For patients diagnosed with breast cancer, treatment looks different from one person to another. At Ochsner Health, physicians combine specialized expertise, coordinated care and advances in medical technology to develop individualized treatment plans and help patients navigate their diagnoses.
“I’ve had patients ask why their treatment may be different from someone else with the same type of cancer. It’s because breast cancer treatment has gotten incredibly personalized with collaboration among multiple specialists and pathology testing to tailor therapies to each individual person,” said Molly Thomas, MD, hematology oncologist, Ochsner Cancer Center of Acadiana – Lafayette.
Dr. Thomas said Ochsner physicians evaluate numerous variables when developing a treatment plan. Those include the cancer’s stage, tumor size, location, whether it has spread to lymph nodes and certain biological characteristics like hormone involvement or genetic markers.
Molly Thomas, MD, Hematology Oncologist, Ochsner Cancer Center of Acadiana-Lafayette
JAMIE ORILLION
Those evaluations often begin with the work of fellowship-trained breast radiologists, Dr. Thomas said. These experts have extensive experience reviewing mammograms, ultrasounds and breast MRIs, and help guide discussions on the extent of the cancer, the size of the tumor and its type. In Lafayette, their input is shared with a multidisciplinary team of surgeons, medical oncologists and radiation oncologists, who then meet with each patient in one coordinated day of visits.
“The patient gets a good idea of the entire treatment plan. I find that their anxiety lessens after we meet with them in the multidisciplinary clinic and we take a proactive approach in their care,” Dr. Thomas said.
Individualized treatments offer new approaches to care
Advances in targeted therapies and immunotherapies continue to expand treatment possibilities for patients with different types of breast cancer. Kimberly LeBlanc, MD, hematology oncologist, Ochsner MD Anderson Cancer Center in Baton Rouge, said there have been specific improvements in treating triple-negative and hormone-positive forms of the disease.
“The advances in treating triple-negative breast cancer have been around a regimen with immunotherapy, not simply chemotherapy. In addition, the targeted therapies for hormone-positive breast cancers have shown great advances in preventing cancer recurrence,” Dr. LeBlanc said.
The individualized nature of modern breast cancer treatment means several specialists are often involved, including surgeons, hematology oncologists, radiation oncologists, nurses and other support professionals.
Kimberly LeBlanc, MD, Hematology Oncologist, Ochsner MD Anderson Cancer Center in Baton Rouge
JAMIE ORILLION
“For the patient, the goal is coordinated care. Instead of looking at one part of treatment in isolation, we are considering how each piece fits into the overall plan,” Dr. LeBlanc said. “When I speak with a patient, I always tell them it is a fluid process, and our conversation is based on the information we have that day. Things can change based on the results of another test or scan. I try to prepare them emotionally for the fluidity of the process.”
Ochsner’s clinically integrated partnership with MD Anderson Cancer Center has also opened up more clinical trial opportunities for breast cancer patients in Louisiana.
“When someone is in Stage IV, those trial treatments may save their life or prolong their life until another treatment becomes available. I find that for my patients with advanced disease, they are critical,” Dr. LeBlanc said. “For early stage cancers, those trials can give us good information about potential side effects.”
Claire C., breast cancer patient at Ochsner MD Anderson Cancer Center at The Gayle and Tom Benson Cancer Center.
Modern techniques bring greater precision to surgery
Surgery remains a core part of treatment for most breast cancer patients, said Amy Rivere, MD, breast surgical oncologist, Ochsner MD Anderson in New Orleans. Each patient’s surgical plan is developed based on their specific diagnosis, extent of the cancer and personal preferences. Some patients may undergo a lumpectomy, while a mastectomy may be more appropriate for others.
Dr. Rivere said that when she discusses surgical options with breast cancer patients, she also talks about how each procedure will affect them in the future.
Amy Rivere, MD, Breast Surgical Oncologist, Ochsner MD Anderson Cancer Center in New Orleans
“A lumpectomy generally has a shorter recovery time and less surgical intervention,” she said. “A mastectomy involves a longer recovery and more risk of complications. With reconstruction, there may be multiple surgeries. We talk about whether the patient is inclined to have less surgery and more follow-up after, or a larger surgery that may not require those other obligations.”
Regardless of the procedure, Dr. Rivere said improved surgical imaging and techniques allow surgeons to often preserve more healthy breast tissue than ever before, place incisions where they are less visible and improve cosmetic outcomes.
“Our goal is to treat the cancer appropriately while also considering how the patient will recover and live with the results of surgery long after treatment is complete,” she said.“ I try to get to know their personal preferences as well and take those into account.”
Dr. Rivere said improved breast imaging technology, including 3D mammography, contrast enhanced mammography and breast MRI, has changed how surgeons approach their work. Today, surgeons begin a procedure with a much clearer picture of how much cancer is present and where it is located. That means less chance of subsequent operations and a smoother process overall.
“There are fewer times where the cancer is underestimated prior to surgery,” she said. “We use real-time images to make sure we remove all of the areas the radiologist indicated. It’s a gift to us and to patients to be able to use advanced imaging technology to make surgical decisions in real time. That’s really what we mean when we talk about coordinated multidisciplinary care.”
Nicole D., breast cancer patient at Ochsner Cancer Center of Acadiana.
JAMIE ORILLION
Specialized expertise and early detection strengthen treatment approaches
Ochsner’s integration with MD Anderson provides another layer of specialized support. Ochsner physicians in Baton Rouge and New Orleans can consult with MD Anderson clinicians and researchers on complex cases, and Ochsner MD Anderson’s eight locations, including those in New Orleans, Covington, Slidell and Baton Rouge, follow MD Anderson treatment protocols and practice standards.
“Working so closely with MD Anderson has vastly expanded my network of colleagues in different areas of oncology. We consult them in particular for the rarest types of breast cancer, when the cancer doesn’t fit into normal guidelines or is otherwise out of the ordinary. That is where it is extremely beneficial,” Dr. LeBlanc said. “It also means all of our patients receive that advanced level of care close to home.”
While breast cancer treatment continues to advance, early detection remains the most important way to improve outcomes. Recommendations call for women of average risk to begin annual mammograms at age 40. Women with higher risk factors should discuss screening with their doctor, as earlier tests may be recommended.
Family history and genetic mutations can increase a woman’s risk of breast cancer, along with lifestyle choices. Maintaining a healthy weight, exercising regularly, limiting alcohol consumption and eating a healthy diet can all help reduce risk.
“As breast cancer treatment becomes increasingly personalized, Ochsner MD Anderson is bringing together advanced diagnostics, leading-edge therapies and a multidisciplinary team approach to ensure patients receive the right treatment at the right time close to home,” Dr. Rivere said.
Ochsner Health is the leading nonprofit healthcare provider in Louisiana, Mississippi and across the Gulf South, delivering expert care at its 47 hospitals and more than 370 health and urgent care centers. To learn more about how Ochsner empowers people to get well and stay well, visit .