CCH offers full range of breast cancer treatments
About one in eight woman in the United States will be diagnosed with breast cancer at some point in their lives and, unfortunately, the disease is random enough that there are no risk factors that can be mitigated.
For example, smoking tobacco products causes almost 90% of cases of lung cancer, so not smoking tobacco greatly decreases the odds of contracting lung cancer, but there really is nothing one can to to lessen the odds of a breast cancer diagnosis.
"The vast, vast majority of breast cancers are sporadic," said Dr. Christopher Veale, a radiation oncologist at Columbus Community Hospital. "Obviously, women who have a strong family history of breast cancer, some other female cancers, can be at a higher risk if there happens to be a genetic component, but the majority of breast cancers are sporadic."
Veale recommends a maintaining a healthy diet and physical activity, which is something most doctors will advise you to be doing anyway.
So while preventing breast cancer is not really an option, the next best thing is undergoing regular screenings so that if the cancer does appear, it can be caught at an early stage.
"In general, this is with breast cancer, but also other cancers, earlier diagnosis, earlier cancer stage, typically means less overall treatment is needed, so potentially less side effects and a lower chance of a cancer coming back after the treatment is finished," Veale said. "So, for breast cancer, it's very beneficial and highly recommended in the medical community to have the screenings, because that increases the chance ... of a breast cancer being found in a more early stage."
The oncology department at CCH recommends women begin annual screenings at the age of 40, unless there are reasons to start earlier, like if the family has a history of breast cancer. The doctors also recommend annual screenings rather than once every couple of years.
Screenings take the form of a mammogram, during which each breast is compressed between two plates "to spread out the tissue and allow the use of as little radiation as possible," said Dr. Matthew Pieper, a radiologist at CCH.
"We acquire a 2D image and what's called a tomosynthesis image, which allows us to kind of break the tissue down into thinner slices," Pieper said. "We can see finer detail and smaller cancers with that technology."
Pieper said that getting a mammogram takes about five minutes and at CCH the results are available before the woman leaves the office.
If an abnormality is detected on the screening images, doctors will want to obtain additional images, whether that means additional mammogram images or ultrasound.
"Ultrasound becomes a workhouse in further identifying abnormalities on mammograms," Pieper said. "Some of which are cancer and some of which are not. If we find something on mammogram or ultrasound that we cannot conclusively say is not worrisome ... it goes on to a biopsy."
Biopsies are done using live ultrasound or mammogram images that allow the doctor to make sure they're targeting the exact right area.
"It's done with local anesthesia, meaning numbing medication administered via a needle into the skin, just like what the dentist might use," Pieper said. "It's not a pain-free procedure, but I would say most women, when they're done, feel like the biopsy was maybe less painful or traumatic than what they were expecting."
If the biopsy confirms that cancer is present, patients are referred to a surgeon and a medical oncologist to determine what the next steps are going to be.
"For most women, that's surgery first, but for some they need treatment from the medical oncologist prior to undergoing definitive surgical management," Pieper said.
Some patients, prior to surgery, might undergo medication or drug therapy, Veale said.
"And then some women will have an option of either a mastectomy or a lumpectomy if they have a preference of keeping the breast," Veale said. "And based on the tumor pathology and their surgical decision, radiation may or may not be indicated."
With most cancers, there is a chance that it will come back within the first couple of years after treatment, Veale said. He recommends frequent followup visits in those first years to "ensure that a cancer didn't come back or, if it did come back, to catch it soon.
"And the second reason I follow a patient is to kind of manage and follow any side effects from the treatment that they've received, so 'cancer surveillance' and following any side effects they've had during their treatment," Veale said.
Followup visits may or may not involve mammograms, depending on whether the patient has breast tissue, like if they elected for a lumpectomy instead of a mastectomy, or if they only had a mastectomy on one side, the other side will still have breast tissue.
Veale, who started seeing patients at CCH only about a month ago, has been very impressed with the radiology department at the hospital.
"We have a fairly comprehensive oncology team from the surgeons to the medical oncologists to the radiation here in Columbus so that most of the treatment and management of anything that may be found could likely be done here, locally, if the patient so desires," he said.
"With Dr. Veale here full time now, we have everything people need to get all their treatment here," Pieper said.
