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Oct 20, 2020

What to Know About Breast Cancer Treatment and Support

Responses submitted by Debra Camal, M.D., FACS, Medical Director Breast Surgery at Hackensack Meridian Riverview Medical Center

Hackensack Meridian Health’s Breast Imaging and Breast Cancer program is the largest in New Jersey offering comprehensive services such as breast screening, care for benign breast diseases, services for patients at high risk of breast cancer, and breast cancer diagnosis, treatment, support and survivorship. Riverview Medical Center is proud to treat hundreds of breast cancer patients each year with dignity, compassion, and the highest level of clinical excellence close to home.

Q: How has surgery advanced to treat breast cancer?
A: Surgery to treat breast cancer has become both more advanced and more limited in the past 10 years. For example, in many cases fewer lymph nodes now require removal to treat breast cancer even when the cancer has spread to a lymph node. This can limit postoperative complications such as arm swelling. When patients need chemotherapy, it is often given before surgery to allow the surgery to be less invasive.
In addition, newer technology has allowed for techniques such as nipple-sparing mastectomy with reconstruction with the scar placement below the reconstructed breast to allow for the best possible cosmetic and functional outcome. At Riverview, we have a very robust DIEP flap surgery program where a woman’s own excess abdominal tissue is used to create a natural appearing reconstructed breast.

Q: What is the difference between the various types of breast cancer, and how does a certain diagnosis affect treatment options?
A: There are many types of breast cancer, and each cell type is treated based on its biologic activity and distribution in the breast. The age of the patient and body type and medical conditions also factor into treatment. The very slowly moving types of breast cancer can sometimes be treated with limited excision alone. More aggressive cell types might require chemotherapy, surgery and radiation for the best outcomes. Newer treatments including immunotherapy and targeted therapies can expand treatment options even in advanced stage disease.

Q: What are some ways people can keep themselves healthy and look for signs of illness?
A: Basics such as proper diet, regular physical activity and limiting alcohol intake can really reduce the chance of getting breast cancer. Living a healthy lifestyle also reduces the chance that breast cancer will recur after it is treated. Not all cancers can be prevented, but being healthy can also lead to better outcomes after treatment and fewer treatment-related complications. It is also important to continue regular health screenings such as annual mammograms. Women should have a breast exam yearly and report any new symptoms to their doctor. Self-monitoring includes watching for symptoms such as persistent pain or ache in one breast, a change in shape or size of the breast and new nipple discharge or inversion

Q: How can loved ones of someone going through treatment for breast cancer best support them during this difficult time? Are there support groups available for patients associated with your facility?
A: Many types of support are available through Hackensack Meridian and in our communities. Nurse navigators are available at all sites to lend psychosocial support, provide financial counseling, and assist with needs such as transportation to treatments. Support groups are also available (currently online, but in person when possible) for breast cancer patients and their families. We also have a very active integrative medicine program providing broad-based care and symptom management to patients at all points in their treatment with services such as acupuncture, yoga, medical massage, and health coaching.

Q: What should someone do if they feel a lump or worry that they’re at risk of developing breast cancer?
A: If a woman (or man) feels a lump in the breast, they should call their primary care physician or gynecologist right away. Appropriate imaging tests will be ordered, and a referral will often be made to a breast surgeon for evaluation.

If a person is concerned that they might be at high risk for developing breast cancer due to family history or a previous abnormal mammogram, they can also request an evaluation by a breast surgeon for a breast exam and discussion of the most appropriate imaging schedule. Genetic testing is also available for patients who qualify and is generally covered by insurance. Many patients with a strong family history of breast cancer have had genetic testing years ago, but only for two of the most common mutations, BRCA1 and BRCA2. Full panel genetic testing is now offered to allow for identification for less common but still clinically important mutations that can indicate increased risk for breast cancer and other cancers as well.

Q: Is there any other information you’d like to share regarding your team’s practices and care?
A: We have enhanced our processes to protect the safety of our patients, team members and physicians, and our commitment to high-quality and compassionate care remains. Our hospitals continue to monitor the temperature of all patients, visitors, team members, and physicians, rigorously clean and sanitize all facilities, provide masks to all who enter our buildings, and practice social distancing. Our office staff members go above and beyond basics to help all new breast cancer patients navigate the system and complete testing and treatment as efficiently and safely as possible.

Community resources are available to assist patients with financial needs as well. A patient with a breast problem who is uninsured, underinsured or lacks family support should never be afraid to reach out for help. You are never alone – we have a team of kind and helpful nurses, physicians, and team members to help navigate the system and assist patients with any breast problem.

Call 732-531-5200 to make an appointment with Dr. Camal or Dr. Campo or visit HackensackMeridianHealth.org/Cancer.

Debra Camal, M.D., FACS, Medical Director Breast Surgery at Hackensack Meridian Riverview Medical Center (right) and partner, Catherine Campo, D.O., FACOS breast surgeon at Riverview Medical Center and Medical Director, Breast Surgery at Hackensack Meridian Bayshore Medical Center work together provide the highest level of clinical and compassionate care to breast cancer patients.