Treatment Options

In this Section

There are three primary avenues for treating cancer – medical oncology, radiation oncology and surgical oncology. Some individuals only need one, while others may need all three modalities to fight their cancer. At Columbia St. Mary’s, we offer the most advanced technologies in treating cancer in all three arenas and work together as a team to ensure that our patients' treatment plans incorporate everything that is needed for the best possible outcomes.

While our commitment to advanced technology sets us apart, you’ll find the real difference resides in the people who work on your Columbia St. Mary's team. We are here to help you in your battle against cancer by providing a compassionate team of integrative oncology specialists.

Medical Oncology

Medical oncology includes chemotherapy, hormone therapy, immunotherapy and other pharmaceutical services. All of these treatments kill cancer cells and/or alter their ability to grow and form new cells. While the type, frequency and duration of medical oncology treatments depend on individual needs, all treatment is overseen by an expert medical oncologist and a team of oncology certified nurses.

Chemotherapy may be recommended as a breast cancer treatment option. Chemotherapy is available intravenously or as a pill and has two primary functions: to eradicate early stage tumors and to shrink an advanced tumor in preparation for surgical removal. There are a variety of chemotherapy drugs that are administered either individually or combined as part of a regimen that you and your doctor will discuss based on what would work best for you and your specific type of cancer. Chemotherapy cycles typically last between 14 and 28 days with periods of rest in between to allow the body to recover.

Hormone Therapy
Some breast cancers have hormone-receptors, which means they use your body’s estrogen to fuel their growth and reproduction. In these cases, lowering a patient’s estrogen levels is necessary to combat the cancer and prevent it from spreading and/or returning. There are three primary ways this is done. 

Sometimes, cancer develops when the immune system stops functioning properly. In those cases, doctors can actually use your body’s own immune system to fight the cancer.

Radiation Oncology

Columbia St. Mary’s radiation oncology program is accredited by the American College of Radiology. They are one of only 12 such accredited programs in the state.

Radiation oncology is the use of high-energy, penetrating waves or particles such as X-rays or gamma rays, to destroy cancer cells and keep them from reproducing. This treatment requires a radiation oncologist, radiation therapist, dosimetrist and medical physicist to work together to create and deliver a treatment plan customized to the size, location, and specificity of each individual’s cancer.

Radiation treatment plans are created through the use of a specialized Computerized Tomography (CT) scanner. This state-of-the-art method creates a 3D image of your internal anatomy, allowing your cancer team to pinpoint the location and size of your tumor as accurately and precisely as possible. This is a critical first step in any breast cancer treatment plan.

We offer the full spectrum of radiation therapy services and the most advanced technology including: Stereotactic Body Radiation Therapy (SBRT), the Trilogy™ Stereotactic System, conventional external beam radiation treatments, radioactive implants (brachytherapy), Intensity Modulated Radiation Therapy (IMRT), and more.

Partial Breast Irradiation
For years, radiation treatment of the whole breast has been the standard treatment option – and it’s been successful in preventing breast cancer recurrence. But at Columbia St. Mary’s, we also offer partial breast irradiation. This treatment option achieves similar results in less time and targets the tumor site and surrounding area with external beam radiation or internal brachytherapy. In addition, targeted radiation greatly reduces the exposure of healthy tissue to radiation.

Image-Guided Radiation Therapy (IGRT)

Imaging such as fluoroscopy, ultrasound or CT are utilized prior to daily treatment. This gives the radiation oncologist real-time updates of the tumor location and increases the accuracy of the treatment.

Stereotactic Radiosurgery (SRS)
SRS is a highly effective treatment option for smaller, well-defined tumors. Using extremely accurate image-guided tumor targeting, SRS delivers one or more high doses of radiation with minimal damage to surrounding healthy tissue.

Intensity Modulated Radiation Therapy (IMRT)
IMRT utilizes hundreds of tiny radiation beams to deliver a single dose of radiation. By using so many delivery devices, IMRT is able to increase the radiation dose to the areas that need it and reduce radiation exposure to specific sensitive areas of surrounding normal tissue.

3D Modulated Radiation Therapy (3DMRT)
3D treatment is much like IMRT in that both treatment options utilize highly-targeted radiation applications in order to reduce exposure of healthy tissue. Previous radiation treatments have been able to match the height and width of the targeted tumor, but 3D treatment allows us to match the specific shape, further reducing damage to the surrounding tissue.

Respiratory Gating
Tumors in the breast can often be difficult to target accurately with radiation due to the movement caused by the patient’s breathing. In the past, doctors were forced to broadly target the entire region, which would invariably include healthy tissue. Now, however, respiratory gating allows doctors to map the movement of the tumor and only deliver radiation as the tumor passes through a precise, predetermined window. This is particularly important for cancer of the left breast, where excess radiation could affect the heart.

Surgical Oncology

Most women who have breast cancer will need to do undergo surgery as part of their treatment plan. Our team of board certified, dedicated surgeons are key members of the multidisciplinary team, working with the patients to decide the best method for removing cancer. They specialize in oncologic surgery and are highly skilled in breast surgical procedures, including: minimally invasive techniques, palliative surgery, and neo-adjuvant treatments as well as traditional methods.

In a lumpectomy, the entire tumor itself is removed (with minimal healthy breast tissue). The goal is to remove all signs of cancer while preserving as much of the breast as possible.

A mastectomy is the surgical removal of some or all of the breast tissue. There are several different types.

Partial Mastectomy: In a partial mastectomy, a portion of the breast is removed – such as a quarter of the tissue as in a quadrantectomy – in order to eliminate the cancer. The removal of some of the chest muscles is sometimes necessary as well.

Skin-Sparing Mastectomy: For women who intend to have breast reconstruction, a skin-sparing mastectomy is the best treatment option. This procedure removes the breast tissue, nipple, areola and lymph node but preserves the breast skin.

Simple Mastectomy (total mastectomy): This surgery entails removal of the breast, nipple and areola but preserves the major chest muscles and lymph nodes.

Modified Radical Mastectomy: This procedure entails the removal of the breast, nipple, areola and axillary lymph nodes (in the underarm), but leaves the major chest muscles intact.

If your cancer has spread to your lymph nodes (this occurs in about 40 percent of breast cancer patients), you will need to have them removed as well. They can either be removed at the same time as your tumor or at a later date.


Breast reconstruction can either be done at the same time as your mastectomy or after your treatment is finished.  Our plastic surgeon utilizes groundbreaking, innovative procedures for optimal cosmetic results. There are many options when it comes to breast reconstruction. Dr. John Yousif, plastic surgeon, can help you decide which option is best for you. Click here for Dr. Yousif's locations and contact information.


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