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Breast Cancer Treatments Expanded on Multiple Fronts

November 15, 2019

Tremendous progress has been made in a wide range of cancer treatment options, which has led to millions of people in the United States living with cancer. Chilton Medical Center is continuing to make new methods and technologies available to cancer patients – from new surgical techniques, to safer radiation methods, to targeted therapy that precisely attacks an individual’s cancer. Here are some advances Chilton is pioneering to treat women living with breast cancer.

Surgical Advances Can Restore Health and Confidence

The team of dedicated specialists at Chilton’s Breast Center recognizes the need to also address the psychological and emotional impact of breast cancer. Chilton’s surgeons are skilled in the latest techniques for breast-conserving lumpectomies and mastectomies, including hidden scar surgery and nipple-sparing mastectomy.

“Removing cancer remains our top priority,” says Chilton’s medical director of breast surgery, Margaret Mary Sacco, MD, “but surgical advances have also helped to enhance cosmetic outcomes,” which can help restore body image and self-confidence. “Improved instrumentation allows surgeons to operate through smaller, more concealed incisions around the dark portion of the nipple, crease at the lower part of the breast (inframammary fold) or armpit area; in many cases, the scars are barely visible.”

“As microsurgery advanced, we also discovered new ways of reconstructing the breast,” states Charbel Chalfoun, MD, a board-certified plastic surgeon who specializes in breast reconstruction. He is certified by the American Board of Plastic Surgery. Utilizing the muscle-sparing DIEP flap procedure, for example, surgeons rebuild the breasts using skin, fat and blood vessels from the abdomen, which “lowers the risk of complication and side effects while allowing patients to have natural feeling breasts,” he explains. Chilton is leading the region with the equipment and expertise for this highly complex procedure.

Safer Radiation to Protect the Heart

“While radiation is effective in the treatment of breast cancer, research suggests an association with heart damage in patients treated with radiotherapy in the past, particularly in left-sided breast cancers,” reports Joanne Zhung, MD, Chilton's medical director of radiation oncology. To protect the heart during radiation, Chilton introduced Deep Inspiration Breath Hold, which repositions the heart during treatment, exposing it to less radiation. Before radiation is delivered, patients take a deep breath and hold it for 15 to 25 seconds. “This allows the lungs to expand and pushes the heart away from the radiation field,” says Dr. Zhung. “Increasing the distance by even a few centimeters can reduce the dose of radiation [to the heart] by more than 50%.”

Precision Therapy for Personalized Treatment

Perhaps most consequential is the emergence of precision therapy, based on the understanding that all breast cancers are not the same. Genetic profiling and other advanced tests available at Chilton provide valuable information for preventive care and targeted treatment.

Chilton’s High-Risk Breast Screening Program helps identify patients at high risk for breast cancer. Diligent monitoring, imaging and targeted interventions can empower participants to remain one step ahead of the disease.

Andrew M. Bernstein, DO, medical director of oncology at Chilton, states: “We can individualize medical therapies based on the receptor status of the cancer. The receptor is like a TV antenna that sits on top of the cancer cell. If it doesn’t get the signal it needs, the cancer cannot grow.” Targeted therapies act as a shield. For example, endocrine therapy blocks enzymes that strengthen hormone-sensitive cancers, while other therapies target aggressive cancers fueled by the HER2 protein.

Thanks to these breakthroughs and more, Chilton is fighting breast cancer on every front. “Our multidisciplinary team fosters innovative, personalized medicine that continues to improve diagnosis, treatment and survivorship,” asserts Dr. Sacco. “For many women, there is less fear about a breast cancer diagnosis.” And more hope.

Drs. Sacco and Zhung are part of Atlantic Medical Group, a multispecialty network of health care providers. 

Removing cancer remains our top priority, but surgical advances have also helped to enhance cosmetic outcomes, which can help restore body image and self-confidence.”

Margaret Mary Sacco, MD, Medical Director of Breast Surgery, Chilton Medical Center

Outpatient Cancer Care Close to Home

Patients who live near Chilton Medical Center now have access to outpatient cancer care close to home. The physicians of Atlantic Surgical Oncology have opened an office for outpatient consultations and follow-up visits at the Atlantic Health Pavilion at 242 West Parkway.

Lawrence Harrison, MD, chief of Atlantic Surgical Oncology, explains that physicians there can provide same-day surgery for procedures such as minor endocrine surgery, like thyroid surgery. “We're doing smaller biopsies on skin lesions in the treatment of melanoma,” he says. “It's giving patients the same quality tertiary care with the convenience of being local.”

Dr. Harrison says the surgical oncology team, which has expertise in robotic and laparoscopic surgery, including liver, pancreatic and other gastrointestinal malignancies, provides consultations in the Chilton area. “We want to provide convenience and access for those patients who live in the Chilton area, so they can be seen closer to home.”