October is National Breast Cancer Awareness Month. The Joan Knechel Cancer Center at Hackettstown Regional Medical Center provides the latest, stateof-the-art radiation and chemotherapy programs for treating breast cancer in both women and men.

More common in women, an annual mammography is highly recommended beginning at age 40 for women at average risk for breast cancer. Clinical breast exam by a physician is also recommended at the same time intervals, along with periodic breast self examination. Women with a strong family history or other reason for increased risk may be advised to start earlier and have exams more often.

If an abnormality is detected either in a self-exam, a physicians exam or mammogram, further workup, such as a breast ultrasound or an MRI (magnetic resonance imaging), may be recommended. A physician may also recommend that a biopsy be performed. If an abnormality cannot be felt by examination, performing the biopsy under mammographic guidance is the best way to be certain the correct area is sampled or removed for study in the pathology department.

If the presence of cancer is confirmed, the original or primary breast lesion can usually be treated conservatively, meaning with preservation of the breast. In many situations, limited surgery, lumpectomy and/or radiation therapy have demonstrated equivalent long term survival and cure rates opposed to radical mastectomy. Today, most women choose the limited surgery and radiation when offered the choice.  The tumor is removed, or excised, along with clean, uninvolved margins of normal tissue. A surgical procedure, either lymph node dissection or sentinel lymph node sampling, is done to check for spread to lymph nodes in the armpit, or axilla.

Most women with breast cancer are recommended to take either chemotherapy or hormonal therapy to reduce their chances of the cancer spreading to distant sites in their bodies such as brain, liver, lungs, and bones. 

Chemotherapy, if indicated, is usually given after surgery and before radiation therapy. Hormonal therapy may be started right after surgery or deferred until after completion of the radiation therapy portion of treatment. 

To prevent recurrence in the breast after lumpectomy, radiation therapy is recommended. Just as the surgeon would have removed the entire breast, the whole breast is initially included in the radiation beams. Treatment generally lasts for five to six weeks, followed by five to eight further treatments just concentrating on the tumor bed itself. Treatment is generally well tolerated, and the majority of women who work continue to do so while receiving radiation therapy to the breast. However, we encourage patients to rest as necessary. 

There may be some skin reactions usually limited to some red, dry and itchy areas toward the end of the treatment and for a couple of weeks afterward. Very occasionally the reactions are worse, and nursing care will vary depending on what is happening with the individual patient. Patients are monitored closely and each is carefully advised on her own situation and recommended skin care. Long term cosmetic results are usually very good to excellent. 

For more information about breast or other cancer diagnoses, call (908) 441-1500.