Our comprehensive program for early detection, diagnosis and treatment of breast cancer, including care for those at high risk for breast cancer, is designed to provide each patient with the optimal care and outcomes. We provide the most advanced diagnostic and treatment technologies to precisely diagnose and stage each person’s cancer.
Services we provide include customized breast screening using digital mammography, ultrasound and MRI; risk assessment and genetic counseling; customized surgical, medical and radiological treatments; fertility counseling for adolescents and young adults; and Lifestyle Redesign® for cancer survivors.
Among our latest advances are:
- Brachytherapy (SAVI system) after a lumpectomy that reduces the course of radiation to just one week.
- Onco-plastic surgery, which combines cancer surgery with plastic and reconstructive surgery for optimal clinical and cosmetic results.
- Specialized minimally invasive surgery that minimizes scarring and speeds recovery.
We also are home to the Lynne Cohen & Georgia Cord Preventive Care Clinic for Women’s Cancers, a highly specialized, innovative women’s care facility that unites research, screening and clinical care for women who are at high risk for breast and ovarian cancer. Patients receive comprehensive breast exams and screenings and have access to some of the latest clinical trials, genetic counseling and, if needed, psychosocial counseling.
As part of a university-based medical center, we provide access to groundbreaking clinical trials that offer innovative and promising therapies that are a crucial step in advancing care and developing potentially beneficial drugs and treatments. Trials cover a variety of components including early- and advanced-stage cancer, prevention and coping with side effects.
For more detailed information on breast cancer, click here to view our online health library.
Standing as trailblazers in breast cancer care, we are leaders in onco-plastic surgery that combines surgery with breast reconstruction in the same procedure. We also have been on the forefront of developing localized therapies and innovative pharmacology.
We treat the whole person, not just the cancer. Our multidisciplinary approach involves collaboration among specialists to customize therapy for an individualized treatment plan for you, delivering a coordinated course of care. You are unique, and we will treat you that way.
Our multidisciplinary approach allows patients to see all the appropriate specialists in a coordinated fashion to create an individualized treatment plan. Your team of national and international experts treats you concurrently under one roof so you receive better care, have fewer return visits and access to immediate appointments.
An entire team of specialists including surgical oncologists, medical oncologists, radiation oncologists, plastic and reconstructive surgeons, pathologists and genetic counselors, will review your case during our weekly breast center conference, in which all cases are evaluated, and individual treatment recommendations are developed based on your tumor’s characteristics. Your integrated team can be in immediate communication with other to share new information or advise on your treatment.
Breast cancer is cancer that forms in the cells of the breasts. In the United States breast cancer is the second most common form of cancer in women after skin cancer. Although it is more commonly seen in women, men can get breast cancer as well. In the past decade, there have been significant advances in the screening, diagnosis and treatment of cancer. Survival rates have increased and breast cancer mortality rate has been decreasing largely due to earlier detection methods and a new personalized approach to treatment.
Breast cancer occurs when breast cells begin growing abnormally. These cells divide more quickly than healthy cells do and continue to accumulate, forming a lump or mass. The cells may spread (metastasize) through your breast to your lymph nodes or to other parts of your body.
Breast cancer often begins with cells in the milk-producing ducts known as invasive ductal carcinoma. Breast cancer may also begin in the glandular tissue called lobules (invasive lobular carcinoma) or the breast’s other cells or tissue. Researchers have identified some hormonal, lifestyle and environmental factors that may increase your risk of breast cancer. Yet, it’s not clear why some people who have no risk factors develop cancer, while others with risk factors never do. It is assumed that breast cancer is caused by a complicated interaction of genetic makeup and environment.
Doctors estimate that 5 to 10 percent of breast cancers are the result of gene mutations passed through generations of a family. If you have a strong family history of breast cancer or other cancers, your doctor may recommend a blood test to help identify specific mutations in BRCA or other genes that are being passed through your family.
The Adolescent and Young Adult (AYA) Cancer program (AYA) also provides valuable information about different treatments and how they may impact fertility. The AYA program has a referral mechanism for young patients to see fertility specialists, so that therapies can be altered or added to preserve the functionality of their ovaries or preserve their eggs before treatments.
Signs and symptoms of breast cancer may include:
- A breast lump or thickening that feels different from the surrounding tissue
- Bloody discharge from the nipple
- Change in the size, shape or appearance of a breast
- Changes to the skin over the breast, such as dimpling
- A newly inverted nipple
- Peeling, scaling or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
- Redness or pitting of the skin over your breast
If you find a lump or other change in your breast (even if a recent mammogram was normal) make an appointment with your doctor for prompt evaluation.
Your treatment options are based on the type, stage, grade, and size of your breast cancer; additionally whether the cancer cells are sensitive to hormones also plays a part. Your doctor also considers your overall health and your own preferences. Most women go through surgery for breast cancer and also receive additional treatment before or after surgery, such as chemotherapy, hormone therapy or radiation.
Breast cancer patients at USC Norris Comprehensive Cancer Center receive all encompassing care and treatment from some of the top experts in the world who work together in a multidisciplinary program. This multidisciplinary approach means a patient who comes in for a mammogram and finds an abnormality can be evaluated by a surgeon the very same day.
All the staff members who are part of the patient’s care team (geneticists, radiologists, surgery, medicine, radiation oncology, pathology, etc) meet every week to discuss the special needs and particular course of treatment for the patient.
Since the center is part of the academic program, clinical trials are integrated into all levels of patient care. All the latest scientific findings are incorporated into clinical trials, and the best new approaches are used to apply to each individual patient’s treatment plans.
Breast cancer surgery
There are several operations used to treat breast cancer. They include:
- Removing the breast cancer (lumpectomy)
During lumpectomy, also known as breast-sparing surgery or wide local excision, the surgeon removes the tumor and a small margin of surrounding healthy tissue. A Lumpectomy is usually performed if the tumors are smaller.
- Removing the entire breast (mastectomy)
A Mastectomy is surgery to remove all of your breast tissue. Most mastectomy procedures remove all of the breast tissue — the lobules, ducts, fatty tissue and some skin, including the nipple and areola (simple (TOTAL) mastectomy). In a skin-sparing mastectomy, the skin over the breast is left intact to improve reconstruction and appearance. The nipple may also be spared depending on the location and size of the tumor.
- Removing a limited number of lymph nodes (sentinel node biopsy)
To determine whether cancer has spread to your lymph nodes, your surgeon will discuss with you the role of removing the lymph nodes that are the first to receive the lymph drainage from your tumor. If no cancer is detected in those lymph nodes, the chance of finding cancer in any of the remaining lymph nodes is small, so no other nodes need to be removed.
- Removing several lymph nodes (axillary lymph node dissection)
If cancer is found in the sentinel node, your surgeon will discuss removing additional lymph nodes in your armpit.
- Removing both breasts (contralateral prophylactic mastectomy)
Some women with cancer in one breast may choose to have their other healthy breast removed if they have a very high increased risk of cancer in the other breast because of a genetic predisposition or strong family history. However, most women with breast cancer in one breast will never develop cancer in the other one. Discuss your breast cancer risk with your doctor, along with the benefits and risks of this procedure.
Complications of breast cancer surgery depend on the procedures you choose. Surgery carries a risk of bleeding and infection. Some women choose to have breast reconstruction after surgery. You should discuss your options and preferences with your surgeon.
Consider a referral to a plastic surgeon before your breast cancer surgery. Your options may include reconstruction with a breast implant (silicone or water-filled) or reconstruction using your own tissue. These operations can be performed at the time of your mastectomy or at a later date.
Chemotherapy uses drugs to destroy cancer cells. If your cancer has a high risk of returning or spreading to another part of your body, your doctor may recommend chemotherapy to decrease the chance that the cancer will recur (adjuvant systemic chemotherapy).
Chemotherapy is sometimes given before surgery in women with larger breast tumors. The goal is to shrink a tumor to a size that makes it easier to remove with surgery. It is also used in women whose cancer has already spread to other parts of the body. Chemotherapy may be recommended to try to control the cancer and decrease any symptoms the cancer is causing.
Chemotherapy’s side effects depend on the drugs you receive. Common side effects include hair loss, nausea, vomiting, fatigue and an increased risk of developing infection. Rare side effects can include premature menopause, infertility (if premenopausal), damage to the heart and kidneys, nerve damage, and, very rarely, blood cell cancer.
Hormone therapy (also known as hormone-blocking therapy) is often used to treat breast cancers that are sensitive to hormones. Doctors sometimes refer to these cancers as estrogen receptor positive (ER positive) and progesterone receptor positive (PR positive) cancers.
Hormone therapy can be used after surgery or other treatments to decrease the chance of the return of cancer. If the cancer has already spread, hormone therapy may shrink and control it.
Treatments that can be used in hormone therapy include:
Medications that block hormones from attaching to cancer cells are called selective estrogen receptor modulator (SERM) medications act by blocking estrogen from attaching to the estrogen receptor on the cancer cells, slowing the growth of tumors and killing tumor cells. SERMs include tamoxifen, raloxifene (Evista) and toremifene (Fareston). Possible side effects include hot flashes, night sweats and vaginal dryness. More-significant risks include blood clots, stroke, uterine cancer and cataracts.
Medications that stop the body from making estrogen after menopause, which are called aromatase inhibitors, these drugs block the action of an enzyme that converts androgens in the body into estrogen. These drugs are effective only in postmenopausal women. Aromatase inhibitors include anastrozole (Arimidex), letrozole (Femara) and exemestane (Aromasin). Side effects include hot flashes, night sweats, vaginal dryness, joint and muscle pain, as well as an increased risk of bone thinning (osteoporosis).
A drug that targets estrogen receptors for destruction called fulvestrant (Faslodex) blocks estrogen receptors on cancer cells and signals to the cell to destroy the receptors. Fulvestrant is used in postmenopausal women. Side effects that may occur include nausea, hot flashes and joint pain.
Surgery or medications to stop hormone production in the ovaries. In premenopausal women, surgery to remove the ovaries or medications to stop the ovaries from making estrogen can be an effective hormonal treatment.
Radiation therapy uses X-rays or other high-powered beams of energy to kill cancer cells. Radiation therapy is usually done using a large machine that aims the energy beams at your body (external beam radiation). It can also be done by placing radioactive material inside your body (brachytherapy).
External beam radiation is commonly used after lumpectomy for early-stage breast cancer. Doctors may also recommend radiation therapy to the chest wall after mastectomy for larger breast cancers or cancers that have spread to the lymph nodes.
Side effects of radiation therapy include fatigue and a red, sunburn-like rash where the radiation is aimed. Breast tissue may also appear swollen or firmer than before. Rarely, more-serious problems may occur, such as damage to the heart or lungs or, very rarely, second cancers in the treated area.
Targeted drug treatments attack specific abnormalities within cancer cells. Targeted drugs used to treat breast cancer include Trastuzumab (Herceptin). Pertuzumab (Perjeta). AdoAlso-trastuzumab (Kadcyla) and Lapatinib (Tykerb)
Cancer Care Breast Cancer Resources
American Cancer Society’s Breast Cancer Page
Financial Assistance for Women with Breast Cancer
National Cancer Institute’s Breast Cancer Page
Imaginis Breast Cancer Resource Page
Breast Cancer Research Foundations Statistics and Resources
Los Angeles Area Breast Cancer Resources