A new diagnosis of breast cancer is often paired with difficult sensations, emotions and responses including fear, shock, numbness and disbelief, as well as anger, betrayal, grief and sadness. In the midst of this emotional trauma, women must gather information, often learn a new language of medical terms, understand treatment choices and make difficult decisions. Women often report being overwhelmed or at least intensely challenged to make sense of the medical maze.
Three specialty areas of central importance in the treatment of breast cancer include: surgical oncology, medical oncology and radiation oncology. Not everyone is treated with all of these modalities, but each is weighed for the benefits offered and for the potential risks incurred.
Each of these areas can be thought of as the treatment building blocks — they may be given in different orders, over differing amounts of time, all depending on the stage and biological behavior of the breast cancer and the individual references of the women diagnosed with disease. A combination of treatment strategies from the three key breast cancer modalities is often the best method to achieve both local and systemic control of breast cancer.
The treatments are accompanied by a range of emotions, possible side effects and potential variability in response to treatment. While none of these treatments is easy to undergo, many women weather breast cancer treatments with support.
The Breast Care Center offers coordinated care for newly diagnosed breast cancer patients by specialists from each of these areas in one patient-oriented facility. At the Breast Care Center, these specialists work together to coordinate the most appropriate care for each individual. These specialists include, but are not limited to, surgical oncologists, medical oncologists and radiation oncologists.
A breast cancer surgeon is a doctor with specialty surgical training and experience in diseases of the breast, including breast cancer. The surgeon has expertise in clinical breast exam, biopsy and breast surgery for benign breast diseases and breast cancer.
The surgeon works collaboratively with physicians in mammography and radiology, nuclear medicine, and pathology to plan and do diagnostic procedures. They work collaboratively with physicians in radiation and medical oncology to plan breast cancer treatment once it has been diagnosed. The breast surgeon does breast surgery, either alone or in collaboration with a plastic surgeon.
A medical oncologist is an internist with a specialty residency (and often fellowship) in medical oncology. Medical oncology is the study of and use of systemic therapies, or treatments, that treat the entire body. It includes the use of chemotherapy (drugs to treat cancer) and hormone therapy (drugs that interfere with the body's hormonal stimulation of tumor growth).
Chemotherapy may be given for primary breast cancer — cancer believed not to have spread outside of the breast and lymph nodes — either before or after surgery. Chemotherapy may also be used as treatment for metastatic breast cancer — breast cancer that has spread to other organs of the body.
Hormonal therapy, such as Tamoxifen or Nolvadex, can be given for primary or metastatic breast cancer. A medical oncologist has expertise in managing these treatments and treatment side effects and problems encountered with breast cancer over the course of the illness.
A radiation oncologist is a physician who completes a residency in the treatment of cancer with radiation therapy — the use of radiation particles in a controlled way to treat cancer.
Radiation therapy may be used in the local treatment of primary breast cancer, most often following breast-conserving surgery — lumpectomy — or as a method to control metastatic disease and alleviate symptoms. For example, radiation of the spine in the setting of bone metastasis may stop or slow growth of disease, preventing damage to the spinal cord and decreasing pain.
We at the UCSF Carol Franc Buck Breast Care Center hope to provide you with information and support that will enable you to experiment and to explore ways of feeling better that best match you and your needs.
Below, you will find links to some of the educational information that is applicable to women with newly diagnosed breast cancer. In addition, further information can be gathered at our UCSF Cancer Resource Center or by talking with your doctor.
Clinical trials are formal, controlled protocols designed to test the effectiveness of new treatments, including novel drugs, types of intervention or combinations of therapy.
If you are interested in obtaining more information on specific breast cancer clinical trials offered at UCSF Medical Center, please visit the clinical trial section on the UCSF Breast Care Center website. You also can visit the National Cancer Institute's CancerNet, where you will find access to PDQ, the NCI-sponsored database of clinical trials nationwide.
Note: The clinical protocols listed here are presented as an educational service to doctors and patients; they should not be interpreted as providing medical advice nor be used for the diagnosis or treatment of cancer or any other health problem. Enrollment is based on satisfying eligibility criteria; final determination for inclusion in a study is made solely at the discretion of the principal investigator.
Different services and information are needed at different points in the wide spectrum of breast health care and breast cancer treatment. We have created a map to serve as an example of a general path of diagnoses and/or treatment in order to help you to better understand your own individual experience.
While there are common pathways to screening, diagnosis and treatment within breast care and breast cancer, you must be aware that your individual path may differ from that presented on our website. It is important to discuss the details of your individual story with your doctor.
Reviewed by health care specialists at UCSF Medical Center.
This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.