Breast cancer

Breast cancer overview

You are at the center of everything we do at Seattle Cancer Care Alliance (SCCA). Here, we surround you with a team of experts who focus exclusively on breast cancer. Our breast surgeons, medical oncologists, radiation oncologists, breast imaging specialists and many others work together closely to provide state-of-the-art breast cancer care and compassionate support throughout your treatment and beyond.

We guide you every step of the way, combining our deep clinical expertise in every type and stage of breast cancer with a commitment to meet your unique needs, hopes and desires.

Why choose SCCA?

  • Access to breast cancer specialists 
    Newly diagnosed patients are seen quickly in our NOW Clinic and then meet with their team in our one-of-a-kind Breast Cancer Specialty Center for a full evaluation and individualized treatment plan.

  • Comprehensive breast cancer treatment 
    Our doctors are experts in the full spectrum of breast cancer treatments. Based on the unique characteristics of your disease, your team may recommend surgery, radiation therapy, chemotherapy, hormonal therapy or targeted biological therapy, all available at SCCA.
  • Breast cancer clinical trials
    To give you access to the most innovative therapies, SCCA unites the leading researchers and cancer specialists of Fred Hutch and UW Medicine so you can take part in breast cancer clinical trials not available everywhere. 

  • Everything from screenings to follow-up 
    We offer mammograms and other breast cancer screenings, see women concerned about a breast lump or other symptom and provide long-term follow-up care for breast cancer survivors.

  • A national leader in cancer care
    SCCA is the leading cancer treatment center in the region and among the top five nationally, according to U.S. News & World Report.

  • NCI comprehensive cancer center 
    We are a comprehensive cancer center, a designation from the National Cancer Institute that reflects our scientific leadership and the depth and breadth of our research to prevent, diagnose and treat cancer.

What to expect

To get you started, we’ve put together some information about what you can expect when you become a breast cancer patient at SCCA.

For evaluation

If you have a breast lump, another symptom of breast cancer, your first visit will be at the

  • Breast Health Clinic: Women who have suspicious lumps or symptoms have an evaluation at the Breast Health Clinic. Staff members at the clinic also provide pre- and post-operative care.

If you have a confirmed diagnosis of breast cancer, your first visit will be at either the NOW Clinic or the Breast Cancer Specialty Center.

  • NOW Clinic: Staffed by breast specialist nurse practitioners who aim to see you within just a few days from the time you call. They will provide information, prepare you for what’s ahead, and answer your questions to help ease your anxiety about your diagnosis, as well as determine if there are any tests or scans that should be completed before you meet with Seattle’s finest breast cancer treatment specialists at the Breast Cancer Specialty Center.
  • Breast Cancer Specialty Center: Women with a confirmed diagnosis of breast cancer have an evaluation with a breast surgeon, a medical oncologist, and a radiation oncologist at the Breast Cancer Specialty Center. This team of people will help you decide on the best treatment plan for you.
For treatment

During treatment for breast cancer, you will have regular appointments with your doctors at the Women’s Center. Depending on the type of treatment you are receiving, you will see a surgeon, a medical oncologist, or a radiation oncologist. If you develop recurrent or metastatic breast cancer, you will also be seen here at the Women’s Center.

  • Surgery takes place at University of Washington Medical Center (UWMC).
  • Chemotherapy treatment takes place in the Infusion Suite on the fifth floor of the SCCA clinic.
  • Radiation therapy takes place in the Radiation Oncology suite on the first floor of the SCCA clinic. Patients may also receive radiation therapy at UW Medical Center-Northwest.
For those at high risk for breast or ovarian cancer

If you are at high risk for breast or ovarian cancer, SCCA has a special program to help you know which screenings are appropriate for you and how you can decrease your cancer risk. It’s called the Breast and Ovarian Cancer Prevention Program located at the SCCA Wellness Center. Call the patient care coordinator at (206) 606-6100 with questions or to make an appointment. Patients in the prevention program who need routine medical exams and close monitoring are also seen at the Women’s Wellness Clinic at SCCA.

Learn about the Breast and Ovarian Cancer Prevention Program

For those who have completed treatment

After your breast cancer treatment is complete, you will be seen at our Women’s Wellness Clinic. Staff members there can help you with life after breast cancer, including putting together a wellness plan to maintain good nutrition, manage menopause, regain strength and flexibility, take care of your emotional health, and handle sexual issues. You may also need help managing lingering side effects of cancer treatment, or you may want to come to the Women’s Wellness Clinic for routine follow-up care.

Where you will be seen

Learn more about a specific clinic or center that you may be seen at.  Women who have breast cancer or concerns about breast cancer are seen in the Women’s Center on the third floor of the SCCA clinic. The Women’s Center is home to our:

  • NOW Clinic
  • Women's Wellness Clinic
  • Breast Cancer Specialty Center
  • Breast Medical Oncology Clinic
NOW Clinic

If you have recently been diagnosed with breast cancer, you’re probably concerned, worried, anxious, and thinking hard about what to do next. Educating yourself about cancer and understanding your treatment options will help you feel more in control. The most important decision for you to consider is where to get treatment.

Step one

Your first step to getting on the road to recovery from breast cancer is to make an appointment at the Seattle Cancer Care Alliance NOW Clinic.

NOW Clinic breast specialist nurse practitioners, will almost always see you within just a few days from the time you call us. During your appointment, we will provide you with information, prepare you for what’s ahead, and answer your questions to help ease your anxiety about your diagnosis. We will determine if there are any tests or scans that should be completed before you meet with nationally renowned breast cancer treatment specialists at the Breast Cancer Specialty Center (BCSC).

Step two

After your appointment at the NOW Clinic, your second step will be to meet with your physician or BCSC physician team to determine your treatment plan.

If you are scheduled for a BCSC visit, the nursing team will carefully coordinate your care through your next appointment and afterwards. At this appointment you may meet with one or all of your breast cancer doctors—a radiation oncologist, surgeon, and medical oncologist—at the same time. Together they will discuss your options based on your type and stage of cancer while taking into consideration your general health, lifestyle, and personal preferences. Then you will meet your team to determine a blend of treatments and a sequence in which to deliver your treatments, to achieve the best results.

A video with Dr. Julie Gralow, MD about how SCCA brings all the specialists to you in one afternoon.
NOW Clinic

If you have been recently diagnosed with breast cancer, your first step is to call SCCA and be seen at the NOW Clinic.

Women's Wellness Clinic

We also monitor women at increased risk for developing cancer. Women who are shifting their focus from cancer treatment to recovery receive a wellness plan and cancer prevention strategies that include information on good nutrition, fitness and emotional support.

Visit the Women’s Wellness Clinic if you

  • Want information about cancer prevention—to do everything you can to keep your cancer from coming back
  • Would like help dealing with some of the lingering side effects of cancer treatment, such as lymphedema, anxiety, or depression

The Women’s Wellness Clinic offers the care and services you need without leaving the medical supervision of the oncologists you know and trust. Routine checkups, including mammograms, Pap smears, and various scans, are an important part of taking care of yourself after cancer, and all are provided at the Women’s Wellness Clinic.

Women at high risk

Women who are at high risk for breast or ovarian cancer and who have been seen at our Breast and Ovarian Cancer Prevention Program may be referred to the Women’s Wellness Clinic for routine medical exams and close monitoring. You do not have to have had cancer to come to the clinic. You may come for help with cancer prevention

Contact Us

Women's Wellness Clinic
Women's Wellness Clinic

The Women’s Wellness Clinic at SCCA offers wellness-focused follow-up care for women who have completed cancer treatment for a gynecologic or breast cancer.

Breast Cancer Specialty Center

Seattle Cancer Care Alliance (SCCA) and its founding organizations—UW Medicine and Fred Hutchinson Cancer Research Center—have brought together a world-class team of breast cancer experts who focus exclusively on treating women with breast cancer and who provide compassionate, individualized care as well as access to new treatments and procedures.

Your first visit

If you have been newly diagnosed with breast cancer, during your first appointment at the Breast Cancer Specialty Center, you will meet with a team of breast cancer specialists that includes experts in breast cancer surgery, radiation oncology, and medical oncology.

This team will work with you throughout your diagnosis and treatment to determine the best treatment plan for you—one that takes into account the type of breast cancer you have and your values, beliefs and lifestyle. Because our doctors conduct leading-edge breast cancer research as well as treat patients, you can be sure that you will be offered the most promising new treatments available.

Your mammograms and scans will be reviewed by a breast-imaging specialist, who will will discuss your medical records with your team of doctors.

Next your team will review your pathology slides (tissue samples from any biopsies) using a special microscope that allows everyone to see the same image at the same time. 

Then one or more of the doctors on your team will see you for a thorough physical examination.

Finally one or more of your doctors will meet with you (and your family or friends) to discuss the team’s findings, answer all of your questions, and suggest a treatment plan. You will leave at the end of the afternoon with a treatment plan for care either at SCCA or with the doctor who referred you to SCCA.

In addition to doctors who are specialists in various types of breast cancer care, you will have the support of registered nurses, patient care coordinators, social workers, chaplains, psychiatrists, psychologists, and others.

The Breast Cancer Specialty Center is part of the Women’s Center on the third floor of the SCCA clinic on Lake Union.

Breast Cancer Specialty Center

If you have been newly diagnosed with breast cancer, during your first appointment at the Breast Cancer Specialty Center, you will meet with a team of breast cancer specialists.

Treatment

Our breast cancer experts understand that every woman’s cancer is different, as are her genetics, lifestyle, and personal preferences. We work together as a team to design an individualized treatment plan specifically for you — using the most advanced therapies — and to surround you with the support you need.

Providers

At SCCA, you receive care from a team of providers with extensive experience in your disease. Your team includes doctors, a team coordinator, a registered nurse, an advanced practice provider and others, based on your needs. You also have access to experts like nutritionists, social workers, acupuncturists, psychiatrists and more who specialize in supporting people with cancer or blood disorders.

Clinical Trials

For some people, taking part in a clinical trial may be the best treatment choice. For breast cancer patients, this means: 

  • Our surgeons offer several innovative treatment approaches through clinical trials, such as a study to figure out if radiation therapy is as effective as surgery to treat cancer in lymph nodes under the arm. Radiation therapy carries a lower risk of lymphedema.
  • SCCA participates in national clinical trials to study different radiation doses, schedules, and delivery methods; whether all women need radiation to their lymph nodes; and other ways to reduce side effects and improve results.
  • Our medical oncologists lead clinical trials to find new, more effective breast cancer drugs and delivery methods with fewer side effects for every type and stage of breast cancer.

Screening and prevention

Breast cancer is the second most common cancer among women, after skin cancer. We have breast health experts who offer screening mammography and other services to detect breast cancer early.

Many factors may increase a woman’s risk of developing this disease. For women with a very strong risk for breast cancer or ovarian cancer, we have our Breast and Ovarian Cancer Prevention Program.

Breast health

Getting screened is the first and most important step to early detection. Seattle Cancer Care Alliance (SCCA) can help you figure out which screenings are right for you based on your age, health, risk level and other factors. 

Mammograms and breast density

Once you have a mammogram, you may learn that you have dense breasts. As this information may be confusing, here is patient information on breast density and what you should know. If you are a provider, learn the importance of discussing breast density with your patient.

What is breast density?

Breast density refers to the amount of normal, non-fatty tissue visible in a woman’s breasts on mammograms. Washington state law now mandates that women be directly notified if they have dense breast tissue on a screening mammogram.

There are four categories of breast density: almost entirely fat, scattered fibroglandular, heterogeneously dense, and extremely dense.  If your patients’ breasts are in the higher two categories (heterogeneously or extremely) they are considered “dense.” 

 

Images of four categories of breast density

Mammograms can be less accurate in women with dense breasts. The dense tissue looks white on mammograms and can appear similar to breast masses or tumors. Breast density also has been linked to an increase in future risk of developing breast cancer, though it is important to note that breast density alone has only a small impact on breast cancer risk.

Relative risks 

The table below provides relative risks for developing breast cancer by density category*. 

table
· Credit: Annals of Internal Medicine: Benefits, Harms, and Cost-Effectiveness of Supplemental Ultrasonography Screening for Women With Dense Breasts

Seattle Cancer Care Alliance mammograms and breast density

The below chart breaks down breast density type from SCCA mammogram patients from 2015 to 2017.

chart

Next steps

We recognize that notifying patients of their breast density may lead patients to have questions on what they should do next. Every woman who receives a mammogram at the SCCA or University of Washington Medicine will receive an information pamphlet on breast density. To assist you with counseling your patient, we encourage you to discuss the following with your patients:

  • Reassure your patient that screening mammograms, particularly those with 3D technology, also known as tomosynthesis, remain useful for detection of breast cancer regardless of their density. 
  • Explain your patient that the data are not clear on whether supplemental screening of women with dense breasts with additional imaging tests provide greater benefit than harm. The most commonly discussed supplemental examinations are ultrasound and MRI. The UW/SCCA is actively involved in research studies on identifying optimal supplemental screening exams for patients with dense breasts. More information on our active research trials can be found here
  • Talk with your patient to see if there is anything besides breast density that may increase her risk for getting breast cancer. Women at higher breast cancer risk as determined by a risk assessment model that appropriately weights family history may be eligible for supplemental screening with breast MRI. This approach is supported by robust evidence. 

When to refer for additional screening

You are encouraged to perform your patients' risk assessment using the Breast Cancer Surveillance Consortium Risk Calculator

  • If the resultant risk is greater than 2.5 percent at five years, you may consider a referral to the SCCA Breast Health Clinic or the UW Roosevelt Women's Clinic for additional risk assessment and counseling. 
  • If the resultant risk is less than 2.5 percent at five years, your patient should continue to get yearly mammograms, particularly ones with tomosynthesis technology.

Refer your patient

Our breast health experts provide breast cancer screenings and can help you figure out which screenings are right for your patient based on age, health, risk level and other factors. 

Breast Health Clinic at SCCA – South Lake Union
fax (206) 606-6994
Women's Health Care Center at UWMC – Roosevelt
fax (206) 598-6048
Mammograms and breast density

Screening mammograms are the most common and most studied screening test for breast cancer.

SCCA Mammogram Van

The SCCA Mammogram Van travels around the Puget Sound area so you can conveniently get a mammogram. 

SCCA Mammogram Van Schedule (PDF) 

Mammovan

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SCCA Mammogram Van

When will the SCCA Mammogram Van be in your area?