate targeting. This is commonly delivered in a single treatment. Some commonly used SRS systems are gamma knife and cyber knife.

Surface-guided radiation therapy (SGRT/SIGRT) is an approach to radiation targeting that offers real-time beam guidance from face and body surface-recognition systems.

This treatment is particularly effective at treating several types of cancer while at the same time reducing toxicity and harm to vital organs, thus minimizing side effects.

This advanced procedure requires a sophisticated facility and equipment, along with highly specialized physicians. It is available at some Providence locations.

Three-dimensional conformal radiation therapy (3DCRT) is a radiation planning and treatment technique in which three-dimensional (3D) imaging enables improved targeting for radiation treatment. 3D planning with CT imaging makes radiation treatment much more conformal, or tailored to the target.

Lymphedema therapy may include several types of therapy used to address the buildup of lymph fluid that can be caused by cancer or its treatment. These treatments may include massage, the wrapping of an extremity or the use of mechanical pumps to move fluid back into circulation.