Breast Cancer

Care team

At Fred Hutchinson Cancer Center, we surround you with experts who focus completely on cancer care. A handful of people make up the core of your care team, based on the types of treatment you need. For many people, the core team includes a nurse navigator, breast surgeon, medical oncologist and radiation oncologist who all specialize in breast cancer. At some visits, you might see an advanced practice provider. Most patients get part of their treatment from infusion nurses. A patient care coordinator will schedule your visits.

Others join your team depending on your personal needs. For example, if you are interested in breast reconstruction, we have surgeons who specialize in this. If you have heart, brain or digestive problems, we call in a dermatologist, neuro-oncologist or gastroenterologist. We have specialists based at Fred Hutch who know the issues that matter for people with cancer.

Supportive care providers are also here to help. You may see Fred Hutch dietitians, physical therapists, psychologists, social workers and others. All of them specialize in caring for people during and after cancer.

Gastroenterologist Gastroenterologists are trained to diagnose and treat diseases of the gastrointestinal system, including cancers of the liver, pancreas, esophagus, stomach, colon, rectum and anus. Infusion An injection of medications or fluids into a vein over a period of time. Medical oncologist A physician who has special training in diagnosing and treating cancer in adults using chemotherapy, hormonal therapy, biological therapy and targeted therapy. A physician who has special training in diagnosing and treating cancer in adults using chemotherapy, hormonal therapy, biological therapy and targeted therapy. A medical oncologist is often the main health care provider for someone who has cancer. A medical oncologist also gives supportive care and may coordinate treatment given by other specialists. Neuro-oncologist A physician who has special training in diagnosing and treating brain tumors and other tumors of the nervous system. Oncologist A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment, such as treating cancer with radiation. A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation.

Your care team

Meet the caring, dedicated people who take care of you and your family at Fred Hutch.

What each team member does

Advanced practice provider (APP)

Advanced practiced providers have training that is similar to physicians and can see you without your physician. At SCCA, these health care professionals work closely with your medical oncologist in the clinic. There are two types: physician assistants (PAs) and advanced registered nurse practitioners (ARNPs). They help provide and plan your treatment and also help manage the effects of your disease and treatment.

Medical oncologist A physician who has special training in diagnosing and treating cancer in adults using chemotherapy, hormonal therapy, biological therapy and targeted therapy. A physician who has special training in diagnosing and treating cancer in adults using chemotherapy, hormonal therapy, biological therapy and targeted therapy. A medical oncologist is often the main health care provider for someone who has cancer. A medical oncologist also gives supportive care and may coordinate treatment given by other specialists. Nurse practitioner A registered nurse who has additional education and training in how to diagnose and treat disease. In cancer care, a nurse practitioner may manage the primary care of patients and their families. A registered nurse who has additional education and training in how to diagnose and treat disease. Nurse practitioners are licensed at the state level and certified by national nursing organizations. In cancer care, a nurse practitioner may manage the primary care of patients and their families, based on a practice agreement with a physician. Physician assistant A health professional who is licensed to do certain medical procedures under the guidance of a physician. A health professional who is licensed to do certain medical procedures under the guidance of a physician. A physician assistant may take medical histories, do physical exams, take blood and urine samples, care for wounds and give injections and immunizations.

Breast cancer surgeon

This physician does surgery to remove as much of your cancer as possible, along with a margin of healthy tissue around the cancer. They might also remove lymph nodes to check for cancer spread.

Your surgeon will:

See you at the start of treatment, if surgery will be the first step (or one of the early steps) in your care.
Explain, along with other team members, what your diagnosis and stage mean.
Recommend surgery to match your exact case. They will explain your surgical options. They will also talk with you about the benefits and risks.
Answer your questions about surgery, like why you need it and what to expect.
Perform your surgery, along with a team that includes an anesthesiologist and nurses.
Work closely with your reconstructive surgeon.
Offer you ways to prevent, relieve and cope with side effects of surgery.
Work with the rest of your care team if you need other types of treatment.

Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores. Stage The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer and whether the cancer has spread from the original site to other parts of the body.

Breast reconstructive surgeon

This physician does surgery to restore your breast after cancer surgery, if you want this. Depending on your exact needs, they may work closely with your cancer surgeon to operate on the same day your cancer is removed, or they may do your reconstruction later in a separate procedure.

Your reconstructive surgeon will:

See you if your evaluation shows that reconstruction is possible and if you are interested. They will meet with you to talk about options.
Recommend surgery to match your exact case, based on your health needs and your wishes. They will also talk with you about the benefits and risks.
Answer your questions about reconstruction, like what to expect.
Do your surgery, along with a team that includes an anesthesiologist and nurses.
See you after surgery to check your healing.
Offer you ways to prevent, relieve and cope with side effects of surgery.
Work with the rest of your care team if you need other types of treatment.

Infusion nurse

Cancer nurses who are experts in infusions give these treatments. They will also check on you during each infusion. They will help any medical issues that come up and keep you comfortable.

Infusion An injection of medications or fluids into a vein over a period of time. Infusion An injection of medications or fluids into a vein over a period of time.

Medical oncologist

This physician manages your medicine-based treatments. Most people with breast cancer get chemotherapy. Some people get endocrine therapy, targeted therapy or immunotherapy.

Your medical oncologist will:

See you at the start of treatment, unless we expect that surgery will be the only form of treatment you need.
Explain, along with other team members, what your diagnosis and stage mean, and answer your questions.
Recommend medicine-based treatments to match your specific case. They will choose the medicines, doses, schedule and sequence. They will also talk with you about the benefits and risks.
See you on a regular schedule to check how your cancer responds to treatment and how you are overall.
Offer you ways to prevent, relieve and cope with side effects of treatment, like medicine to help with nausea.
Work with the rest of your care team if you need other types of treatment.

Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Hormone therapy Hormones can cause some cancers to grow. To slow or stop growth, synthetic hormones or other drugs can be used to block the body’s natural hormones, or surgery is used to remove a hormone-producing gland. Treatment that adds, blocks or removes hormones. For certain conditions (such as diabetes or menopause), hormones are given to adjust low hormone levels. Hormones can also cause certain cancers (such as prostate and breast cancer) to grow. To slow or stop the growth of cancer, synthetic hormones or other drugs can be used to block the body’s natural hormones, or surgery is used to remove the gland that makes a certain hormone. Also called endocrine therapy, hormonal therapy and hormone treatment. Immunotherapy A type of therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. A therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. Some immunotherapies only target certain cells of the immune system. Others affect the immune system in a general way. Types of immunotherapy include cytokines, vaccines, bacillus Calmette-Guerin (BCG) and some monoclonal antibodies. Medical oncologist A physician who has special training in diagnosing and treating cancer in adults using chemotherapy, hormonal therapy, biological therapy and targeted therapy. A physician who has special training in diagnosing and treating cancer in adults using chemotherapy, hormonal therapy, biological therapy and targeted therapy. A medical oncologist is often the main health care provider for someone who has cancer. A medical oncologist also gives supportive care and may coordinate treatment given by other specialists. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores. Stage The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer and whether the cancer has spread from the original site to other parts of the body. Targeted therapy A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. Some targeted therapies block the action of certain enzymes, proteins or other molecules involved in the growth and spread of cancer cells. Other types of targeted therapies help the immune system kill cancer cells, or they deliver toxic substances directly to cancer cells and kill them. Targeted therapy may have fewer side effects than other types of cancer treatment. Most targeted therapies are either small molecule drugs or monoclonal antibodies.

Nurse navigator

The Fred Hutch Breast Cancer Specialty Clinic has nurse navigators to help you deal with the health care system. They will help with transitions in your treatment, like going from recovery after surgery to the start of chemotherapy. They will listen to your needs and direct you to the right services, departments and resources.

Patient care coordinator

Your patient care coordinator works closely with you and your physicians. They will schedule your appointments.

Radiation oncologist

This physician treats cancer with radiation. They prescribe and manage this part of your care. Working with a radiation oncology team, they plan and deliver your treatments.

Your radiation oncologist will:

See you at the start of treatment if we expect that radiation therapy will be part of your care.
Explain, along with other team members, what your diagnosis and stage mean.
Recommend radiation therapy to match your case. They will decide the type, dose and schedule. They will also talk with you about the benefits and risks.
Work behind the scenes with other radiation experts. These experts make sure you receive the right dose in the right places (dosimetrist). They also maintain the equipment that is used (medical physicist).
Answer your questions about radiation therapy, like why you need it and what to expect.
See you on a regular schedule during radiation therapy to check how your cancer responds and how you are doing overall.
Offer you ways to prevent, relieve and cope with side effects of treatment.
Work with the rest of your care team if you need other types of treatment.

Oncologist A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment, such as treating cancer with radiation. A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation. Radiation therapy The use of high-energy radiation from X-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. The use of high-energy radiation from x-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores. Stage The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer and whether the cancer has spread from the original site to other parts of the body.

Radiation therapist

This specialist positions you each time you come in for radiation treatment. This makes sure that your treatment goes to the right places on your body. They also operate the machines that deliver the radiation.

Radiologist

This physician reads and gives the results of your imaging tests. They also do some types of biopsies.

Your radiologist will:

Look for abnormal areas on images from tests like mammography, breast MRI (magnetic resonance imaging) and many others.
“Decode” the meaning of your images and recommend if you should have more imaging, a biopsy or other care.
Do a fine-needle biopsy or core biopsy, often guided by an X-ray or ultrasound.
Work closely with your surgeon to tell exactly where your tumor is and how this affects the type of surgery, and how much surgery, you need.
Put a tiny infrared chip or thin guide wire into your breast to show your surgeon which tissue to remove, if your cancer is too small to feel.
Answer your questions about imaging, like why you need it and what to expect.
Work with the rest of your care team about any tests and treatments you need.

Biopsy The removal of a sample of tissue or fluid that is examined to see whether cancer is present. This may be done with a large needle or through surgical removal of tissue or fluids. Biopsy The removal of a sample of tissue or fluid that is examined to see whether cancer is present. This may be done with a large needle or through surgical removal of tissue or fluids. Core biopsy The removal of a tissue sample with a wide needle for examination under a microscope. Fine-needle biopsy The removal of fluid, cells or tissue with a thin needle for examination under a microscope. Also called FNA biopsy. Imaging In medicine, a process that makes pictures of areas inside the body. Imaging uses methods such as X-rays (high-energy radiation), ultrasound (high-energy sound waves) and radio waves. Mammography The use of film or a computer to create a picture of the breast. Magnetic resonance imaging A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. MRI makes better images of organs and soft tissue than other scanning techniques, such as computed tomography (CT) or X-ray. MRI is especially useful for imaging the brain, the spine, the soft tissue of joints and the inside of bones. Radiologist A physician who has special training in creating and interpreting pictures of areas inside the body. The pictures are made with X-rays, sound waves or other types of energy. Ultrasound A procedure that uses high-energy sound waves to look at tissues and organs inside the body. The sound waves make echoes that form pictures of the tissues and organs on a computer screen. A procedure that uses high-energy sound waves to look at tissues and organs inside the body. The sound waves make echoes that form pictures of the tissues and organs on a computer screen (sonogram). Ultrasound may be used to help diagnose diseases, such as cancer. It may also be used during pregnancy to check the fetus (unborn baby) and during medical procedures, such as biopsies. Also called ultrasonography.

Registered nurse

Your nurses manage your care with your physicians. They also help with procedures and treatments. Nurses are resources for you and your caregiver. They can answer questions on a wide range of topics, like how to cope with side effects or get other services you need at Fred Hutch.

Caregiver A person who gives care to people who need help, such as children, older people or patients who have chronic illnesses or disabilities. A person who gives care to people who need help taking care of themselves, such as children, older people or patients who have chronic illnesses or disabilities. Caregivers may be health professionals, family members, friends, social workers or members of the clergy. They may give care at home, in a hospital or in another health care setting. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores.

Supportive care services

Many types of supportive care team members are here to help you and your family. They include dietitians, physical therapists, pain medicine specialists, psychologists, social workers, spiritual health staff, genetic counselors, palliative care specialists, naturopaths and acupuncturists.

Supportive Care Services

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