We know that breast cancer affects the heart and soul of a woman, as well as the body. To focus on the unique needs of those diagnosed with this disease, The Center for Cancer and Blood Disorders created a Center of Excellence especially for breast cancer patients. Robyn Young, M.D., a medical oncologist focusing solely on breast cancer, leads this special department. Woman-to-woman, Dr. Young walks through your journey with you.

If you'd like to make an appointment with Dr. Robyn Young, call 817.759.7000 or you can email your questions about breast cancer to www.AskDrRobyn.org.

To meet the special needs of breast cancer patients, the following services are available:

Breast Cancer Detection

Early Detection Strategy
You can help detect possible breast cancer at its earliest stage with our recommended three-part early detection strategy:

• Breast self-exam once a month beginning at age 20
• Breast exam by a physician every three years beginning at age 20; at age 40 begin every year
• Mammogram once a year beginning at age 40

High Risk Breast Cancer Assessment
You may wish to consider seeing a physician, such as Dr. Robyn Young, who focuses on breast issues if you have any of the high risk factors listed below:

• Do you have two or more relatives with breast or ovarian cancer?
• Has breast cancer occurred in a relative on either side of the family before age 50?
• Do you have one or more relatives with both breast and ovarian cancer?
• Do you have one or more relatives with cancer in both breasts?
• Have you been diagnosed with a marker for possible future breast cancer, such as LCIS?
• Have you had genetic testing and been told you have a BRCA1 or BRCA2 mutation?

High Risk Surveillance/Screening
If you are at high risk of developing breast cancer, you may wish to consider scheduling an appointment with Dr. Robyn Young in order to:

• Discuss your personal risk factors for developing breast cancer
• Assess your potential for developing breast cancer through testing options
• Evaluate your physical health through a breast exam every six months
• Determine your options for preventive medical treatment to reduce risk

For more information or to schedule an appointment, call 817.759.7000.

Breast Cancer Treatment

Before Surgery: As a vital part of our commitment to breast cancer patients, Dr. Young is willing to meet with patients prior to surgery or at any point during treatment. At any time, you can contact her with questions or suggestions at AskDrRobyn.org.

At The Center, we provide a Relaxation Class with proven methods for reducing stress and enhancing healing before or during chemotherapy, radiation, or surgery. Some of the techniques taught in this free class include relaxation methods, guided imagery, and deep breathing.

Surgical Answers: After a lump or questionable area is discovered, the next step is diagnosis. We are very fortunate to have a number of highly qualified surgeons in the north Texas area. You may choose the surgeon of your choice to perform a biopsy of the area in question. This is often done as an outpatient procedure and involves removal of a small portion of breast tissue. The tissue is analyzed for the presence of cancer.

When the presence of cancer is confirmed, surgery for removal of the tumor is usually the first treatment. In some cases, chemotherapy is prescribed first, in order to shrink the cancerous tumor. There are several options for removal of the tumor, these should be discussed with your surgeon.

We encourage breast cancer patients to visit with a medical oncologist before surgery, in order to be better prepared for their entire treatment program.

Breast Cancer Navigator: The entire process of treatment for breast cancer can be daunting. We want to ease your fears and provide you with the explanations as soon as possible. We have assigned a specially trained person to the position of Breast Cancer Navigator. This individual is a trained nurse, but takes care beyond the clinical level. She is available to answer questions when Dr. Young is with another patient or to explain answers in as much detail as you need.

Laboratory and Radiology Services: Extensive laboratory and radiology services are available onsite at The Center for Cancer and Blood Disorders. Many visits during your journey with breast cancer will involve lab tests and scans. The convenience of making only one trip for all needs or of returning to a familiar location is part of the success of the Breast Cancer Center of Excellence concept.

Chemotherapy, Hormone Therapy, Immune Therapy:
After surgery, chemotherapy or other therapies are often recommended in order to treat the entire body to kill any undetected cancer. Here is information on how the each type of treatment works:

Chemotherapy: This foundation of cancer treatment is a combination of drugs that kill fast-growing cells in the body, such as cancer. New chemotherapy drugs are being developed rapidly. In addition, there are a wide variety of new medications to help patients effectively manage pain, nausea, fatigue, or infection. Chemotherapy remains a frequently prescribed treatment for breast cancer, however, it is also often given in combination with other emerging treatments.

Hormone Therapy: The treatment of breast cancer with hormone therapy should not be confused with hormone replacement therapy for menopausal women. In treating breast cancer, hormone therapy works by stopping hormones (estrogen) that cause cancer cells to grow. This can be done with drugs that block the estrogen inside cancer cells, stop the enzyme that converts other hormones into estrogen, or by shutting off estrogen production in the body.

Immune Therapy: Using the body’s immune system to destroy cancer cells is one of the most recent advancements in treating breast cancer.

Herceptin, is a groundbreaking immune therapy called a monoclonal antibody. Herceptin is believed to affect cancer cells in these ways:

• Interferes with the growth of cancer cells
• Works with other cancer-destroying drugs to improve effectiveness
• Enhances the body’s immune response to the cancer

Herceptin can work only if the woman carries the HER-2 gene in those tumor cells. About 20% of breast cancer patients carry this gene.

Radiation Therapy: Radiation therapy is another of the cornerstone treatments for breast cancer. The Centers for Cancer and Blood Disorders offers radiation oncology professionals and equipment that rank among the finest in the nation. This includes the most advanced treatment capability, intensity modulated radiation therapy (IMRT).

IMRT radiation therapy represents an entirely new level of care. Through this treatment, radiation by in three-dimensional patterns via hundreds of thin beams targeted directly at the tumor. This type of treatment is known as external beam therapy. This technology spares healthy tissues and results in fewer side effects. IMRT can be used to treat areas close to critical organs and is already improving outcomes for breast cancer patients, as well as many other cancer patients.

Radiation delivered using external beam therapy usually takes about 35 days, with treatment lasting about 20 minutes twice a day.

Mammosite Therapy: When a woman is faced with breast cancer, she is often overwhelmed with the emotional impact as well as the physical implications. For those diagnosed in the early stages, a new treatment, MammoSite therapy or partial breast irradiation, means being able to get on with life much more quickly than with traditional radiation therapy. In fact, the treatment only last five days. It consists of two treatments daily, each lasting about fifteen minutes.

About 30% of breast cancer patients are eligible for this type of treatment. The major factor is early stage diagnosis with a lumpectomy, rather than a mastectomy being performed.

MammoSite therapy, also called partial breast irradiation and brachytherapy, is a two-part process, with the surgeon in a separate surgical procedure after a lumpectomy has been performed. A tiny balloon with the MammoSite catheter attached is placed in directly the area where the tumor was located. The balloon can be inflated to precisely fit the area. The catheter is connected to a high-dose radiation source. Patients receive radiation for five days, usually twice per day for about fifteen minutes.

Electronic Medical Record Sharing: The Center for Cancer and Blood Disorders creates an electronic medical record for each patient. This provides maximum confidentiality for the patient and also offers the medical care team immediate access to vital information. For example, there is no delay in sending medical history from your medical oncologist to the radiation oncologist. It is all available with a few touches of the keyboard.

Patient Support Services: The Breast Cancer Center of Excellence concept focuses on the patient as a whole. This means emotional and spiritual support, as well as, medical treatment. We offer the following services to assist you and your loved ones in dealing with all aspects of a breast cancer diagnosis:

• Massage
• Acupuncture
• Yoga
• Nutritionist
• Chaplain and Meditative Services
• Pyscho/social professionals
• Financial Assessment
• Social services
• Support Groups (link to support groups page)
• AskDrRobyn.org website devoted to your questions