Once the diagnosis of breast cancer is made the surgeon will discuss a management plan with the patient.
With the patients consent their case will be discussed in a multidisciplinary team meeting. There is good evidence that patients that have a multidisciplinary breast cancer team will have improved survival. The meeting consists of members of the breast specialist cancer team that will be involved in the care of the patient. These include the breast surgeon, the specialist breast pathologist, the medical oncologist, radiation oncologist, the geneticist, the breast care nurses, and the breast radiologist.
The clinical history, the imaging and the biopsies will be reviewed and a management plan will be constructed.
In general, patients with early breast cancers will proceed to surgery first in order to remove the cancer and sample the lymph glands under the arm pit (Axillary lymph nodes). Post operatively a review of the pathology of the cancer and the lymph nodes will be undertaken and decisions will be made regarding the need for further postoperative (adjuvant) treatment.
Surgery may be in the form of breast conservation or mastectomy, with or without immediate reconstruction and a procedure to sample the axillary lymph nodes either a sentinel lymph node biopsy or Axillary Lymph node dissection.
The case will usually be discussed preoperatively and post operatively in the Once the multidisciplinary team meeting. A decision will be made regarding if any further surgery is required.
The final operative pathology is required so that options regarding the most appropriate adjuvant or postoperative treatment can be discussed. In patients who have undergone breast conserving surgery, radiotherapy will be required as part of the primary treatment.
In some patients that undergo a mastectomy, postmastectomy radiotherapy will be recommended. This is more common in young women who have large tumours or lymph nodes involved with metastatic disease.
Chemotherapy, Endocrine treatment and targeted cancer therapies eg- Herceptin (Monoclonal antibodies) may be suggested postoperatively in order to improve survival. This is commonly known as systemic treatment. The patients may be offered chemotherapy only, if the cancer is not estrogen or progesterone receptor positive, also termed triple negative breast cancer.
Because we are increasingly aware that breast cancer is an extremely diverse disease, Dr Thornton aims to provide a management plan that is focused, individualised, and tailored to every patient. Dr Thornton also works at the Peter MacCallum Cancer Centre; Victorian Comprehensive Cancer Centre the largest cancer centre in the Southern hemisphere and therefore has the ability to enter patients in a variety of International clinical trials and research projects which may offer them access to medications that would not currently be funded / available on the PBS in Australia.
