Breast Cancer Treatments
The Mount Sinai Health System uses the most advanced breast cancer treatments available. Your medical team will recommend one type of treatment or a combination of treatments. The main approaches we use are surgical, medical (including chemotherapy), and radiological.
Our cancer treatment team will discuss your treatment options and tell you about our integrated services. These range from reconstructive surgery and nutritional consulting to yoga and massage therapy. When appropriate, your team will tell you about emerging therapies, clinical trial opportunities, and breast cancer research that you may find helpful and informative. We guide you through the treatment process, step-by-step, making appointments for you with all the specialists you need. You are not alone on this journey.
Our specialists across Mount Sinai Health System’s locations are skilled in providing the newest and most promising therapies. These include the following approaches.
Breast Localization
Surgery is often part of a breast cancer treatment plan. When you will be having surgery, the first step is to pinpoint precisely the location of the cancerous tissue (called localization). We do not want to move any more normal, healthy tissue than absolutely necessary. We use one of two methods for localization, depending on your situation.
One approach to locate the cancerous tissue requires using a fine needle to insert a thin wire into the breast. An experienced radiologist guides the needle with the help of a mammogram, ultrasound, or magnetic resonance imaging (MRI). Wire insertion takes place on the same day of your surgery. The wire will be removed as part of the surgical specimen during the procedure.
The second method is using a fine needle to insert a tiny radioactive particle or seed into the breast. Seed insertion can take place days before your surgery. Following a seed procedure, you will be able to go home with no activity restrictions. You will come back at a later date for your surgery. The radioactive seed poses absolutely no danger to you or others. At the time of your surgery, the surgeon removes the seed as well as the tissue specimen.
Breast localization involves these steps:
- Taking images to determine the best angle at which to introduce the needle or seed
- Cleaning the skin and numbing the breast
- Injecting the thin wire or tiny seed into the breast with a fine needle
- Removing the needle once the seed or wire is in place
- Taking additional images to confirm correct placement
Breast Surgery (Surgical Oncology)
If you have early-stage breast cancer, you may need surgery. Your medical team will talk with you about which procedure is most appropriate for you, taking into account your preferences. There are basically two types of procedures that are equally effective for women with early stage breast cancer. Breast-conserving surgery involves removing the cancer and leaving most of the normal breast. A mastectomy involves removing the whole breast. Research shows that women with early-stage breast cancer who have breast-conserving surgery along with radiation therapy live as long as those who have a mastectomy. If you require or choose mastectomy, we may be able to perform a skin- or nipple-sparing procedure with immediate reconstruction. All Mount Sinai breast surgeons have expertise in the most advanced surgical techniques. We want you to lead a long, healthy life, with the best possible aesthetic outcomes.
Treatment for breast cancer usually begins a few weeks after diagnosis. In these weeks, you should meet with a surgeon, learn about your surgery choices, and consider what is important to you. As you make a decision about surgery, you should think about both medical and personal factors. Your Mount Sinai breast surgeon will work with you to ensure the best possible outcome.
Breast Reconstruction (Plastic Surgery)
Our breast reconstruction services provide you with the utmost care. Our plastic surgeons work closely with our breast surgeons and oncologists to offer you a team approach to breast reconstruction.
Breast reconstruction is often performed in stages. Typically surgeons do the first stage at the time of the mastectomy. The remaining stages take place later, over a period of time. Sometimes, we can complete breast reconstruction in one step. There are two types of reconstruction: implant reconstruction, which uses silicone or saline implants, and autologous reconstruction, which uses your own tissue.
Implant Reconstruction: We begin this process by placing a tissue expander at time of your mastectomy. The tissue expander is a temporary inflatable implant. Over time, you will experience the following:
- We inflate the tissue expander soon after surgery.
- You will probably stay in the hospital for a day or two.
- You may be able to return to work in two to three weeks.
- At a second ambulatory surgery about three months after your initial surgery, we remove the tissue expander and replace it with a permanent implant.
- Your permanent implants can be silicone or saline.
- You may also choose nipple reconstruction, which we perform after placement of the permanent implant.
- Sometimes we are able to place the actual implant when you have your mastectomy, eliminating the need for the exchange procedure.
- With nipple sparing mastectomy, we preserve your original nipple skin. If we are able to perform this procedure, you will not need nipple reconstruction.
Autologous Reconstruction (Your Own Tissue): With this approach, we use your own tissue for skin replacement and breast contour. This often provides a natural, long-lasting reconstruction. Each procedure has a different name depending on where the flap of reconstruction tissue comes from. The options are:
- Reconstruction with perforator flap: We use a combination of muscle, fat, and skin taken from your abdomen, back, or other parts of the body.
- Deep inferior epigastric perforator flap (DIEP Flap): This is the most common type of perforator flap for breast reconstruction. We use living tissue from the skin and fatty tissue from the abdomen. With this procedure, we can spare the muscle from the abdominal wall.
- Superior and inferior gluteal artery perforator flap (SGAP and IGAP): We use the living tissue of your upper buttock.
- Inner thigh or transverse upper gracillis (TUG) Flap: We use the living tissue of your excess inner thigh.
- Profunda artery perforator Flap (PAP): We take the extra tissue from the back of the upper thigh.
Medical Oncology
Our medical oncologists specialize in treating breast cancer. From diagnosis to post-treatment care, our medical oncologists oversee your therapy. We offer consultations, second opinions, treatment, and follow-up care. All care is geared to your needs and preferences. We always consider the most advanced care options.
Medical oncology can involve a combination of medical treatments. We provide anti-hormonal or endocrine treatment, or treatments given in the form of chemotherapy, immunotherapy, and biotherapy in our state-of-the-art infusion suites.
Radiation Oncology
Our radiation oncologists focus on you, our patient. At the same time, we also perform groundbreaking research to improve cancer therapy. Our physicians, nurses, physicists, radiation therapists, and support staff work together to give you compassionate and advanced care. During treatment, we strive to make you as comfortable as possible, physically and emotionally. We offer some of the latest techniques in radiation therapy. These approaches let us to pinpoint cancer cells, leaving normal cells untouched. We are here for you.
We customize a radiation treatment plan for you. Some of the key techniques we use are:
- External Beam
- Accelerated
- IORT
- Proton
Supportive Services
We believe in the importance of ensuring that all patients’ needs are addressed—body, mind, and spirit—and we therefore strive to give patients the care, support, and tools they need to live a healthier, calmer, and happier life.
On our Supportive Services section, we offer a wide range of symptom management and wellness programs to help you to enrich your quality of life, enhance your ability to cope with stresses associated with diagnosis and treatment, ease any symptoms and side-effects you experience and enable you to meet your personal lifestyle goals.