Advances in Breast Cancer Treatment Explained

with Lyle Henry, M.D., General/laparoscopic Surgeon, Columbia St. Mary’s

Posted: Oct. 1, 2005

Several years ago, the two major medical schools in Wisconsin conducted a survey of the health status and needs of the state's residents. Almost 90 percent of the respondents said that the state of women’s health was a major concern. Statistics compiled recently by the Wisconsin Woman's Health Foundation backed this up and revealed these significant facts about breast cancer:

• The most common cancer among Wisconsin women — breast cancer — is second only to lung cancer as the leading causes of cancer death.
• One out of seven women in our state will develop the life-threatening disease during her lifetime.
• Approximately 1,400 women are diagnosed with breast cancer every year in southeastern Wisconsin.

“It’s a disease of epidemic proportions, when you think about it,” said Lyle Henry, M.D., a general/laparoscopic surgeon for Columbia St. Mary’s.

Lyle Henry, M.D., General/laparoscopic Surgeon, Columbia St. Mary’s "When it comes to breast cancer, patients and their families are encouraged by the fact that Columbia St. Mary’s is one of the best places in the country where collaborative efforts provide them with outstanding care."

“But when it comes to breast cancer, patients and their families are encouraged by the fact that Columbia St. Mary’s is one of the best places in the country where collaborative efforts provide them with outstanding care,” he said. “Our excellent diagnosticians, oncologists, surgeons and radiation specialists combine their expertise, experience and talents to uniquely benefit our patients.”

According to Dr. Henry, Columbia St. Mary’s has a “spectacular” diagnostic breast cancer center, the Van Dyke Haebler Center, that does digital mammography, state-of-the-art ultrasound and all kinds of non-invasive biopsies, along with the newer science of magnetic resonance imaging (MRI) scans of the breast.

“The diagnostic group here is teamed up with long-experienced surgeons like myself for not only standard breast surgery, but now in a majority of cases, for breast- conservation surgery,” he said.

“We also have access to excellent reconstructive surgeons for those patients who need breast reconstruction and now we are a reference center for a major radiation treatment provider. And we have a radiation staff that can now do limited breast radiation, called brachytherapy. We offer the whole gamut of breast care and have a comprehensive breast conference for discussion and problem solving of difficult cases.”

Surgical options
Breast-conservation surgery involves a surgical procedure to remove a tumor or lump with a small amount of normal tissue around it, explained Dr. Henry.

“Partial mastectomy, for those women whose anatomy is suitable, gives them an option offering the same kind of results as those who choose total mastectomy. It’s a clear option and benefit for them.”

Partial mastectomies and lumpectomies are as effective as total mastectomies, according to Dr. Henry. ”Which treatment to choose is a very personal decision between the woman and her doctor,” he said. “But all women who are suitable candidates ought to be offered a choice. And that’s what we have to offer here.”

Pre-treatments of large tumors are performed now for women who in the past weren’t candidates for breast conservation, he points out. “This gives them a chance to have breast-conservation, if that’s what they choose, because they can be pre-treated with chemotherapy before their surgery to reduce the size of the tumor.”

Lymph node dissection
Dr. Henry explained that patients who are treated with breast-conserving surgery have some of the lymph nodes under the arm removed for biopsy as well. This procedure is called lymph node dissection and is done at the same time as the breast-conserving surgery. Lymph node dissection is done through a separate incision.

“Utilizing a new advance in eight-lymph node dissection, we perform what we call a ‘sentinel node’ biopsy,” Dr. Henry said. “We first identify the first one or two lymph nodes going into the armpit.

“If we sample those and they prove negative, we have 97 or 98 percent assurance that the rest of the lymph nodes are negative and we don’t have to remove them. Since about 85 percent of women have negative nodes at time of diagnosis, we save them from having all of their nodes removed. That’s becoming the standard of care for those women having clinically negative nodes. If we know that the woman has a positive node or nodes in her armpit, we’d remove all of her nodes. We do this because we need to know how many positive nodes are involved.”

Dr. Henry said earlier detection of breast cancer coupled with improvements in surgery techniques, hormonal therapy, and chemotherapy has clearly increased the percentages of cure for this serious disease.

Lyle Henry, M.D.
2015 E Newport Ave, #305
Milwaukee, WI 53211
414-961-2120

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