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Breast Cancer Specialist

Dallas Surgical Group

Breast Cancer Surgeons & Skin Cancer Surgeons located in Dallas, TX

Statistics show that one in eight women, which is 12% of all women in the United States, will develop breast cancer in their lifetimes. When you have breast cancer, you deserve the advanced care and expertise provided by Peter Beitsch, MD, at Dallas Surgical Group. As a specialist in breast cancer and a leader in the field, Dr. Beitsch participates in ongoing breast cancer research, uses the most innovative technologies, and offers genetic testing to optimize your treatment. If you need breast cancer treatment, call the office in Dallas or schedule an appointment online.

Breast Cancer Q & A

What are the different types of breast cancer?

Breast cancer begins when healthy cells start to grow abnormally and gradually become cancerous. Once the cells turn into cancer, they can invade the breast and enter the lymph system, where they spread to other areas of your body.

Breast cancer can very early and non-invasive, DCIS or LCIS.

Ductal carcinoma in situ (DCIS)

DCIS, is a very common type of breast cancer, begins in the milk ducts (tubes) that carry milk to the nipple. It’s typically discovered during a mammogram, where it appears as tiny, white calcium deposits called microcalcifications. When cancer is in situ, the cells haven’t spread beyond the ducts (meaning have not invaded the breast so cannot go elsewhere in the body).

Lobular carcinoma in situ

LCIS derive from the cells that produce milk. Despite its name, LCIS isn’t considered to be cancer. The cells grow abnormally and they’re similar to cancer, yet they seldom invade the surrounding breast tissue. However, LCIS is frequently diagnosed and it increases your risk of invasive carcinoma in the future, so it must be closely monitored or treated with preventive measures. Invasive lobular carcinoma is the second most common type of breast cancer.

Invasive breast cancer occurs in two broad categories - invasive lobular cancer (~10% of all invasive cancers) and invasive ductal cancer (~90%).

Invasive Lobular Carcinoma

LC derive from the cells that produce milk and often present as a mass since they are difficult to detect on mammography.  They usually have estrogen and progesterone receptors on their cell surface which allows for targeted treatment with anti-estrogen pills.

Invasive Ductal Carcinoma

IDC originate in the milk ducts and are the most common type of breast cancer.  There are 4 main subtypes of breast cancer - luminal A (least aggressive), Luminal B, Her2 positive, and triple negative.  Most cancers are treated with surgery, radiation, and systemic therapy (either chemotherapy or oral hormonal therapy). The order of the treatments vary based on many factors and if you need breast cancer treatment, call the office in Dallas or schedule an appointment online.

What types of surgery are used to treat breast cancer?

The first line of treatment for most women with breast cancer is minimally invasive surgery called a lumpectomy to remove the breast tumor and a sentinel lymph node biopsy to remove the lymph nodes that drain the breast. If your cancer has extensively invaded your breast, you may need a mastectomy to remove the entire breast but most of the time a new breast can be reconstructed for you.

Many women choose oncoplastic surgery, which combines tumor removal with plastic surgery to restore their natural appearance. During this procedure, the affected breast is reconstructed, while the opposite breast undergoes plastic surgery to match the same shape and size.

Dr. Beitsch works closely with a German company, Lumicell, that’s developing an innovative technique to visualize cancer cells during surgery. This technology makes it possible to assess the lumpectomy tissue margins and remove all signs of cancer in one surgery.  This is currently on trial here in the United States.

What other treatment options are available?

Your breast cancer surgery may be combined with treatments such as:

Radiation

Radiation is typically used after lumpectomy to ensure that all remnants of cancer cells are destroyed. Your treatment may be done using external or internal radiation. External radiation is done using a machine outside your body, while internal treatment is accomplished by temporarily placing a small radioactive source in your body.

Chemotherapy

Chemotherapy may be performed prior to surgery to shrink a tumor or after surgery to eliminate any cancer cells that may remain in your body. If your cancer has already spread beyond the breast at the time you’re diagnosed, chemotherapy may be your primary treatment.

Targeted therapy for HER2-positive breast cancer

Advanced medications are available that block the growth and spread of cancer cells in women with HER2-positive breast cancer. Targeted drugs can help even when chemotherapy doesn’t, because they specifically target growth-promoting proteins.

Hormone therapy

Hormone therapy may be used after surgery to reduce the risk of recurring cancer. However, it only helps women with estrogen or progesterone receptor-positive breast cancers.

What is the role of genomic and genetic testing in breast cancer?

Genomic testing helps Dr. Beitsch provide individualized treatment by showing how well you’ll respond to breast cancer treatments such as radiation and chemotherapy. He also uses genomic testing for DCIS to determine if you need radiation after your surgery.

Genetic or hereditary testing is done on all women with breast cancer to see if their cancer could have been caused by a genetic mutation (also called pathogenic variant).  This could change the best treatment for you and also could be used to prevent breast (and other) cancers in your siblings/children/parents. He recently published a paper in the Journal of Clinical Oncology showing that all women with breast cancer need genetic testing.  This led to the American Society of Breast Surgeons to change their genetic testing guidelines. His latest role is as the principal investigator for the iGAP Registry™, which is an extension of his previous research. The iGAP database captures information on women with breast cancer (as in previous study) as well as women at high risk for breast cancer, their genetic mutations, and the impact of genetic testing on treatment.