One out of eight American women will develop breast cancer during her lifetime. As women age, their chances of getting breast cancer actually increases every year. But the good news is that up to 90 percent of breast cancers can be treated successfully if they are found early and have not spread beyond the breast. 

Saint Agnes Medical Center offers a variety of services for breast cancer patients including a full time Nurse Navigator, a patient advocate for our breast cancer patients and their families. The Nurse Navigator assists patients from the time of diagnosis, throughout the surgery and recovery process by consulting with the healthcare team, answering questions, providing moral support and making referrals to other resources. Detailed information about these other services are listed below.

Our Breast Center Nurse Navigator:

• Provides one-on-one education and emotional support to patient.
  
• Guides patient through the healthcare system from the day of breast cancer diagnosis until patient no longer needs her.
  
• Helps patient access community resources and supportive care needs.
  
• Coordinates services and facilitates continuity of care for patient
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• Is available for community education of self-breast exam and other topics related to breast health.

Technological Advancements

MammoSite® Radiation Therapy - Breast brachytherapy is an alternative to full breast radiation therapy for properly selected lumpectomy patients with early stage breast cancer. The procedure uses a catheter-type device inserted into the space created by the lumpectomy with a balloon attached to its tip to deliver the prescribed levels of radiation. It's a site-specific treatment that enables radiation oncologists to deliver a more targeted and intense dose of radiation to the cavity and the immediate tissue surrounding the tumor, while minimizing harm to healthy surrounding tissue. Treatment is usually given twice a day for five days. (Conventional external radiation therapy takes about six weeks.)

For more information read the article in Health Scene magazine.

Early Detection – Breast Self Examination

Detail from breast self-exam shower card.

• Perform monthly breast self-exams every month beginning at age 20.
  
  
• Have a clinical breast exam performed by your physician or qualified healthcare professional
  
  
  • Every three years from age 20 to 39
  • Every year beginning at age 40
    
    
• Obtain screening mammograms on a regular basis
  
  
  • Baseline mammogram by age 40
  • Annual mammography thereafter

Breast Self-Exam Shower Card - This pdf explains how to perform a breast self-examination with step-by-step instructions.

Breast Self-Exam Video - The Susan G. Komen Web site also has an online instructional video that helps demonstrate the proper method for breast self-examination.

What is breast self-exam?
Breast self-exam (BSE) is just what it sounds like – a process you can use to examine your own breasts in order to detect any lumps, bumps or changes. If a change occurs, i.e. development of a lump, swelling, skin irritation, dimpling, nipple pain or retraction, redness or scaliness of the nipple or breast skin, a spontaneous discharge other than breast milk, a change in the nipple direction, or a change in the contour or silhouette of the breast, see your healthcare provider as soon as possible. .

When should I do breast self-exam?
This examination should be performed every month, seven to ten days after the start of your menstrual cycle. This is when you will have the least amount of swelling and tenderness within the breast. Women who are postmenopausal should perform this exam on the same date each month. Women who are breastfeeding should perform the exam once a month after nursing. By performing this examination on a regular basis, you become familiar with how your breasts feel normally. This will improve your ability to identify something new or different in your breast, should something develop.

What should I do if I find a change?
If you should find something new or identify a change in your breast, notify your physician and have a clinical evaluation as soon as possible. Remember, most changes are not cancer, but all changes should be evaluated by a healthcare professional.

What is a screening mammogram and why should I have one?
A mammogram is an X-ray that can reveal both harmless and cancerous growths. A lump can be discovered two years before it can be felt. Finding a lump early increases a woman’s chance of surviving breast cancer and allows more treatment choices.

Your breast will be placed on a special supporting platform. Firm compression will help position the breast and reduce breast thickness, resulting in a clearer "picture" of the breast tissue as well as reducing radiation dose. It may require additional views of the breast to better visualize the area of concern. (It may also include the use of other imaging modalities, such as ultrasonography). Spot compression and magnification views are intended to better define a possible mammographic abnormality.

Mammography is the most advanced, effective, and accurate way to detect early breast cancer. However, about 10 percent of all breast cancers will not be identified by mammography alone – so monthly breast self exams, regular clinical exams, as well as routine screening mammograms, are recommended. 

Preparation
Before your mammogram, please wash thoroughly and avoid the use of deodorant, powder, perfumes or ointments on your underarm areas or breasts. Because you will be asked to undress from the waist up, it is advisable for you to wear a two-piece outfit.

Try to schedule your mammogram following your period. This is when there will be the least tenderness. If you typically experience a lot of breast tenderness, reduce your caffeine consumption two weeks before your appointment.

Examination Time
Your exam will take approximately 20 to 30 minutes. We recommend that you allow an hour for your visit. After the radiologist reads the films, you and your physician will both receive the results. 

Why would I need a diagnostic mammography exam instead of a screening exam?
Diagnostic mammography is used to evaluate a patient with a specific breast problem or a questionable screening mammogram (mass, spontaneous discharge from the nipple, skin changes, an abnormal or questionable screening mammogram, etc.) or a history of breast cancer. The diagnostic mammogram should be correlated with physical findings and symptoms. Allow 45 - 60 minutes for a screening exam.

It may require additional views of the breast to better visualize the area of concern. (It may also include the use of other imaging modalities, such as ultrasonography). Spot compression and magnification views are done to better define a possible mammographic abnormality.

Spot compression is used to optimize compression over a local area of concern and to displace overlying tissues away from the area of concern. Magnification is used to improve the visibility of the margins of a mass or to better see and characterize microcalcifications. The examination may be slightly uncomfortable, but should not be painful.

Written communication between the ordering physician and the mammography facility is very important. The radiologist will be present to discuss the results of your diagnostic mammogram with you. The radiologist may need to examine your breasts. A final report will be sent to your physician within two to three working days.

How will I receive the results?
You will be given the results of your diagnostic mammogram or ultrasound at the conclusion of your examination by the radiologist. Your screening mammogram results will be mailed to you within two weeks.

Diagnostic Procedures 
The Saint Agnes Breast Center evaluates any detected abnormality by using a variety of imaging tests including ultrasound, breast biopsies, fine needle aspiration, cyst aspiration, core biopsy, galactogram, ductogram, needle localization and stereotactic core biopsy/mammotome breast biopsy.  

For more information on specific procedures, visit the Mammography/Breast Centers page.

Breast Cancer Resources:

• Inpatient Visits – The Breast Center Nurse Navigator meets with patients before and after breast cancer surgery. Following the operation, she is available to discuss concerns and suggest resources. For any questions, contact the Nurse Navigator at (559) 450-2572.
  
  
• Reach to Recovery – The American Cancer Society provides this support program for post-surgery patients. The Nurse Navigator will make a referral for Reach to Recovery with your consent and a physician order. For information about the program, check out www.cancer.org.
  
  
• Breast Cancer Support Group – This group meets twice each month to provide support for women dealing with breast cancer. Call (559) 908-0925 for details.

Other services available for our breast patients include:

• Therapeutic Massage – This is a light touch therapy that is available pre- and post-operatively to promote healing. Ask your nurse to make an appointment.
  
  
• Lymphedema Clinic – Lymphedema is a condition that occurs postoperatively to some breast cancer patients. It is caused by a protein rich fluid that creates swelling on the side of surgery (due to damage to the lymphatic system). If you develop any swelling following surgery, Saint Agnes has certified lymphedema therapists that will help you develop a management plan. For more information, visit the Lymphedema Management section.
  
  
•  Breast Brachytherapy –  Lumpectomy patients who meet certain criteria may be eligible for internal radiation, called brachytherapy. These patients will have a balloon catheter placed within their lumpectomy cavity at the time of surgery. A radioactive seed is placed in the center of the balloon catheter for five- to ten-minute durations for each treatment (twice a day for five days). Breast surgery patients should consult with their physicians to see if they qualify. For more information, visit the Cancer Services section.
  
  
• Saint Agnes Clinical Research Center – The Saint Agnes Clinical Research Center (CRC) partners with physicians to bring innovative drug and device research studies to the people of the Central Valley. Patients can participate in studies sponsored by the National Cancer Institute (NCI), the Department of Health and Human Services (DHHS), international pharmaceutical and biotech companies. For more information, visit the Clinical Research Web page or call (559) 450-7790.  

For more information about breast cancer:

American Cancer Society

nabco.org

Susan G. Komen Breast Cancer Foundation 

networkofstrength.org (formerly known as Y-Me National Breast Cancer Organization)