Breast Cancer Treatment

Funmi Olopade, MD, and Tara Gehring, RN Medical oncologist and Director of the Center for Clinical Cancer Genetics, Olufunmilayo Olopade, MD, left, and cancer nurse Tara Gehring, RN.

When a breast cancer patient comes the University of Chicago Medicine, our multidisciplinary team considers several factors when deciding on the best course of treatment, such as the stage of the cancer, tumor biology, family medical history and past medical history. By targeting breast cancer using a team approach, each patient receives tailored treatment based on her individual needs.

Learn more about treatment options for breast cancer:

Surgery for Breast Cancer: Options Matter

University of Chicago Medicine surgeons are highly skilled, nationally recognized experts in the latest surgical techniques for breast cancer, including:

  • Breast conservation therapy: For many women, our breast surgeons perform breast conservation surgery, in which the tumor and surrounding tissue are cut away as a way to leave most of the breast intact. Patients then undergo radiation therapy to destroy any cancer cells left in the breast after surgery.
  • Mastectomy: For women who are not eligible for breast conservation, our breast surgeons also offer mastectomy, in which the entire breast is surgically removed. They may perform simple mastectomy (remove the entire breast, extra skin, nipple and areola), skin sparing mastectomy, (remove the nipple and areola but maintain the extra skin for immediate reconstruction) or total skin-sparing mastectomy (remove breast tissue but leave the skin and nipple and areola intact for immediate breast reconstruction).
  • Lymph node surgery: In order to determine whether cancer cells from the breast have spread outside of the breast. our breast surgeons will also perform lymph node surgery. Findings from these procedures (sentinel lymph node biopsy and axillary lymph node dissection), allows the surgeons to determine if a woman needs additional treatment after her breast cancer surgery.
  • Radioactive seed localization: We are the first in the Chicagoland area to offer radioactive seed localization for tumors that are only seen on mammography or ultrasound. Radioactive seeds can be placed up to five days before surgery and can facilitate a more targeted surgical excision.
  • Nipple-sparing procedures: For women undergoing mastectomy (removal of a breast), our surgeons have unparalleled experience and outcomes in the Chicago area using nipple-sparing techniques.
Eloise Orr Eloise Orr looked to our breast cancer experts to tailor a treatment regimen that would not interfere with her life plans. »Read Eloise's story

UChicago Medicine breast surgeons take a balanced approach to breast cancer surgery, using evidence-based medicine to tailor surgery to each woman's needs. For example, our surgeons use minimally invasive techniques in women with cancer in their lymph nodes who have had an excellent response to chemotherapy to remove only the select lymph nodes that are affected by cancer, rather than more extensive surgery that involves removing healthy lymph nodes. This careful approach effectively treats cancer while reducing the risk for post-surgical complications, such as numbness and lymphedema, or tissue swelling.

Shirley Mertz When Shirley Mertz was diagnosed with metastatic breast cancer, she searched for an oncologist who provided support and additional options for care. »Read Shirley's story

Medical Oncologists Offer Novel Therapies

Medical oncologists at the University of Chicago Medicine are skilled at managing all types of breast cancers, with special expertise in aggressive forms of breast cancer, such as triple-negative breast cancer. Our team of breast cancer medical oncologists offers the latest medical treatments for breast cancer, including:

Adjuvant therapy, in which patients may receive treatment after surgical removal of the cancer. Types of adjuvant therapy include the following:

  • Chemotherapy: Medicines or drugs designed to kill cancer cells.
  • Hormonal therapy: Treatment designed to block or lower estrogen, which promotes growth of cancers that are hormone receptor-positive.
  • Biologic therapy: Treatment designed to help the immune system fight cancer.

Radiation therapy is another form of adjuvant therapy. 

Neoadjuvant therapy, in which patients may receive adjuvant therapy (typically chemotherapy or hormone therapy) to shrink the tumor(s) before surgical removal. Neoadjuvant therapy allows physicians to better understand how an individual's cancer responds to therapy, so that the treatment plan can be adjusted accordingly. Neoadjuvant therapy also opens the gateway for patients to access newer chemotherapies. This approach is hailed as a pioneering therapy that may soon change the standard of breast cancer care.

Through our robust clinical trials program, our team also offers many promising emerging therapies that are not available at other institutions.

Targeted Radiation Therapy Preserves Healthy Tissue

DIBH AlignRT Advanced 3-D surface imaging technology to facilitate deep-inspiration breath-hold (DIBH) accurately tracks the patient's position and breathing so that radiation is delivered only when the patient is in the best possible position.

At the University of Chicago Medicine, our radiation oncologists are nationally recognized for their expertise, and use sophisticated methods and machines to deliver precise treatments that target breast tumors while sparing healthy tissue. We offer the full range of treatment options, all designed to provide accurate, comfortable and safe care. Here, treatment approaches are customized to each patient's needs, taking into account the type of breast cancer, location of the tumor, body shape and the patient's preferences.

UChicago Medicine radiation oncologists and medical physicists are pioneers in prescribing the right type of radiation therapy and the optimal position for receiving therapy (patient lying chest down or chest up). We're often among the first in the nation to offer leading-edge technology and treatment approaches -- years before these options become the standard of care elsewhere. Some Chicago-area radiation therapy firsts that occurred at UChicago Medicine include:

  • Intensity-modulated radiation therapy (IMRT): IMRT is an advanced type of radiation treatment that uses 3-D images to shape the beam and its intensity to the contour of the tumor, minimizing radiation to healthy tissue.
  • Prone-position radiation therapy: Prone positioning (patient lying chest down), allows the radiation beam to target the cancer without delivering unnecessary radiation to the heart and lungs.
  • Hypofractionated radiation therapy: With this technique, larger doses of radiation are given less often, shortening the traditional course of therapy from six weeks down to three weeks.
  • 3-D Surface Imaging to Facilitate Deep-Inspiration Breath-Hold (DIBH): Patients receiving radiation for left-sided breast tumors while in the supine position (lying chest up) are at greater risk for radiation exposure to the heart. Women can minimize this risk by breathing deeply and briefly holding their breath during treatment, which moves the heart and lungs away from breast tissue. To make DIBH easier for the patient, our experts use a state-of-the-art system that relies on 3-D surface imaging to detect the breast's position for accurate treatment. This highly sensitive technology delivers radiation only during optimal positioning, and shuts off automatically when the patient coughs or exhales. Unlike older DIBH technology, this system is non-invasive and does not require the patient to breathe into a device during treatment.

In addition, our radiation oncologists are actively recruiting patients for clinical trials of promising new treatments. A key area of research emphasis is the focused treatment of limited metastases (cancer that has spread beyond the primary site) -- a subset of metastatic disease called oligometastasis. Our radiation oncologists have designed and authored the first international group phase 1 trial of targeted therapy to treat multiple metastases simultaneously.

Optimizing Breast Reconstruction for Form and Function

Our fellowship-trained plastic and reconstructive surgeons offer some of the latest breast reconstruction techniques, including microsurgery in which surgeons use microscropes to repair or reconnect tiny blood vessels and improve blood flow. This particular technique helps maintain form and function for breast cancer patients who have undergone oncologic surgery. Women may choose from several different options for breast reconstruction:

  • Oncoplastic reconstruction for breast cancer patients undergoing lumpectomy or breast conservation to maintain a symmetrical and aesthetic look
  • Implant-based reconstruction for women undergoing mastectomy or surgical removal for breast cancer
  • Autologous tissue-based reconstruction, in which our plastic surgeons are proficient in using tissue from various areas of the body to reconstruct the breast

Because our experts provide the full spectrum of reconstructive options, an individualized plan for reconstruction is made based on each woman's priorities, needs and physique. 

Pam Anderson, lymphedema patient Breast cancer survivor Pam Anderson traveled from Nashville to UChicago Medicine for lymphovenous bypass surgery. »Read Pam's story

Surgery to Reduce the Swelling and Discomfort of Lymphedema

The University of Chicago Medicine is the only institution in the region that offers surgical treatment of lymphedema, a condition many breast cancer survivors develop as a result of therapy. Lymphedema is a disorder in which lymph fluid accumulates, leading to chronic swelling in the upper arm. When medical management of lymphedema is not enough, surgery may be a suitable option for many women.

Procedures offered include:

  • Lymphovenous bypass: Under a microscope, surgeons use minute instruments to connect blocked lymphatic vessels (as small as 0.3 mm in diameter) to a nearby vein. The bypass allows excess lymph fluid to flow more freely.
  • Lymph node transfer: Healthy vascularized lymph nodes (lymph nodes that have a rich blood supply) are microsurgically transplanted to an area of lymphatic injury to reestablish lymphatic connections.

» Learn more about lymphedema surgery