Breast Cancer

Breast cancer is the most common form of cancer in women, affecting 1 in 8 women during their lives. It is also the second most common cause of cancer death in women. Men can also develop breast cancer, although these cases are very small in number compared to women.

Many women are understandably concerned about developing breast cancer, which is why preventive measures such as routine breast exams and mammograms have become commonplace.

There are several factors which raise the risk of breast cancer, including:

• Being overweight
• Prior use of hormone-based contraceptives
• Age (increased risk as a woman gets older)
• Menses starting before age 12
• Menopause after age 55
• Not having children
• Having dense breasts
• Family history of breast cancer, especially if in first-degree relatives (mom or sister)

Many breast cancers are first discovered when a lump is detected on an exam or on imaging. However, other signs such as nipple discharge, change in breast size, and breast tenderness can also signal breast cancer.

A biopsy is used to determine the presence of cancer, as well as the specific type of cancer. Breast cancers typically fall under one of several types, including:

• Lobular carcinoma, involving the lobules of the breast. The lobules are where breast milk is produced. When the cancer extends beyond the lobules, it is termed invasive.
• Ductal carcinoma, involving the milk ducts. The ducts transport breast milk from the lobules to the nipple. This is the most common type of breast cancer, and is either termed in situ (contained within the duct) or invasive (extending beyond the ducts).
• Sarcoma, involving the connective tissue of the breast. This includes muscle, blood vessels, and fat.

As with most cancers, breast cancer has a better prognosis when caught early. The conventional standard of care for breast cancer typically involves some combination of:

• Surgery (lumpectomy or mastectomy)
• Chemotherapy (using one or several drugs in combination)
• Radiation

Cancer cells are given a grade based on their appearance under a microscope, with grade 1 being most similar to normal cells (and thus least aggressive) and grade 3 being the most dissimilar (and thus the most aggressive). The hormonal status of the cancer is also determined to see if estrogen and progesterone fuel the growth of the cancer. The HER2 gene can also be evaluated, and if over-expressed, tells us more about the cancer’s behavior. These specific characteristics are used to guide treatment.

Additional testing to evaluate for spread of cancer is also frequently undertaken. This can include lymph node biopsies to see if the cancer has spread to the lymphatic system, as well as imaging such as a PET scan to look for spread to more distant locations in the body.

In integrative oncology, we do not stop there. Rather than merely looking at the cancer in isolation, and treating each patient with the same diagnosis the same way, we also consider many other patient factors, including:

• Previous medical history
• Chronic medical problems, such as high blood pressure, diabetes, and digestive issues
• Diet and nutritional status
• Activity level and mobility
• Environmental exposures in the home and at work
• Sources of stress
• Support system, including family and friends
• Treatment goals

Once we account for these variables, each cancer case becomes as unique as a fingerprint. Dr. Stegall reviews your case very carefully, and after thorough discussion with you, a specific treatment plan is generated. Once the roadmap is created, we have many tools at our disposal. These tools include advanced testing as well as innovative therapies that are on the cutting edge of science. The tools chosen for your specific case are personalized to you. This patient-centered approach is essential for proper cancer treatment.