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Breast cancer

napbc logoInitially in 2012, and again in 2015 and 2018, our Breast Program was granted three-year/full accreditation designation by the National Accreditation Program for Breast Centers (NAPBC), a program administered by the American College of Surgeons. Accreditation by the NAPBC is only given to those centers that have voluntarily committed to provide the highest level of quality breast care and that undergo a rigorous evaluation process and review of their performance. During the survey process, the center must demonstrate compliance with standards established by the NAPBC for treating women who are diagnosed with the full spectrum of breast disease.

coc logoA breast center that achieves NAPBC accreditation has demonstrated a firm commitment to offer its patients every significant advantage in their battle against breast disease. We are also proud to be a part of the Commission on Cancer (CoC)-accredited cancer program at White Plains Hospital Center for Cancer Care.

According to the American Cancer Society, breast cancer is the most common cancer among American women (after skin cancer). About 1 in 8 (12%) women in the US will develop invasive breast cancer during their lifetime. Although rates of breast cancer are increasing, the good news is that death rates have slowly been declining due to both early detection and improved systemic treatments. As treatments improve, there are now approximately 3.5 million breast cancer survivors in the U.S.

The biggest risk factors for breast cancer are female gender and increasing age. Other risk factors include family history, personal history, genetic mutations, and certain benign conditions with atypical cells (ADH and ALH.) Lifestyle related risk factors include alcohol use, obesity, sedentary lifestyle, and hormone replacement therapy use after breast cancer. For certain patients at high risk for breast cancer, medication may be recommended (chemoprevention) to decrease breast cancer risk.

While most breast cancers are sporadic, approximately 5 to 10% of breast cancers are caused by hereditary genetic mutations. These include the BRCA gene (which is most common in the Ashkenazi Jewish population from Eastern Europe,) as well as multiple other inherited gene mutations. If you have a strong family history of cancer, your physician can help determine whether you are a candidate for genetic testing. White Plains Hospital has two certified genetic counselors to help patients fully understand the testing as well as the results. Learn more about our genetic screening program.

Screening & diagnosis

There are many tools for early detection of breast cancer, and these are thought to play a major role in the improved survival from breast cancer in the modern era. Screening options include tests such as mammograms, ultrasound, and breast MRI. In addition to regular clinical and self-exams, The American Cancer Society recommends that women should begin going for annual mammograms at the age of 40. Those at a high risk for breast cancer based on certain factors should get a breast MRI and a mammogram every year, typically starting at age 30.

If there is an abnormality on imaging, a biopsy may be recommended. At White Plains Hospital, this is done by the highly compassionate and skilled team of dedicated breast radiologists. During a breast biopsy, a tissue sample is taken from your breast so that it can be microscopically examined by a pathologist who can determine whether it is benign or contains cancerous cells. While many biopsies are often benign, a breast cancer diagnosis is made by needle biopsy. Throughout our different sites, White Plains Hospital has the capability of making the biopsy process as comfortable for our patients as possible. Our radiologists use the latest diagnostic technology and equipment, including an upright stereotactic biopsy table that allows more comfortable positioning for patients, as well as a new MRI machine that is more open than prior versions.

Learn more about our breast cancer screening program.

Treatment

Treatment options for breast cancer vary depending on the stage at presentation, as well as other patient and tumor factors. Breast surgery is often the first step, and typically involves removing the cancer in the breast (either with a lumpectomy or mastectomy,) along with assessment of the lymph node status in the axilla. Our surgeons have expertise in surgical techniques including nipple-sparing mastectomy procedures done through a hidden incision on the underside of the breast that remove the breast while leaving the nipple-areola complex in place. The plastic surgery team is composed of pioneers in direct-to-implant reconstruction in selected patients, which is a one-step procedure that can eliminate the need for multiple painful surgeries and office procedures. Other reconstructive options for patients include prepectoral implants (above the muscle), which improve post-operative function and appearance in selected patients. Finally, many microvascular reconstruction procedures are performed at White Plains Hospital including deep interior epigastric perforators (DIEP) flaps.

The medical oncologist determines if any systemic treatment is necessary, specifically chemotherapy or anti-hormonal therapy, to treat cancer cells in the breast and also to prevent spread of disease to other areas of the body. There are some circumstances where systemic treatment is given by the oncologist prior to breast surgery (neoadjuvant therapy), in order to shrink the tumor in the breast and/or lymph nodes. Advances in medical oncology include targeted treatment of a tumor, in order to maximize benefit while minimizing damage to other cells in the body.

Radiation oncology involves administering radiation to the local area of involvement (usually the breast after a lumpectomy, and may include regional lymph node basins depending on the stage of the cancer) to prevent local recurrence of the disease. Most frequently the entire breast is targeted for radiation after lumpectomy, however in some situations only the affected part of the breast is targeted. This approach can minimize any radiation damage to underlying organs including the heart and lungs. The White Plains Hospital approach has resulted in excellent rates of local control after lumpectomy, as well as low rate of radiation related problems after breast reconstruction.