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Fri, Oct. 18

Column: Coordinated care is key to top-rate breast cancer treatment

(Courtesy photo)

(Courtesy photo)

Unfurl the pink ribbon! October, National Breast Cancer Awareness Month, is here. Founded in 1985, the recognition month has raised awareness of breast cancer as well as sparked research to find a cure, support early diagnosis, and discover better treatments for breast cancer.

National Breast Cancer Awareness Month is particularly significant to Yavapai County. Our county has a higher incidence of breast cancer than any other county in Arizona. Couple this with the fact that experts estimate about one of every eight women born today will be diagnosed with breast cancer at some time during their lifetimes, and it's clear there's good reason to focus on National Breast Cancer Awareness Month.

How has Yavapai County's medical community united to battle breast cancer? Physicians, surgeons and other healthcare specialists have worked for years to help women diagnosed with breast cancer. Their efforts got a significant boost when - thanks in part to an anonymous local donor - The BreastCare Center at Yavapai Regional Medical Center (YRMC) opened on Oct. 1, 2011.

Early on, the center's caregivers and medical specialists adopted a "coordinated care model" to focus on patients' individual needs and to involve them as partners in treatment plans. This means that a patient's medical team may include physicians and nurses from oncology, plastic surgery, radiation therapy and surgery. Also part of the team is a clinical navigator who guides, educates and counsels patients and their families through testing, diagnosis and treatment. A comprehensive plan may also incorporate lymphedema therapy, nutrition assessments, occupational therapy, physical therapy, support groups, wellness services and other therapies or services.

In 2013, the BreastCare Center introduced Arizona's first MRI (Magnetic Resonance Imaging) designed exclusively for breast imaging. YRMC's breast MRI features high-resolution, 3-D images and is a powerful tool for diagnosing breast abnormalities as well as determining treatment for women with breast cancer.

"The first priority is to take care of the cancer, but with today's techniques it's also possible to be cognizant of the cosmetic outcome," said Demitra Manjoros, MD, breast surgeon at YRMC.

Here are some new tools to accomplish both of these goals:

• Neoadjuvant Chemotherapy: For women diagnosed with a larger cancerous tumor, a mastectomy may seem to be their only option. However, women who are motivated to save the breast may be eligible for neoadjuvant chemotherapy before surgery. In select cases, neoadjuvant chemotherapy or hormone therapy may be administered before surgery to shrink large tumors. This gives the breast surgeon the best chance to remove only the tumor, rather than the entire breast.

• Nipple-Sparing Mastectomy: During a traditional mastectomy, the breast's nipple and surrounding

skin is removed. Nipple-sparing mastectomy allows the breast to maintain a natural look as the scar is typically hidden under crease of the breast.

• Immediate Breast Re-Construction: In the past, women would undergo a mastectomy followed by reconstructive breast surgery once they had recovered from the initial surgery and other treatments. Today, the mastectomy and the plastic surgery can take place at the same time, which helps minimize the length of the incision and preserve skin.

• Radioactive Seed Localization (RSL): Dr. Manjoros is helping to introduce this procedure to YRMC and our community. RSL increases accuracy during breast surgery with the help of a tiny titanium radioactive seed. About

the size of a pencil lead, the seed is placed into abnormal breast tissue up to five days before breast surgery. The implanted seed contains a small amount of radioactivity. During the operation, Dr. Manjoros uses a Gamma counter to locate the seed, along with the tumor. Both the seed and the tumor are removed during the breast surgery.

Let's all wear a pink ribbon in October to show our support for the battle against breast cancer.

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