Meet the Challenges of Breast Cancer with Confidence

Understanding why you may be at risk for breast cancer can help you spot any early warning signs you should discuss with your doctor.

All women should see themselves as having some level of risk for breast cancer. However, if any of the following risk factors also apply to you, your doctor may recommend that you have mammograms earlier or more often:

• Increased age
• Obesity
• Personal or a family history of breast cancer
• Prior radiation treatment to the chest
• Tobacco or alcohol use, or both

Often, the first sign of breast cancer is a lump or a change in the feel of the breast. But there are other symptoms that may alert your doctor to possible breast cancer and the need for a mammogram. These include:

• Changes in the nipple
• Itchy or irritated breast
• Nipple discharge
• Pain in the breast
• Redness or color changes in the breast
• Swelling of the breast

Detecting cancer early can increase your chances for recovery and may even save your life. Speak with your doctor right away if you notice any unusual changes in your breasts.

There are three levels of breast cancer detection. These include breast self-exams, clinical breast exams and mammograms. Your doctor will recommend the exams that are right for you, based on your age and risk factors.

Breast Self-Exams

A breast self-exam is a check-up you can do at home to look for changes or problems in the breast tissue. Your doctor may recommend that you include a monthly self-exam as part of your wellness routine. If so, your doctor will give you instructions on how to do a breast self-exam.

Clinical Breast Exams

Starting in your 20s and 30s, your doctor will include a clinical breast exam as part of your regular well-woman visit. The exam will be done at least every three years.

Mammograms

Mammograms can find a change in your breasts before you can feel it. That's why ProMedica recommends that you receive a baseline mammogram at 35 years old (25 years old if your mother had breast cancer before the age of 35), then annually beginning at 40 years old.

We believe it shouldn't be hard for you to schedule preventive and diagnostic testing. That's why we offer just one number to call to schedule a mammogram at any of our convenient locations throughout northwest Ohio and southeast Michigan. Our schedulers can help you find a convenient time and location. All you have to do is:

1. Receive an order from your doctor. If your doctor is a ProMedica Physician, you can find this order in your MyChart account.
2. Call ProMedica Central Scheduling at 419-291-3000 or 800-479-8805 to schedule. Or, login to your MyChart account to schedule your mammogram.

Find a mammogram location near you.

If a mammogram finds something suspicious in your breast, the next step is diagnostic testing. At ProMedica Breast Care and our locations across the ProMedica system, we offer specialized diagnostic tests. They're given by caring experts in breast cancer and women's health.

Based on your unique condition and screening results, the needed diagnostic tests may include:

• Breast tomosynthesis
• Breast ultrasound
• Dedicated breast MRI scanning
• Digital mammograms
• Image-guided breast biopsies (ultrasound, MRI or stereotactic)
• Magnetic seed localization
• Molecular breast imaging scanning

Breasts have many layers of glandular and fatty tissue. Because of that, sometimes we need to combine several tests to get a complete picture of your breast health.

The screening process can seem confusing and cause anxiety for many women. We strive to guide you through the screening process as quickly and easily as possible. If your exam is diagnostic, we may offer an ultrasound or biopsy that same day if needed to speed up the process of getting a diagnosis. MRIs and MBIs will likely be scheduled out as they must coincide with your menstrual cycle. Here are the screening steps you might expect when you come to ProMedica for breast care:

1. Clinical breast exam
2. Mammogram to detect abnormalities in breast tissue
3. Ultrasound to learn if the mass is a cyst or tumor
4. Biopsy for lab evaluation
5. Another mammogram to confirm the biopsy was in the right place
6. MRI or MBI if the biopsy is positive for cancer
7. Breast cancer treatment begins.

ProMedica's breast cancer team is made up of multidisciplinary cancer professionals including medical, radiation and surgical oncologists. They deliver state-of-the-art care including:

• Clinical trials
• Genetic testing and counseling
• Healing care
• Nurse navigator services
• Medicine management counseling
• Precision radiation therapy
• Rehabilitation services
• Survivorship program

Your breast cancer care plan may include more than one type of treatment. Your ProMedica providers take into account the stage and type of your breast cancer, its location in your breast, your risk factors and whether it has spread to other parts of the body. Then they will recommend a course of treatments that may be used separately or together in your care plan.

Chemotherapy

Chemotherapy for breast cancer treatment may be given before or after surgery, and also when breast cancer has spread to other areas of the body. It is given through an IV.

Biotherapy (or Immunology)

Biotherapy, also referred to as immunotherapy, uses your own body's immune system to help fight the cancer.

Hormone Therapy

Hormone therapy blocks hormones that are causing the breast cancer to grow. It's used for hormone receptor positive breast cancers.

Radiation

Radiation therapy for breast cancer uses high energy X-rays to shrink and kill cancer cells. It's usually given after surgery or chemotherapy to reduce the risk of the cancer coming back.

Surgery

Surgical treatment is used to remove the cancer and possibly the lymph nodes and healthy tissue around the cancer. Types of surgical treatments for breast cancer include lumpectomy and mastectomy.

If desired, breast reconstruction is then completed by our board-certified reconstructive surgeons. Our team offers a variety of innovative reconstruction methods including breast implants and tissue flap procedures including DIEP flap. Ask your surgeon if robotic-assisted reconstructive surgery is right for you. Benefits of robotic surgery include minimal scarring, less blood loss and less pain.

ProMedica Cancer Institute is home to physicians who are specialty trained to provide breast cancer surgery care.

Jessica Burns, MD and Jennifer Kulick, MD, FACS are specialty trained surgeons in breast oncology. They provide patients with high-quality care and the latest breast surgery techniques. This includes breast conservation surgery and oncoplastic techniques, as well as nipple-sparing mastectomy.

We know cancer treatment can feel overwhelming. We want you to focus on getting better, not trying to keep tests, treatment and doctors straight. A member of your ProMedica Cancer Institute care team or a personal nurse navigator will guide you and your caregiver through every step of treatment, including:

• Working side-by-side with you to ensure compassionate, supportive and individualized care
• Scheduling/coordinating appointments and helping to reduce the amount of time from diagnosis to treatment
• Providing education and support to you and your family
• Facilitating/coordinating care provided by an interdisciplinary team of physicians, including medical, surgical and radiation oncology consults
• Working on behalf of you and your family to remove possible obstacles to care, including insurance issues, medication assistance or lack of transportation
• Communicating with your physician and helping to communicate the physician's plan of care