Breast Cancer Unit: Services and Resources
Moores Cancer Center has a commitment to offer a comprehensive approach in screening, diagnosing, and treating women with breast cancer. Among our services and resources:
- Screening and diagnosis
- Sentinel node biopsy
- Gene therapy
- Weekly breast conference (your advisory board)
Screening and diagnosis
The American Cancer Society recommends a yearly mammogram for all women age 40 and older. Our radiologists are certified by the American Board of Radiology and specialize in the interpretation of mammograms, breast ultrasound, breast MR imaging, and perform breast biopsy procedures. The breast imaging faculty works closely with UCSD breast surgeons, pathologists, radiation, and medical oncology physicians to provide breast cancer diagnosis, evaluation, and follow up for patients. The department is led by one of the world's leading experts in MRI, William G. Bradley Jr., M.D., Ph.D., FACR
The Breast Imaging Center is at the forefront of this program and provides imaging and diagnostic radiology services to include:
Sentinel node biopsy
Approaches to breast cancer surgery are becoming less invasive and far less radical than former standards of care. One of these new techniques is sentinel node biopsy. Here's how it works: The day before surgery to remove your tumor, you are injected with a harmless tracer substance or dye. When the surgeon operates to remove the lesion, the dye helps spot the sentinel lymph node. This is the first lymph node that drains through to the rest of the lymph nodes under the arm. It is called the "sentinel" lymph node because it is the first affected lymph node: It stands sentinel over the tumor, so to speak, and sounds the warning to other lymph nodes that the cancer has spread.
The sentinel node is removed and quickly biopsied. If cancer is found, it and all or most of the other lymph nodes are removed during the surgery. If not, you retain the remaining lymph nodes, avoiding possible long-term side effects or complications and affording you a faster recovery.
Tissue taken from a biopsy is analyzed in the laboratory, where a lot of information is determined before surgery. “It used to be that a pathologist would process tissue and conclude, ‘It looks like this, so this is what it is.’ It was black and white – breast cancer, yes or no,” according to Richard Schwab, M.D., a hematologist and medical oncologist who specializes in breast cancer at UCSD.
“Now we continue the process, using more specific assays and tests performed on the tissue based on antibodies and detected proteins. This is important for knowing how to treat breast cancer, the prognosis and which treatments will and will not work,” said Dr. Schwab. As a result, he added, today’s more sophisticated analyses allow the medical team to select the treatments that will have the highest degree of efficacy with the least toxicity.
Over the last decade, researchers have been studying the changes in cancer cell DNA, identifying extra copies of genes (known as amplification), in particular a gene called HER2 (human epidermal growth factor receptor-2) that controls how cells grow, divide and repair themselves. Knowing specific profiles of cancer cells can signal clinicians about the optimal treatment approaches to take.
UCSD has been integrally involved in the development of Herceptin, a targeted therapy that’s demonstrating dramatic effectiveness in curing localized HER2-overexpressing breast cancer.
“We are changing the natural history of breast cancer by identifying specific changes and providing individual care,” said Dr. Richard Schwab, M.D. In addition to HER2, he cited a new study that identified lesions with an amplification of a gene called topoisomerase II, which may benefit from a specific chemotherapy regimen. In the near future, women without this amplification may be able to forego that chemo and thus avoid unnecessary toxicity.
Weekly Breast Conference: Your advisory board
One of the hallmarks of the UC San Diego Moores Cancer Center is the weekly Breast Conference, a meeting of the minds of breast cancer clinicians who review each breast cancer case in depth.
This is where the entire medical team – radiologists, pathologists, surgeons, medical oncologists, radiation oncologists and nurses – collaborate to review and discuss findings and options, reviewing individual cases and sharing opinions and information.
“Breast cancer is a complicated disease,” said Anne Wallace, M.D., FACS, surgical oncologist, reconstructive surgeon and director of the UCSD Breast Cancer Unit. “It’s easy to miss something. Each patient needs a lot of time and a lot of expertise.”
Wallace believes that these multidisciplinary case reviews provide patients with the most comprehensive and circumspect evaluation and monitoring of their individual case, resulting in optimal care through integration of the clinical care team.