Julie R. Gralow, M.D. Julie R. Gralow, M.D. Director, Breast Medical Oncology, Seattle Cancer Care Director, Breast Medical Oncology, Seattle Cancer Care Alliance Alliance Professor, Medical Oncology, University of Washington Professor, Medical Oncology, University of Washington School of Medicine School of Medicine Member, Clinical Division, Fred Hutchinson Cancer Member, Clinical Division, Fred Hutchinson Cancer Research Center Research Center Treatment Overview: The Treatment Overview: The Multidisciplinary Team Multidisciplinary Team
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Julie R. Gralow, M.D. Director, Breast Medical Oncology, Seattle Cancer Care Alliance
Treatment Overview: The Multidisciplinary Team. Julie R. Gralow, M.D. Director, Breast Medical Oncology, Seattle Cancer Care Alliance Professor, Medical Oncology, University of Washington School of Medicine Member, Clinical Division, Fred Hutchinson Cancer Research Center. - PowerPoint PPT Presentation
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Julie R. Gralow, M.D.Julie R. Gralow, M.D.Director, Breast Medical Oncology, Seattle Cancer Care AllianceDirector, Breast Medical Oncology, Seattle Cancer Care Alliance
Professor, Medical Oncology, University of Washington School of Professor, Medical Oncology, University of Washington School of MedicineMedicine
Member, Clinical Division, Fred Hutchinson Cancer Research CenterMember, Clinical Division, Fred Hutchinson Cancer Research Center
Treatment Overview: The Treatment Overview: The Multidisciplinary TeamMultidisciplinary Team
Breast Cancer Treatment: Breast Cancer Treatment: A Multidisciplinary Team ApproachA Multidisciplinary Team Approach
•RadiologyRadiology
•PathologyPathology
•SurgerySurgery
•Radiation Radiation OncologyOncology
•Medical Medical OncologyOncology
Fighting the Crab – Kiev, UkraineFighting the Crab – Kiev, Ukraine
Personalized Cancer MedicinePersonalized Cancer Medicine
New Strategies in Treating Breast Cancer:New Strategies in Treating Breast Cancer: Better TargetingBetter Targeting
Cancer Treatment: Defining the Cancer Treatment: Defining the CancerCancer
• The first step in designing the treatment The first step in designing the treatment plan is carefully defining the cancerplan is carefully defining the cancer–Clinical examinationClinical examination–Radiology testsRadiology tests–Pathology testsPathology tests–Blood testsBlood tests
Diagnosing the Cancer: Ultrasound-Diagnosing the Cancer: Ultrasound-Guided Breast BiopsyGuided Breast Biopsy
Defining the Cancer: PathologyDefining the Cancer: Pathology
• Treatment recommendations are aided with Treatment recommendations are aided with the help of pathologic factorsthe help of pathologic factors–Prognostic factorsPrognostic factors: aid in estimating : aid in estimating
likelihood of cancer recurrence and deathlikelihood of cancer recurrence and death–Predictive factorsPredictive factors: predict likelihood of : predict likelihood of
response to a given therapyresponse to a given therapy
The First Step in Making a Treatment Plan The First Step in Making a Treatment Plan for Breast Cancer:for Breast Cancer: Defining the CancerDefining the Cancer
Defining the Cancer: RadiologyDefining the Cancer: Radiology
• Radiologic imaging can help determine the Radiologic imaging can help determine the location and spread of the cancerlocation and spread of the cancer– Local extentLocal extent–Regional lymph nodesRegional lymph nodes–Distant spread (metastases)Distant spread (metastases)
Mammogram: Area of abnormality extends over 60 Mammogram: Area of abnormality extends over 60 mmmm
Evaluating Extent of Local Disease: Evaluating Extent of Local Disease: Breast CancerBreast Cancer
Bone Scan Bone Scan
Staging for Distant Disease: Breast Staging for Distant Disease: Breast CancerCancer
Multiple Multiple bone bone
metastasesmetastases
Patient APatient A
The most common sites of distant disease in breast The most common sites of distant disease in breast cancer are the bones, liver and lungscancer are the bones, liver and lungs
Breast Cancer SurgeryBreast Cancer SurgerySometimes “less” Sometimes “less” surgery is bettersurgery is better
•Mastectomy vs. Mastectomy vs. lumpectomylumpectomy
•Lymph node Lymph node dissection vs. sentinel dissection vs. sentinel lymph node biopsylymph node biopsy
Lumpectomy: Wire Localization of Non-Lumpectomy: Wire Localization of Non-Palpable, Imaging-Detected Breast CancersPalpable, Imaging-Detected Breast Cancers
Lumpectomy Margin Evaluation: Inking Lumpectomy Margin Evaluation: Inking the Tumor Specimen in the Operating the Tumor Specimen in the Operating
Optimizing Health and Wellness After Optimizing Health and Wellness After Treatment of Breast Cancer: Treatment of Breast Cancer:
SurvivorshipSurvivorship
• Many breast cancer Many breast cancer patients can look patients can look forward to a long life forward to a long life after treatmentafter treatment
• Breast cancer patients Breast cancer patients and their health care and their health care team need to pay team need to pay attention to all aspects attention to all aspects of health and well-beingof health and well-being