New Treatment Options Available for Women with Early-Stage Breast Cancer

Patient Amy Asbury Benefits from Groundbreaking Clinical Trial

Learning you have breast cancer on a Friday afternoon makes for a frightening and uncertain weekend. What helped Amy Asbury cope with the news was knowing the treatment wheels were already in motion.

“What really impressed me about Virginia Mason was they were already assembling a team to meet with me,” remembers Amy.

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Amy Asbury and her dog, Brody, enjoy a walk.

The following Monday, Amy had an MRI to confirm her diagnosis: ductal carcinoma in situ (DCIS), the presence of abnormal cells inside the breast’s milk ducts. She didn’t wonder about treatment options for long, meeting all the members of her cancer care team just two days later. In successive appointments in the Floyd & Delores Jones Cancer Institute at Virginia Mason, Amy met her oncologist, radiation oncologist and breast cancer surgeon, all with the personal, ongoing support from her dedicated breast cancer nurse coordinator.

“They went through the entire range of options with me,” says Amy. “Originally, I thought I’d hear them out, then look for a second opinion. But I walked out of there thinking I absolutely want these people to be my doctors.”

Because a routine mammogram had caught Amy’s cancer early, she was a candidate for lumpectomy and radiation therapy. What she didn’t know was that a new approach to both treatments would have postsurgical benefits she couldn’t have imagined.

Amy was joking when she asked Virginia Mason breast surgeon Janie Grumley, MD, if her lumpectomy could double as a breast reduction. Dr. Grumley had a surprising answer: her training in a method known as oncoplastic breast surgery — incorporating plastic surgery techniques in cancer removal — meant Amy’s lumpectomy could actually leave her breasts looking better than before her diagnosis. “Of course the goal is to get the cancer out, but it’s an unexpected plus when the surgeon can operate with a nice cosmetic result, too,” says Amy.

As Dr. Grumley performed Amy’s lumpectomy and reshaped her right breast, Virginia Mason plastic surgeon Alexandra Schmidek, MD, simultaneously reduced Amy’s left breast to make both sides symmetrical. Having cancer surgery and reconstruction all at once was a major benefit in itself, but that wasn’t the only treatment that was accomplished in just one operation.

Instead of the typical lumpectomy follow-up involving weeks of daily radiation treatments, Amy received a one-time treatment with intraoperative radiation therapy (IORT), requiring only minutes to administer during her surgery. Virginia Mason is the first medical center in Washington state to offer IORT to women with early-stage breast cancer as part of a clinical trial. Michelle Yao, MD, Virginia Mason radiation oncologist, operates a portable therapy unit that delivers cancer-killing radiation by catheter directly to the site of the tumor, avoiding the unnecessary exposure of surrounding tissues. The application of radiation inside the breast is so precise and effective, one dose is equivalent to weeks of external beam radiation therapy.

For Amy, the option of skipping multiple radiation treatments more than made up for the regular follow-up visits she’ll have as part of the IORT clinical trial. Pictures are taken of her surgery site at these visits, and any side effects are recorded. But Amy hasn’t had a single thing to report.

Recovery was very doable, no side effects, and I only missed about a week of work,” says Amy. “IORT made perfect sense for me and my early stage cancer. And I feel like I’m contributing to the science of better ways to treat this disease.”

***

This story was originally published in the Virginia Mason 2012 Annual Report.

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