This Step by Step Process guide is designed to be used with a health care provider who specializes in breast cancer i.e. radiologist, surgeon, plastic surgeon, medical oncologist, radiation oncologist, nurse breast specialist etc. Although this information is intended to give you an idea of what steps usually follow a breast cancer diagnosis, your treatment path will be tailored to your individual situation.
The information on this page will make more sense when additional data is gathered. The additional data may come from a breast MRI, pathology markers/breast panel i.e. ER/PR (estrogen and progesterone receptor) status, lumpectomy or mastectomy pathology, etc.
Radiologist
Biopsy - Ultrasound, Stereotactic (may be performed by a surgeon)
Breast MRI and possible further biopsies
Surgeon - Consultation
Lumpectomy/Breast conserving therapy - is based on size and location of abnormal tissue and personal preference. Usually followed by radiation therapy.
Needle Localization - performed day of surgery usually with a lumpectomy
Mastectomy - is based on size and location of abnormal tissue and personal preference. Radiation therapy may still be indicated.
Skin sparing mastectomy
Axillary lymph node dissection
Sentinel node procedure
Plastic Surgeon - Consultation may be recommended
Cosmetic results with lumpectomy
Breast reconstruction options with mastectomy
Nipple reconstruction
Medical Oncologist - Consultation
Risk Assessment (Genetic Consultation/Testing may be recommended)
21 Gene Assay Test - indicates risk of recurrence in node negative, ER positive patients
Tamoxifen (pre or post menopausal); Arimidex, Femara or Exemestane are Aromitase Inhibitors (post-menopausal only) for patients who’s cancers are ER or PgR positive
Neo-adjuvant chemotherapy - before surgery to shrink tumor
Adjuvant Chemotherapy - after surgery
Clinical trials
Radiation Oncologist - Consultation may be recommended
Radiation Therapy
Whole Breast Radiation - 5 days/wk for 5-6 weeks
Brachytherapy
Catheters placed in breast and connected to radiation 2x day for 5 days
Balloon placed in breast, radiation instilled 2x day for 5 days
Partial Breast Radiation – Radiation to tumor site and surrounding tissue, Clinical Trials ongoing
Post Surgery Physical Therapy - Consultation
Scar tissue and soft tissue cording management
Arm range of motion and strengthening
Lymphedema precautions
Lymphedema assessment and treatment
Complementary and Integrative Medicine Suggestions
