The Advantages of Receiving Breast Cancer Care at a Comprehensive Cancer Center

There is more to breast cancer treatment at St. Luke’s Health-The Woodlands Hospital than meets the eye. Our patients benefit from the expertise of the full breast oncology team at the internationally renowned Dan L Duncan Comprehensive Cancer Center (DLDCCC), one of the few National Cancer Institute (NCI)-designated cancer centers in the country.  

St. Luke’s-The Woodlands is affiliated with the DLDCCC, which ranks among the top cancer programs in the country, offering expert treatment, infusion services, advanced mammography and more — all in one convenient location. The DLDCCC’s 450 clinicians and researchers develop and translate scientific knowledge from promising laboratory discoveries into new treatments for cancer patients. Its research program is primarily funded through competitive research grants from the NCI and other institutes of the National Institutes of Health.

St. Luke’s-The Woodlands Breast Cancer Surgical Oncologist Dr. Pabel Miah says the ability to consult with highly trained specialists in a single center is an enormous benefit to patients who can still receive care close to home in North Houston.

“I think it's crucial because not only is the surgeon taking care of patients, but you have the medical oncologist, the radiation oncologist, the radiologist, and the pathologist all working together. They meet and discuss your case individually and with our tumor board. Having the benefit of other colleagues' advice really advances how you treat cancer patients,’ he said.

The team adheres to the latest cancer treatment guidelines, which Dr. Miah says recommend less surgery, medication, and radiation to achieve the same outcomes in many instances. “Patients come to us fearful of undergoing extensive procedures, and wind up having less surgery than they anticipated,” Dr. Miah said.  

The highly accomplished breast cancer surgeon and assistant professor of surgery at Baylor College of Medicine says the era of extensive surgery, chemotherapy, and radiation has given way to a more targeted approach.

The St. Luke's-The Woodlands team works closely with each breast cancer patient to develop a tailored treatment strategy. It may involve one or a combination of treatment approaches:

Surgery is generally the first treatment. Occasionally, due to the size of the tumor, chemotherapy is used before surgery, to shrink the tumor, allowing for breast-conserving surgery. Lumpectomy (breast-conserving surgery) involves removing the portion of the breast where the cancer has been found.  Mastectomy is the surgical removal of the entire breast. Most women have the option to choose between lumpectomy and mastectomy.

Chemotherapy treats breast cancer systemically, "mopping up any cells” not removed by surgery. The medical oncologist will determine the best treatment based on the size and type of tumor, whether the cancer has spread to the lymph nodes, if it is hormone receptor positive or negative, if it is HER 2-neu positive or negative, the staging, and what he/she feels the individual will best tolerate. Occasionally, due to the size or characteristics of the tumor, chemotherapy is used before surgery to shrink the tumor and conserve breast tissue. When chemotherapy is given after surgery or radiation therapy, it is used to destroy any cancer cells that have metastasized or been left behind. It also helps keep the cancer from coming back.

Radiation Therapy utilizes high-energy X-rays to destroy any cancer cells remaining after surgery that are too small to be seen. Radiation therapy can be given as external treatment to all or part of the breast. Radiation therapy can last anywhere from several days to several weeks. The type and length of radiation therapy is determined by the size, locations, and other characteristics of the tumor and whether lymph nodes are involved or not.

Hormone Therapy or hormone suppressants are added to enhance chemotherapy in some treatment plans for cancers that are influenced by their hormonal environment. Hormonal therapy is used to change the hormonal environment of women who have cancers that are stimulated by estrogen or progesterone. Drugs are chosen based on the stage of the cancer and whether a woman has gone through menopause.

Targeted Therapy or biological therapy inhibits tumor growth and enhances the immune system’s ability to fight cancer. An example of targeted therapy is herceptin, which is used in cancers that are HER2-neu positive.

“Even with all our groundbreaking research, you're still receiving personalized care,” Dr. Miah said. “Our patients still feel like we are taking our time and making it our priority to provide care that is unique to their case and that we are partners throughout their treatment.”