Not long ago, the conventional treatment for breast cancer was the radical mastectomy — removing the entire breast and much of the underlying tissue, including lymph nodes and muscles.
As described in the recent PBS documentary The Emperor of All Maladies, that one-size-fits-all approach was developed more than a century ago and remained the standard of care for decades. It slowly fell out of favor and then only with advocacy from women and a few courageous surgeons who believed women were being needlessly mutilated. The turning point came in the 1980s, when randomized clinical trials comparing tissue-sparing lumpectomy with mastectomy showed the more extreme options offered no improvements in long-term survival.
Early-stage breast cancer treatment
Surgeons like UC Irvine’s Dr. Karen Lane are dedicated to improving the treatment of early-stage breast cancer. A surgical oncologist, Lane is medical director of the UCI Health Pacific Breast Care Center in Costa Mesa. She has embraced new technology when she believes it offers her patients the best chance at preserving their breast and maintaining their quality of life.
“My focus is always on finding a better breast cancer operation,” Lane says.
Lane believes recent technology can be used to improve the results of lumpectomies in some patients, including:
- Ensuring that all cancer cells are removed. Surgeons can use a device called MarginProbe to check the margins, or borders of a tumor, to determine whether all cancer cells have been removed. This can prevent the patient from having to undergo a second operation to remove additional malignancies.
- Intraoperative radiation therapy. Lengthy courses of radiation therapy are traditionally part of breast cancer treatments. However, some women with early stage breast cancer could benefit from receiving a single dose right in the operating room during the lumpectomy, says Lane.
Best surgery for the right patient
The key is matching a woman with the therapy that best suits her condition, said Dr. Leonard Sender, director of clinical oncology services for UCI Health.
“Women with varying breast density or different sized tumors, for example, require different approaches,” he said. “We have a great responsibility to choose the right treatment.”
For example, intraoperative radiation therapy is not for everyone, Sender said. However, having the system available means UCI Health breast cancer specialists can offer each woman a personalized treatment program that includes access to world-class surgeons, oncologists and radiation specialists.