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Special Advertising Section Understanding Treatment Options for the Spread of Breast Cancer to the Brain As the second-most diagnosed cancer in women in the U.S., the spread of breast cancer can often have a bigger impact than the original diagnosis. Many women may be unaware that breast cancer can spread to other areas of the body, becoming a much larger health issue and requiring additional treatment. The American Association of Neurological Surgeons cites breast cancer as the most common source of a brain metastasis in females. Brain metastasis occurs when a tumor develops in the brain from cancer cells that have spread from a primary tumor site, usually through the bloodstream. About 15 percent of breast cancer patients will develop a brain metastasis within two to three years after initial diagnosis. Louisville CyberKnife at the James Graham Brown Cancer Center provides a nonsurgical treatment method to control the growth of brain metastasis. Known as stereotactic radiosurgery, the procedure is performed with an advanced technology called CyberKnife®. During treatment, the CyberKnife delivers high-dose radiation to the tumor site with sub-millimeter accuracy, minimizing damage to nearby healthy tissue. "A noninvasive option for treating brain metastases that develop from breast cancer is important for those women needing a form of treatment they can undergo while also receiving treatment for their original diagnosis," Dr. Shiao Woo, medical director at Louisville CyberKnife said. "We can offer a solution that helps decrease interruptions in the treatment plan for their original diagnosis." Depending on specifc clinical circumstances, CyberKnife treatment is an option that can be used alone or combined with other metastatic brain tumor treatment options such as surgery or whole-brain radiation therapy. The CyberKnife is able to track the tumor in real time during treatment and adjust for patient movement, reducing radiation exposure to adjacent normal tissue. CyberKnife procedures are completed in one to fve outpatient sessions. Other treatment options for brain metastases vary based on the specifcs of each patient's case and have varying degrees of risks and side effects. Surgery is typically offered to patients with a single metastatic brain tumor that can be safely accessed. Recovery can take several weeks and risks depend on the patient's age and tumor location. Whole-brain radiation therapy is a common form of treatment for brain metastases and is delivered in daily radiation treatments over the course of several weeks. Patients eligible for any procedure should rely on their physician to determine the best course of treatment. www.nortonhealthcare.com/breast { Questions to Ask Your Doctor { If You Find a Lump or Change in Your Breast Breast lumps are actually very common, especially in women who still have periods. They normally go away by the end of your period. Most lumps are not cancerous. But do not ignore a change in your breast. The best advice is to see a health care provider. Answers to the following questions will help you understand tests that may be necessary to diagnose a breast problem. 1 Q: Do I need a mammogram or ultrasound? 2 Q: Should I get an MRI (Magnetic Resonance Imaging)? 4 Q: Can this lump be aspirated (fuid or cells removed with a needle)? If so, who will perform the test? 5 Q: Will I need a biopsy (tissue is examined under a microscope)? Q: If further tests and/or treatment are needed, will you refer me to a doctor who specializes in breast problems? 7 Q: Do you recommend any special follow-up? 8 Q: Other than cancer, what causes breast Q: What is the next step if the mammogram and ultrasound are inconclusive? 3 6 lumps or changes? As recommended by Susan G. Komen for the Cure. Fore more information on breast cancer visit komen,org or call 877-GO-KOMEN 2013 Breast Health Section 13