Breast cancer

Breast cancer treatment in Denver

The HealthONE Breast Care program partners with Sarah Cannon Cancer Institute to provide individualized, innovative breast care and breast cancer services to the Greater Denver area. Through this partnership, we are able to provide individualized, innovative breast care and breast cancer services to the Greater Denver area. Our goal is to use preventive care to detect breast cancer early. If breast cancer is detected, we guide patients and their family members through diagnosis, treatment, recovery and survivorship.

As part of Sarah Cannon, our hospitals are part of a global cancer network providing access to cutting-edge treatments and compassionate care. When you choose a HealthONE hospital for your cancer treatment, you’re being cared for by doctors, nurses and caregivers in one of the most comprehensive health systems in Colorado. IBM Watson Health also named our healthcare division the Top Large Health System in the nation.

Scope of our breast cancer services

A breast cancer diagnosis can be overwhelming, and patients want guidance and coordination to feel confident as they begin their journey. The HealthONE Breast Care team works individually with every patient to schedule consultations with specialists—typically including general surgeons, radiation oncologists and medical oncologists—to discuss diagnoses and next steps.

Following consultations, our clinical team will collaborate and develop your individualized plan of care. Our nurse navigators are connected with you during every step of treatment, keeping you informed and ensuring you receive the emotional and physical support you need.

Our comprehensive scope of services includes:

• Breast tumor conference—Our breast tumor board meets weekly to discuss treatment plans for every patient. This is central to our patient care and engages all disciplines to talk about treatment as a whole.
• Clinical trials—Our doctors remain on the forefront of breast cancer research, clinical trials and therapeutic and registry trials. Search for breast cancer trials.
• Complementary services and therapies—Our patients benefit from a variety of additional services, including oncology rehabilitation, nutrition support, cancer exercise, acupuncture and assistance with cosmetic changes when dealing with hair loss.
• Genetic counseling—To help more patients manage their breast health and detect cancer early, we meet with patients for genetic testing and counseling and to discuss risk reduction strategies.
• In-depth imaging—Our imaging specialists are available to provide second reads on images performed at other facilities and aid in diagnosis by performing image-guided biopsies.
• Medical oncology—We offer many medical treatment options for breast cancer patients, including chemotherapy, hormone therapy and immunotherapy.
• Nurse navigation—Specialized services in nurse navigation are at the heart of our breast cancer program. Our nurse navigators act as advocates, educators, support systems and connectors between patients and their providers throughout the care journey.
• Oncofertility—We have oncofertility experts who help women discuss their fertility options when facing cancer-related and genetic risk-related infertility. They will develop an individualized plan of care that is based on type and extent of cancer.
• Patient education—We educate patients through many channels, including consults with our surgeons, meetings with a nurse navigator and detailed patient guidebooks.
• Radiation therapy—Our radiation oncology services include internal and external radiation therapies to kill cancer cells while sparing as much healthy tissue as possible.
• Reconstructive surgery—Following breast cancer surgery, many patients choose to undergo some type of breast reconstructive surgery to regain a natural breast shape. Our surgeons offer many techniques to reconstruction.
• Support services—There are many facets to the cancer journey, which is why we help patients by providing access to financial counseling, advanced care planning, social workers and support groups.
• Surgical oncology—We perform a variety of surgical procedures, from mastectomies to lumpectomies.

Multidisciplinary breast cancer experts

At HealthONE Breast Care, we offer you access to a group of multidisciplinary, expert physicians. This specialized team reviews each patient’s case to collaborate and develop a comprehensive care plan specific to each patient.

Members of our multidisciplinary breast care team include:

• Breast cancer nurse navigators—an oncology-certified nurse who provides personalized guidance throughout the breast cancer care and acts as your first point of contact to guide you through the entirety of your cancer journey
• Breast ultrasound technician—a staff member specially trained in performing breast ultrasounds
• Digital mammography technician—a staff member specially trained in performing digital mammography exams
• Medical oncologist—a physician who works with you to explain the treatment options available and will determine if chemotherapy is needed
• Radiologist—a physician who oversees imaging tests and specializes in breast imaging techniques
• Surgical oncologist—a surgical specialist who evaluates your breast cancer diagnosis and determines whether surgery is necessary

Breast cancer screening

Early detection of breast cancer allows for the best possible outcomes. This is why our hospitals offer breast cancer screenings and a variety of breast imaging services, including mammography and breast magnetic resonance imaging (MRI).

The breast cancer specialists of Sarah Cannon recommend an annual screening mammogram for women 40-74 years old. Your breast cancer screening strategy should be discussed with your physician, as women at high risk of developing breast cancer may need to begin screening earlier.

Breast cancer risk factors

The following factors indicate a higher risk for developing breast cancer:

• Dense breasts
• First-degree relative with breast cancer
• Gene mutations, including ATM, BRCA1, BRCA2, CDH1, CHEK2, NBN, NF1, PALB2, PTEN, STK11, TP53
• Menopause at 55 years old or older
• Personal history of breast cancer
• Previous diagnosis of atypical ductal hyperplasia, atypical lobular hyperplasia or lobular carcinoma in the breast tissue
• Radiation therapy to the chest at a young age
• Starting menstruation at 12 years old or younger

Diagnosing breast cancer

If a breast imaging exam shows a mass that cannot be designated as noncancerous, our doctors perform a breast biopsy. Breast biopsies are necessary because they help determine if a breast mass is non-cancerous (benign) or malignant (cancerous). They also allow us to accurately diagnose and stage breast cancer.

There are two types of non-surgical biopsies: breast biopsies and ultrasound-guided breast biopsies.

• Stereotactic breast biopsies—Stereotactic breast biopsies are X-ray guided. This exam is necessary when mammography shows a mass, a cluster of tiny calcium deposits or another area of abnormal breast tissue that the mammogram cannot confirm is non-cancerous. If this is the case, it may be necessary to obtain a tissue sample that can be examined to detect breast cancer cells.
• Ultrasound-guided breast biopsies—In ultrasound-guided breast biopsies, the ultrasound images will pinpoint where the breast abnormality is so cells can be collected and analyzed. This biopsy takes less time than a stereotactic breast biopsy and is used when the breast abnormality can be detected with ultrasound.

We also offer additional methods of detecting and diagnosing breast cancer.

Second opinion services

We understand the importance of an accurate breast cancer diagnosis. For this reason, our breast program provides compassionate, thoughtful second opinion services. We work with you to help you understand all testing, results and treatment options.

Treatment options for breast cancer

Our team will work with you to develop a personalized breast cancer treatment plan. Treatment options may include:

• Medical oncology treatment
• Radiation therapy treatment
• Surgical treatment
• Reconstruction procedures

Medical oncology treatment for breast cancer

We offer several medical oncology services for the treatment of breast cancer. In addition to medical therapies, our patients have access to additional services, including targeted therapy, scalp cooling for hair loss prevention and precise cancer staging with analysis of lymph node involvement. The type of treatment that is right for you will depend on your specific diagnosis.

Biological therapy/immunotherapy

These therapies use man-made proteins that alter the growth and replication of a cancer cell by interfering with its specific biological pathways. This stops the cancer from growing and spreading.

Chemotherapy

Chemotherapy is a type of treatment that uses a drug or combination of drugs to treat cancer. The goal of chemotherapy is to stop or slow the growth of cancer cells. These medications may be used in conjunction with other therapies to treat breast cancer.

Hormonal therapy

The hormones estrogen and progesterone can stimulate the growth of some breast cancers—which are called hormone-sensitive or hormone-dependent breast cancers. Hormone therapy is used to stop or slow the growth of these tumors.

Radiation treatment for breast cancer

We offer advanced, specialized radiation treatment options for breast cancer. Your radiation oncologist will help determine which radiation therapy technique will be effective for your type of breast cancer.

Accelerated partial breast irradiation

This is external or internal beam radiation targeting only the small area where a tumor has been surgically removed. This form of radiation is typically completed with five consecutive daily treatments.

Breast brachytherapy

This form of radiation treats breast cancer from within the breast where a tumor has been surgically removed.

Hypofractionated radiation therapy

This radiation treatment uses higher doses over fewer sessions. It still destroys cancer cells and, for some people, may be used as a follow-up treatment.

Deep inspiration breath hold

This is a specific breathing technique used during radiation treatment. When a breath is taken in and held, it pulls the heart farther away from the chest. This is beneficial for patients with left-sided breast cancer and reduces potential damage to the heart caused by radiation exposure.

Intraoperative radiation therapy

This treatment allows for the delivery of a concentrated, single dose of radiation delivered directly to the tumor site during breast cancer surgery. Typically, no further radiation therapy will be needed following intraoperative radiation therapy.

Partial breast radiation therapy

This therapy uses external beam radiation targeting only the small area of the breast where a tumor has been surgically removed. Partial breast radiation therapies significantly reduce the amount of time needed to complete the treatment. They also help limit and prevent radiation exposure to healthy tissue and organs close to the breasts, including the lungs, heart, ribs, muscles and skin.

Prone breast radiation therapy

This form of radiation is performed while the patient lies face down on a specialized table fitted with a breast board to enhance comfort. Aside from the different position, radiation then continues as normal.

Whole breast radiation therapy

This technique involves external beam radiation therapy that uses radiation from high-energy X-ray beams to kill cancer cells or slow their growth. This treatment covers the entire breast, as well as the chest wall and lymph node areas, as needed. Whole breast radiation therapy is typically completed during a period of six to seven weeks.

Surgical treatment options for breast cancer

Many patients with breast cancer need some form of surgery based upon their cancer type and medical history. We provide surgical treatment options to remove as much breast cancer as possible, see if your cancer has spread, relieve symptoms of advanced cancer and restore breast shape after cancer has been removed. We will help you understand all of your options so you and your surgeon can make the right choice for you.

Lumpectomy

A lumpectomy is a breast-conserving surgery where only part of the breast containing cancer is removed, sparing surrounding healthy breast and nipple tissue. The size and location of your tumor will determine how much breast tissue needs to be removed.

For patients who may benefit, we perform reduction lumpectomies. This is a traditional lumpectomy with breast reduction and lift—all of which occur during one procedure.

Lymph node removal

The removal of a lymph node helps your doctor determine the extent of your cancer diagnosis. Lymph node removal may occur during a lumpectomy or mastectomy, or as a separate option.

Mastectomy

A mastectomy is the surgical removal of an entire breast or both breasts. We perform many variations of this procedure, including:

• Double mastectomy—removes the entirety of both breasts
• Modified radical mastectomy—removes the entirety of the breast while sparing certain shoulder muscles
• Skin-sparing mastectomy—removes less skin during surgery compared to traditional mastectomy and performed in combination with breast reconstruction
• Simple mastectomy—removes all of the breast, excluding the lymph nodes
• Total mastectomy—removes all of the breast, including lymph nodes in the underarms

Your surgeons work closely with you to determine the appropriateness of mastectomy and what technique is the best option according to your particular cancer type, stage, genetic risk and personal wishes. Our surgeons have additional training in scar-minimizing surgical techniques, which leave less evidence of surgery after recovery.

Reconstruction

Breast reconstruction surgery helps restore the shape of your breasts following a mastectomy or lumpectomy. Reconstruction may take place immediately following your surgery or years later. Not all women opt for reconstruction. Talk to your surgeon about reconstructive surgery before your mastectomy or lumpectomy to determine the treatment plan that is right for you.

Our surgeons perform many variations of breast reconstruction surgery, including:

• Breast implant removal—removes breast implants following a reconstruction or augmentation procedure
• Implant-based reconstruction—uses breast implants for reconstructive or cosmetic purposes following breast cancer surgery
• Reduction lumpectomy free-flap reconstruction—removes skin and tissue from the abdomen for reconstruction but not muscle, also called deep inferior epigastric artery perforator (DIEP) flap
• Transverse rectus abdominis (TRAM) flap reconstruction—uses excess skin from the abdomen to reconstruct the breast
• Latissimus dorsi flap reconstruction—diverts skin, fat, blood vessels and muscle from behind the shoulder blade to the chest and formed into a breast shape

For some patients, breast reconstruction surgery may occur at the same time as breast cancer surgery. This will depend on individual risk factors and diagnoses.

Breast cancer rehabilitation

We offer rehabilitation services for women who a recovering from breast cancer. Rehabilitation focuses on specialized treatment protocols for patients after breast surgery, as well as during and following chemotherapy and radiation therapy. It also helps reduce symptoms that women may experience due to treatment.