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MKMG's Oncologists
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Oncology Surgery treats breast cancer cells in the breast and nearby lymph nodes. Therapies that go throughout a person's entire system such as hormone blocking therapy and chemotherapy have been shown not only to decrease the chance of breast cancer from recurring after surgery in these areas, but also to prevent a breast cancer recurrence elsewhere in the body.
Hormone Therapy
Hormone therapy is effective in cancers that are hormone sensitive (have estrogen and progesterone receptors on their surface). Hormone therapy for breast cancer includes Tamoxifen (Nolvadex) or the aromatase inhibitors, Arimidex (Anastrazole), Femara (Letrozole), and Aromasin (Exemestane) either alone or in sequence. Currently hormone therapy entails taking one of these pills daily for 5-10 years depending on the situation.
Chemotherapy
Chemotherapy can help further reduce the risk of recurrence and increase the breast cancer cure rate. Chemotherapy is usually given by vein although some are given in pill form depending on the specific regimen used. There are different regimens used depending on the size of the breast cancer or whether the breast cancer is involving the local lymph nodes or not. If the breast cancer has too much of a protein called Her-2 on its surface then a drug called Herceptin is added to the regimen. The oncologists at MKMG have trained at top programs and are highly experienced at tailoring therapy for the individual patient.MKMG has three state-of-the-art Infusion Suites in the Mount Kisco and Carmel offices as well as at Northern Westchester Hospital. Each suite has private treatment bays with flat screen TV’s and DVD players, pleasant outdoor views with comfortable seating for both patients and family members. Suites are equipped with electronic infusion pumps to administer and control the amount of chemotherapy being given. All nurses are specially trained infusion therapy nurses. MKMG’s Infusion Centers are among the first in the nation to use CPOE (computerized physician order entry) to reduce errors in the choice and dose of drugs by the use of electronic ordering.
Clinical Trials
Through its collaboration with the Massachusetts General Hospital, MKMG has been able to achieve affiliation with the MGH Cancer Center and the Cancer and Leukemia Group B (CALGB) for access to important and innovative clinical trials.A cancer clinical trial is a scientific study of a new cancer treatment or a new way of using an established treatment. Participation in a clinical trial can help patients play a more active role in their health care, have access to new treatments before they are widely available, and contribute to medical research. Clinical trials are used to learn whether a new treatment is more effective than the current standard treatments. If a trial ultimately shows a positive result then that new treatment becomes the new standard. All of our current treatment advances were the result of past clinical trials. Choosing to participate in a clinical trial is an important personal decision. Participation in clinical trials is optional, but an important option to have, showing a high level of commitment of our oncologists to the care of people with cancer. For more information on clinical trials please call for an appointment with an MKMG Oncologist at 914-241-1050. Mutations in the BRCA 1 and BRCA 2 genes can increase the risk of breast, ovarian and some other cancers developing. MKMG has an on-site genetic counselor. The genetic counselor meets with a patient both pre- and post-testing. In general, the initial consult consists of a full hour with the patient. An integral part of the counseling is to assess the patient's level of concern, and what issues they want to address, and tailor the session to her needs and provide support. 
The counselor obtains a comprehensive 3-4 generation cancer family history on all patients. Most patients are referred due to a personal/family history of breast cancer and/or ovarian cancer, where BRCA1 and BRCA 2 mutation testing is offered. The genetic counselor can also assess for any personal or family history of other cancers that may be associated with other genetic cancer syndromes such as Li Fraumeni, PTEN or HNPCC, (Lynch Syndrome). If that is the case then the appropriate testing is sent out.
MKMG's genetic counselor spends time discussing the heterogeneity of cancer, which includes sporadic, familial and genetic causes that can also occur in the same family. She also discusses aging, later onset cancers versus early onset cancers as well as certain environmental factors and their significance. All patients who test positive come in for in-depth in person counseling. In the majority of cases where patients test positive the genetic counselor then gets involved with meeting and testing their family members or in referring them to centers near where they live.
Radiation Therapy
Radiation therapy uses a beam of high energy rays to destroy any remaining cancer cells within the breast after surgery. Most women who have breast-conserving surgery will need radiation therapy while most women who have a mastectomy will not. Some women who have a mastectomy, and have certain high risk features, may also require radiation therapy.External beam therapy delivers radiation from a machine outside of the body to the whole breast. This type of radiation is typically given 5 days a week for 5-6 weeks. Some women have the option of partial breast radiation, which is radiation therapy that is limited to the site of where the cancer has been removed. This type of radiation (called MammoSite) uses temporarily implanted radiation inside the breast and requires less radiation time (typically twice a day for 5-7 days). Dr. Ihor Cehelsky of MKMG pioneered this treatment in our area.
The physicians at MKMG work closely with the outstanding radiation oncologists in our community.
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