We Treat
Breast Cancer
At SCRI Oncology Partners, we are leaders in the battle against breast cancer. Our dedicated team of experts offers state-of-the-art, personalized care and pioneering treatments, ensuring you receive a thorough and customized approach to meet your diagnosis needs. With more than three decades of experience and a commitment to clinical excellence, we are at the forefront of breast cancer treatment and research, specializing in treating high-risk breast cancer and aggressive cancer types. Learn more about our team of experts and our innovative approach to cancer care.
What is breast cancer?
The breasts are organs that sit on the outside of the upper ribs and chest muscle and are made up of glands, ducts and fatty tissue. Breast cancer occurs when cells in the breast mutate and begin to grow out of control.
Breast cancer is one of the most common types of cancer in women, second only to skin cancer. It is most common in older women, but can also commonly affect younger women and men. To ensure you stay on top of your breast health, it is important to conduct self-exams, so you know what your normal breast tissue feels like – making it easier to identify irregular tissue if it were to occur. Additionally, it is critical to stay close to your primary care provider and receive regular mammograms at the following ages:
| Age and Condition | Mammogram Screening Frequency |
| 40-74, average risk | Start screening with mammograms annually |
| 75 and over | Continue with mammograms as long as your overall health is good. |
| High Risk | If you are at high risk for breast cancer, you are advised to start screening earlier and may include mammograms as well as other tests like ultrasounds or breast MRIs |
What are the signs and symptoms of breast cancer?
Breast cancer can present with a variety of signs and symptoms, with the most common symptom being the presence of a lump, knot or mass in the breast or underarm area. It is critical to stay in tune with your body and monitor your breasts for any changes in the breast’s size, shape or the color of the skin of the breast, as these changes in appearance can also be indicators of cancer.
Below are a few specific signs to look out for:
- Pink, red or purple skin coloring on the breast or other skin on the chest.
- Changes to the skin, including dimpled or orange peel-like skin, peeling or crusting.
- Nipple changes, including pain, unusual discharge (which may be clear, bloody or another color), physical changes such as retraction, dimpling or the appearance of sores.
- Skin over the nipple may also become red, dry, flaky or thickened.
If the cancer has progressed, you may experience swelling in part of the breast, as well in the armpit or near the collarbone, which can occur if the cancer has spread to nearby lymph nodes. Pain or tenderness in the breast or nipple area, although not always associated with cancer, could be a sign, particularly in rare types such as inflammatory breast cancer or Paget’s disease. It is essential to consult a healthcare provider if you notice any of these symptoms, even if a recent mammogram was clear.
Risk Factors
Staging
Treatment
Clinical Trials
How is breast cancer diagnosed?
Regular screening tests are the most effective way to find breast cancer early. Smaller, localized breast cancers detected through screenings tend to have a better outcomes, making early detection through regular screening essential for successful treatment and increased survival rates.
If your physician suspects you may have breast cancer after routine screening or you are experiencing signs or symptoms of breast cancer, you may need more imaging tests to confirm your diagnosis. This may include a diagnostic mammogram or breast ultrasound. If these imaging tests detect an abnormality, a breast biopsy will be performed.
During a biopsy, a small sample of breast tissue is removed and sent to a lab for analysis. There it will be tested to determine if the cells are cancerous and provide detailed information about the type and aggressiveness of the cancer, which is critical for developing a treatment plan tailored to your specific needs.
Receiving a breast cancer diagnosis can be overwhelming. You may be feeling stress and anxiety over what comes next. Our team at SCRI Oncology Partners is here to support and provide you with the information you need to find the right path for your treatment.
Risk factors for breast cancer
Several factors can increase the likelihood of developing breast cancer, including:
- Older age
- Obesity
- Increased use of alcohol
- Reproductive factors, such as older age at first pregnancy or not having children
- Increased tobacco use
- The use of postmenopausal hormone replacement therapy
- Other childhood cancers or history of chest wall irradation
- Presence of hereditary conditions like BRCA 1 or 2 mutation that increases risk
While having a family history of breast cancer does increase a woman’s risk, the majority of women diagnosed with the disease have no known family history. Meaning that even though you may not have a family history of breast cancer, you may still be at risk of developing the disease – in fact 1:8 women in America will face breast cancer at some point.
In addition, it’s important to note that approximately half of all breast cancer cases occur in women who have no identifiable risk factors beyond being female and over the age of 40. Breast cancer is a complex diagnosis, therefore, it is critical to incorporate regular screenings and to stay vigilant with your self-exams and overall breast health.
Types of breast cancer
If you have been diagnosed with breast cancer, your treatment options may be determined by the type of breast cancer you have. Your physician will determine what type of breast cancer you have by looking at the location in the breast where the cancer has begun to grow, how much the cancer has spread and specific features of the cancer cells. Treatment may involve things like surgery, radiation, chemotherapy or use of endocrine therapy.
Non-Invasive Breast Cancers have not spread beyond the part of the breast where it started. These are also called precancers. The main type of non-invasive breast cancer is called ductal carcinoma in situ (DCIS), which is located in the milk ducts. While this is not life-threatening, it can increase your risk of developing invasive breast cancer and are removed through surgery.
Invasive Breast Cancers have spread from where they were initially located into the surrounding breast tissue.
- Invasive ductal carcinoma (IDC) begins in the milk ducts. This is the most common type of breast cancer, accounting for about 70-80% of all breast cancers.
- Invasive lobular carcinoma (ILC) begins in the lobules and is the second most common type of breast cancer.
- Inflammatory breast cancer blocks lymph vessels in the skin, causing the breast to look inflamed.
Special Types of Invasive Disease
Triple-negative breast cancer tests negative for all 3 receptors: both estrogen, progesterone receptors, and HER-2 Triple-positive breast cancer tests positive for estrogen and progesterone receptors and has elevated levels of HER2 protein.
Less Common Types of Breast Cancer
- Paget disease of the breast starts in the breast ducts before spreading to the skin of the nipple and areola.
- Angiosarcoma starts in the cells that line blood vessels or lymph vessels.
- Phyllode tumors develop in the connective tissue of the breast. Most of these tumors are benign, but they can be malignant.
Staging
Once you have been diagnosed with breast cancer, your physician will determine the stage of your cancer to help guide your treatment plan.
The breast cancer staging system is overseen by the (AJCC). To stage your cancer, your physician will look at the extent of the primary tumor, any spread to nearby lymph nodes and whether the cancer has spread to other parts of the body. They will also consider what the cancer cells look like, whether the cancer cells have receptors for the estrogen and progesterone hormones, and how much of the HER2 protein the cancer cells are producing.
Stage 0
This describes non-invasive breast cancers that have not spread into the surrounding tissue from the milk duct or lobule they have started in.
Stage I
Invasive breast cancers in stage I have begun to spread to nearby tissue and are divided into two categories:
- IA: The tumor measures 2 cm or smaller and has not spread outside of the breast.
- IB: Groups of cancer cells 2 mm or smaller are found in the lymph nodes but not the breast, OR there is a tumor 2 cm or smaller in the breast with small groups of cancer cells found in the lymph nodes.
Stage II
Stage II breast cancers are divided into two categories:
- IIA: No tumor is found in the breast, but groups of cancer cells larger than 2mm are found in 1 to 3 axillary lymph nodes or lymph nodes near the breastbone, OR a tumor in the breast measuring under 2 cm has spread to the lymph nodes, OR a tumor in the breast measures between 2 cm and 5 cm and has not spread to the lymph nodes.
- IIB: A tumor between 2 cm and 5 cm is in the breast and has spread to the lymph nodes, OR the tumor is larger than 5 cm but has not spread to the lymph nodes.
Stage III
Stage III breast cancers are divided into three categories:
- IIIA: Cancer is not in the breast but is found in 4 to 9 axillary lymph nodes or lymph nodes near the breastbone, OR a tumor in the breast is larger than 5 cm with small groups of cancer cells in the lymph nodes, OR the tumor is larger than 5 cm and the cancer has spread to 1 to 3 axillary lymph nodes or the lymph nodes near the breastbone.
- IIIB: The tumor is any size and has spread to the chest wall or skin of the breast and has spread to 9 or fewer axillary lymph nodes or the lymph nodes near the breastbone. This usually includes inflammatory breast cancers.
- IIIC: There may be no tumor in the breast or the tumor may be any size and the cancer has spread to the chest wall and/or skin, OR it has spread to 10 or more axillary lymph nodes, the lymph nodes near the collarbone, or near the breastbone.
Stage IV
This describes all breast cancers that have spread beyond the breast and nearby lymph nodes to other parts of the body. These cancers are often called metastatic breast cancer.
How can breast cancer be treated?
If you have been recently diagnosed with breast cancer, your cancer care team at SCRI Oncology Partners will work with you to develop a treatment plan that best fits your cancer, overall needs and personal preferences. The treatment your physician recommends may depend on a variety of factors, including the type and stage of your breast cancer, any potential side effects and your personal preferences when it comes to your health. It’s important to speak to your physician about your needs, goals for your health and lifestyle and any other concerns you may have about treatment.
Surgery
Many people with breast cancer will have surgery as a part of their cancer treatment plan. Sometimes, this is combined with other treatments before and/or after surgery. Surgery can be done to remove as much of the cancer as possible, discover whether the cancer has spread to the lymph nodes under the arm, restore the shape of the breast after treatment or relieve cancer symptoms.
Two types of surgery are usually used to remove breast cancer:
- A lumpectomy removes the tumor and a small amount of surrounding lymph nodes may also be removed. This treatment is sometimes referred to as breast-conserving surgery because patients given a lumpectomy usually keep most of their breast and don’t need reconstruction of their breast shape.
- A mastectomy removes breast cancer by removing the entire breast. Sometimes, nearby tissues are also removed. Patients may choose to have reconstruction to rebuild their breast or not.
Sometimes surgery is done to remove nearby lymph nodes to determine how big the cancer is or how much it has spread. This can be done as a part of a cancer-removing surgery or on its own.
If cancer has spread to other parts of the body, surgery may be done to slow the spread or to prevent or relieve symptoms.
Some patients may have the option of breast reconstruction surgery following surgery to remove their cancer. There are several types of reconstructive surgeries, depending on your medical needs and personal preferences. Discuss your options with your cancer care team before you have surgery to remove the cancer.
Radiation therapy
Radiation therapy treats cancer by using high-energy rays to target and eliminate cancer cells. Radiation therapy can be used as a part of treatment for almost every stage of breast cancer. Your physician may recommend radiation to treat cancer that cannot be removed with surgery, after surgery to treat any remaining cancer cells or to target breast cancer that has spread to other parts of the body. It may also be used to reduce symptoms caused by breast cancer.
There are two main types of radiation therapy used to treat breast cancer:
- External beam radiation therapy: This form of radiation therapy uses a machine to deliver radiation to the area of the body affected by cancer. This procedure is painless and only lasts a few minutes, though set up for the treatment takes longer. This is the most common form of radiation therapy used to treat breast cancer and uses tangential fields to minimize any radiation to the rest of the body and only hit the chest wall that is the goal.
- Internal radiation therapy: Also called brachytherapy, this treatment is usually used after surgery. Radioactive substances are placed directly into the breast tissue in the area where the cancer was removed to destroy any remaining cancer cells.
Chemotherapy
Chemotherapy uses anti-cancer drugs that travel through the bloodstream to target cancer cells throughout the body. Chemotherapy can be given intravenously or taken by mouth. Not every patient with breast cancer will need chemotherapy and for some patients we have tests that can tell us whether it may be needed, but it can be used:
- After surgery: Also called adjuvant chemotherapy, this treatment can be used to eliminate cancer cells left behind after surgery or microscopic cancer cells that cannot be seen by the naked eye. Chemotherapy given after surgery can lower the risk of breast cancer recurrence.
- Before surgery: Also called neoadjuvant chemotherapy, this treatment is sometimes given to shrink the tumor before surgery. Chemotherapy before surgery can be given for multiple reasons: inflammatory breast cancer, cancers that are too big to be removed by surgery without shrinking first, or simply to see how it responds to chemotherapy so we can tailor additional treatment after surgery based on response. Some patients receiving chemotherapy before surgery may also need more chemotherapy after surgery.
- To treat metastatic breast cancer: Chemotherapy is sometimes used as the main treatment for cancer that has spread to other parts of the body. It can also be used after a different initial treatment.
Radiation therapy
Radiation therapy treats cancer by using high-energy rays to target and eliminate cancer cells. Radiation therapy can be used as a part of treatment for almost every stage of breast cancer. Your physician may recommend radiation to treat cancer that cannot be removed with surgery, after surgery to treat any remaining cancer cells or to target breast cancer that has spread to other parts of the body. It may also be used to reduce symptoms caused by breast cancer.
There are two main types of radiation therapy used to treat breast cancer:
- External beam radiation therapy: This form of radiation therapy uses a machine to deliver radiation to the area of the body affected by cancer. This procedure is painless and only lasts a few minutes, though set up for the treatment takes longer. This is the most common form of radiation therapy used to treat breast cancer and uses tangential fields to minimize any radiation to the rest of the body and only hit the chest wall that is the goal.
- Internal radiation therapy: Also called brachytherapy, this treatment is usually used after surgery. Radioactive substances are placed directly into the breast tissue in the area where the cancer was removed to destroy any remaining cancer cells.
Chemotherapy
Chemotherapy uses anti-cancer drugs that travel through the bloodstream to target cancer cells throughout the body. Chemotherapy can be given intravenously or taken by mouth. Not every patient with breast cancer will need chemotherapy and for some patients we have tests that can tell us whether it may be needed, but it can be used:
- After surgery: Also called adjuvant chemotherapy, this treatment can be used to eliminate cancer cells left behind after surgery or microscopic cancer cells that cannot be seen by the naked eye. Chemotherapy given after surgery can lower the risk of breast cancer recurrence.
- Before surgery: Also called neoadjuvant chemotherapy, this treatment is sometimes given to shrink the tumor before surgery. Chemotherapy before surgery can be given for multiple reasons: inflammatory breast cancer, cancers that are too big to be removed by surgery without shrinking first, or simply to see how it responds to chemotherapy so we can tailor additional treatment after surgery based on response. Some patients receiving chemotherapy before surgery may also need more chemotherapy after surgery.
- To treat metastatic breast cancer: Chemotherapy is sometimes used as the main treatment for cancer that has spread to other parts of the body. It can also be used after a different initial treatment.
Hormone therapy
Some breast cancer cells have proteins called receptors which help the cancer grow by attaching to hormones like estrogen and progesterone. These cancers are called hormone receptor-positive, and account for two out of three breast cancers. Hormone therapy treatments work by blocking your hormones from attaching to these receptors.
Hormone therapy is often used after surgery to reduce the risk of recurrence and is often taken for at least five years. It can also be started before surgery. Hormone therapy is sometimes used to treat cancer that has come back after treatment or spread to other parts of the body.
Targeted drug therapy
Targeted drug therapy uses medicine to target specific proteins on breast cancer cells to eliminate the cancer or slow its growth. These drugs travel through the bloodstream to reach cancer in all areas of the body. Different targeted therapy medications may be used to treat HER2-positive breast cancer, hormone receptor-positive breast cancer, cancer with a BRCA gene mutation and triple-negative breast cancer.
Immunotherapy
Immunotherapy drugs treat breast cancer by restoring the immune system’s ability to recognize breast cancer cells and start an immune response. Pembrolizumab (Keytruda®) can be used with chemotherapy to treat triple-negative breast cancer before and after surgery for stage II or III cancers, cancer that has returned or cancer that has spread to other parts of the body.
Breast cancer clinical trials
Today’s clinical trials are tomorrow’s treatment options. A clinical trial can help determine if a treatment, drug or procedure shows a better way of treating a particular cancer or condition. At SCRI Oncology Partners we are committed to offering the latest clinical trials to improve your outcomes and ensure access to cutting-edge scientific advancements for our patients in the community.
If you are looking for a local oncologist in Nashville, Tennessee and are interested in participating in a clinical trial for breast cancer through our collaboration with Sarah Cannon Research Institute (SCRI), a global leader in oncology research, the first step is to talk to our healthcare team.
We are here to help, discover more resources
What is Metastatic Breast Cancer?
Metastatic breast cancer is breast cancer that has spread from the breast to other parts of the body. This is also referred to as advanced or stage 4 breast cancer.
Receiving an Abnormal Mammogram Report, What Next?
It is not unusual to get recalled after an initial screening mammogram. Additional imaging is often requested so that a clearer view of a particular area of breast tissue can be captured.
Contact Us
Whether you are newly diagnosed, previously treated or seeking additional care or research options, we are here to support you every step of the way.
Contact Us
Whether you are newly diagnosed, previously treated or seeking additional care or research options, we are here to support you every step of the way.
Contact Us
Whether you are newly diagnosed, previously treated or seeking additional care or research options, we are here to support you every step of the way.