--- title: "Breast cancer services at Sutter Health" description: "Sutter offers breast cancer care, including advanced diagnostic imaging, genetic counseling, personalized treatment plans and reconstructive surgery options." url: "https://www.sutterhealth.org/services/breast-cancer" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Services](https://www.sutterhealth.org/services) / 3. Breast cancer services # Breast cancer Receiving a breast cancer diagnosis can be shocking and scary. You want answers and the best care possible. Our skillful specialists are here to support you every step of the way. From your first screening to survivorship, we’re committed to helping you heal and thrive. [Find an oncologist](https://www.sutterhealth.org/find-provider-results?staticFilters=%5B%7B%22displayName%22%3A%22Breast%20Cancer%22%2C%22selected%22%3Atrue%2C%22filter%22%3A%7B%22kind%22%3A%22disjunction%22%2C%22combinator%22%3A%22%24or%22%2C%22filters%22%3A%5B%7B%22kind%22%3A%20%22fieldValue%22%2C%22fieldId%22%3A%22c_relatedConditions.name%22%2C%22value%22%3A%22Breast%20Cancer%22%2C%22matcher%22%3A%22%24eq%22%7D%5D%7D%7D%5D%0A&verticalKey=healthcare_professionals) [Request a referral](https://www.sutterhealth.org/referrals) ## Why choose Sutter? When you turn to us for [breast cancer](https://www.sutterhealth.org/health/breast-cancer-screening-guidelines) treatment, you’ll have dedicated doctors, nurses and care staff working together to create a care plan tailored to you. Specialists review cases collaboratively in tumor boards and cancer case conferences, using evidence-based pathways and the latest research to guide your care. Our nationally accredited centers offer access to advanced therapies and hundreds of clinical trials, helping improve outcomes and extend lives. Along with personalized treatment, we provide whole-body support through patient navigators, wellness classes, support groups, educational webinars and pain management services — helping you through every step of your journey. ## By the numbers ### 250+ cancer specialists deliver nationally recognized, team-based care. ### 6 cancer centers accredited by the American College of Surgeons’ National Accreditation Program for Breast Centers. ### 150+ cancer clinical trials are underway to unlock the next breakthrough cancer treatment. ### 370K+ people entrust Sutter with their mammograms each year. ## Need a referral? Chat live with our team Monday through Friday, 8:00 am — 5:00 pm, or call us at [888-834-1788](tel:+18888341788). [Request a referral](https://www.sutterhealth.org/referrals) ## Conditions - Ductal carcinoma in situ (DCIS) - HER2-positive breast cancer - Inflammatory breast cancer - Invasive Ductal Carcinoma (IDC) - Invasive Lobular Carcinoma (ILC) - Lobular carcinoma in situ (LCIS) - Male breast cancer - Metastatic breast cancer - Triple-negative breast cancer ## Diagnostics - Breast biopsy - Breast magnetic resonance imaging (MRI) - Breast ultrasound - Digital 3D mammogram - [Mammogram](https://www.sutterhealth.org/services/mammogram) - Sentinel node biopsy for breast cancer ## Treatments - Biotherapy - Brachytherapy - [Breast reconstruction surgery](https://www.sutterhealth.org/services/breast-reshaping) - Chemotherapy - External beam radiation therapy (EBRT) - Hormone therapy - Immunotherapy - Lumpectomy - Mastectomy - Oncoplastic breast surgery - [Radiation therapy](https://www.sutterhealth.org/services/radiation-oncology) - Targeted therapy ## Related services - [Breast health services](https://www.sutterhealth.org/services/breast-health) - [Breast imaging services](https://www.sutterhealth.org/services/breast-imaging) - [Cancer case conferences](https://www.sutterhealth.org/services/cancer-case-conference) - [Cancer pain management](https://www.sutterhealth.org/services/cancer-pain-management) - [Cancer patient navigators](https://www.sutterhealth.org/services/cancer-patient-navigators) - [Cancer rehabilitation](https://www.sutterhealth.org/services/cancer-rehabilitation) - [Cancer services](https://www.sutterhealth.org/services/cancer) - [Cancer special services and support](https://www.sutterhealth.org/services/cancer-special-services-support) - [Genetic testing and counseling for cancer risk](https://www.sutterhealth.org/services/genetic-testing-counseling) - [Lymphedema](https://www.sutterhealth.org/services/lymphedema) Breast cancer programs **Breast Cancer High Risk Program** Our Breast Cancer High Risk Program in San Francisco at Sutter Sutter Mills Peninsula Medical Center monitors women at increased risk for breast cancer and helps reduce that risk as much as possible. Our staff partners with your primary care doctor and OB/Gyn to create a customized plan to manage your risk. This includes lifestyle changes, surveillance imaging and, when appropriate, chemoprophylaxis such as tamoxifen. You may also be referred to our genetic counselor if you have a personal or family history that suggests inherited cancer risk. You might be a good fit for this program if you have: - Been diagnosed by breast biopsy with atypia, atypical ductal hyperplasia (ADH), Lobular carcinoma in situ (LCIS) or lobular neoplasia - A personal history of chest irradiation between ages 10–30 - A known BRCA1 or BRCA2 mutation - A first- or second-degree relative with a BRCA mutation - A first- or second-degree relative diagnosed with breast or ovarian cancer - A first- or second-degree relative with breast or ovarian cancer and are of Ashkenazi Jewish descent For more information about the Breast Cancer High Risk Program at Sutter Mills Peninsula Medical Center in San Mateo, please call [650-342-9491](tel:650-342-9491) to speak with a clinical breast specialist. **Carol Ann Read Breast Health Center** The [Carol Ann Read Breast Health Center](https://www.sutterhealth.org/find-location/facility/carol-ann-read-breast-health-center-1043246602) brings comprehensive breast cancer screening and diagnostic services to women across the East Bay, with convenient locations in [Oakland](https://www.sutterhealth.org/find-location/facility/5730-telegraph-avenue-imaging-1043247377), [Lafayette](https://www.sutterhealth.org/find-location/facility/women-s-health-center-in-lafayette-1043246668), [Castro Valley](https://www.sutterhealth.org/find-location/facility/eden-medical-center-1043246538) and [Antioch](https://www.sutterhealth.org/find-location/facility/sutter-delta-medical-center-1043246751) as well as a mobile mammography van. Our American College of Radiology-accredited teams specialize in breast imaging and use advanced technologies such as 3D mammography, breast ultrasound, breast MRI, contrast enhanced mammography and minimally invasive biopsy techniques. Patient navigators are available to help coordinate appointments, answer questions and support you through the diagnostic process. Our center also offers resources such as genetic screening, breast cancer risk assessment and connections to wellness and support services. For more information about breast cancer services available through the [Carol Ann Read Breast Health Center](https://www.sutterhealth.org/find-location/facility/carol-ann-read-breast-health-center-1043246602), please call [510-869-8377](tel:510-869-8377). **COMPASS Breast Cancer Program** The Compassionate Peer Advocacy Support Services Program (COMPASS) in Oakland at Alta Bates Medical Center pairs current patients with a breast cancer survivor. As someone who has been through a similar experience, your peer understands the disease and provides emotional support so that you’re free to concentrate on your health and wellness. For more information about the COMPASS Program, please call [510-655-4000,](tel:510-655-4000) ext. 3638. **Notkin Family Breast Cancer Recovery Program** The Notkin Family Breast Cancer Recovery Program at CPMC in San Francisco provides seamless support services to assist you and your loved ones through a cancer diagnosis, treatment and survivorship. Our program is accredited by the National Accreditation Program for Breast Centers (NAPBC) and offers a multidisciplinary team approach for personalized treatment. Your team may include nurse navigators, psychologists, dietitians and licensed clinical social workers. Call [415-600-2717](tel:415-600-2717) to make an appointment. ## Mammograms made easy Sutter patients can schedule through [My Health Online](https://www.sutterhealth.org/patient-resources/my-health-online). New to Sutter? Just have a referral from your provider ready. [Schedule now](https://myhealthonline.sutterhealth.org/mho/Scheduling?workflow=Procedure&rfvId=100,107) Breast cancer screening and education 1 / 4 1 / 4 ![female-scientist-working-in-the-laboratory](https://edge.sitecorecloud.io/sutterhealt962c-sutterhealt8fce-production57cc-4860/media/Project/SutterHealth/SutterHealth/Images/people/women/female-scientist-working-in-the-laboratory.jpg?h=494&iar=0&w=708) ## Breast cancer research Our breast cancer research propels detection, diagnosis, treatment and recovery forward by inventing and refining new methods and treatments. See our current clinical trials. [View clinical trials](https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Breast+Cancer%22%5D%7D%5D&verticalKey=clinical_trial) ![female-scientist-working-in-the-laboratory](https://edge.sitecorecloud.io/sutterhealt962c-sutterhealt8fce-production57cc-4860/media/Project/SutterHealth/SutterHealth/Images/people/women/female-scientist-working-in-the-laboratory.jpg?h=494&iar=0&w=708) ![thoughtful-female-cancer-patient](https://edge.sitecorecloud.io/sutterhealt962c-sutterhealt8fce-production57cc-4860/media/Project/SutterHealth/SutterHealth/Images/people/women/thoughtful-female-cancer-patient.jpg?h=483&iar=0&w=724) ## Predict cancer through genetics If you have cancer or a family history of cancer, consider genetic counseling and testing with trusted professionals at Sutter. [Explore genetic counseling](https://www.sutterhealth.org/services/genetic-testing-counseling) ## Sutter spotlight Page ### [Breast Cancer Screening Guidelines](https://www.sutterhealth.org/health/breast-cancer-screening-guidelines) Finding breast cancer early means everything. It boosts the 5-year survival rate to 99%. Health & wellness ### [Reduce Your Risk of Breast Cancer](https://www.sutterhealth.org/health/reduce-your-risk-of-breast-cancer) Breast cancer specialists at Sutter discuss simple steps that can help you lower your risk of disease. Health & wellness ### [3 Tell-Tale Signs of Male Breast Cancer](https://www.sutterhealth.org/health/male-breast-cancer) Identify common symptoms and catch early warning signs to keep yourself safe.  ## Patient stories [View all stories](https://www.sutterhealth.org/patient-stories) - [Patient story ### Blooming beyond breast cancer ](https://www.sutterhealth.org/patient-stories/blooming-beyond-breast-cancer-2031551256) - [Patient story ### Tattoo-Free Breast Cancer Treatment Leaves a Profound Impact ](https://www.sutterhealth.org/patient-stories/tattoo-free-breast-cancer-treatment-leaves-a-profound-impact-2031551257) - [Patient story ### $580,000 raised to support cancer patients in Sonoma ](https://www.sutterhealth.org/patient-stories/580000-raised-to-support-cancer-patients-in-sonoma-2032168139) [View all stories](https://www.sutterhealth.org/patient-stories) ## Breast cancer treatment and personalized care Find comprehensive breast cancer care at Sutter, from diagnosis and treatment through recovery and survivorship. [Find an oncologist](https://www.sutterhealth.org/find-provider) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"MedicalWebPage","@id":"https://www.sutterhealth.org/services/breast-cancer#medicalwebpage","url":"https://www.sutterhealth.org/services/breast-cancer","breadcrumb":{"@id":"https://www.sutterhealth.org/services/breast-cancer#breadcrumblist"},"name":"Breast cancer at Sutter Health","description":"Sutter offers breast cancer care, including advanced diagnostic imaging, genetic counseling, personalized treatment plans and reconstructive surgery options.","inLanguage":"en-US","medicalAudience":{"@type":"MedicalAudience","audienceType":"Patient"},"mainEntity":{"@type":"MedicalSpecialty","@id":"https://www.sutterhealth.org/services/breast-cancer#medicalspecialty","name":"Breast cancer","alternateName":["MRI Scans","Magnetic resonance Imaging","Breast Cancer","Paget's Disease of Breast","Male Breast Cancer","Mastectomy","Lumpectomy","BRCA","mammogram"],"url":"https://www.sutterhealth.org/services/breast-cancer"},"about":[{"@type":"MedicalCondition","name":"Ductal carcinoma in situ (DCIS)"},{"@type":"MedicalCondition","name":"HER2-positive breast cancer"},{"@type":"MedicalCondition","name":"Inflammatory breast cancer"},{"@type":"MedicalCondition","name":"Invasive Ductal Carcinoma (IDC)"},{"@type":"MedicalCondition","name":"Invasive Lobular Carcinoma (ILC)"},{"@type":"MedicalCondition","name":"Lobular carcinoma in situ (LCIS)"},{"@type":"MedicalCondition","name":"Male breast cancer"},{"@type":"MedicalCondition","name":"Metastatic breast cancer"},{"@type":"MedicalCondition","name":"Triple-negative breast cancer"},{"@type":"MedicalTest","name":"Breast biopsy"},{"@type":"MedicalTest","name":"Breast magnetic resonance imaging (MRI)"},{"@type":"MedicalTest","name":"Breast ultrasound"},{"@type":"MedicalTest","name":"Digital 3D mammogram"},{"@type":"MedicalTest","name":"Mammogram","url":"https://www.sutterhealth.org/services/mammogram"},{"@type":"MedicalTest","name":"Sentinel node biopsy for breast cancer"},{"@type":"MedicalProcedure","name":"Biotherapy"},{"@type":"MedicalProcedure","name":"Brachytherapy"},{"@type":"MedicalProcedure","name":"Breast reconstruction surgery","url":"https://www.sutterhealth.org/services/breast-reshaping"},{"@type":"MedicalProcedure","name":"Chemotherapy"},{"@type":"MedicalProcedure","name":"External beam radiation therapy (EBRT)"},{"@type":"MedicalProcedure","name":"Hormone therapy"},{"@type":"MedicalProcedure","name":"Immunotherapy"},{"@type":"MedicalProcedure","name":"Lumpectomy"},{"@type":"MedicalProcedure","name":"Mastectomy"},{"@type":"MedicalProcedure","name":"Oncoplastic breast surgery"},{"@type":"MedicalProcedure","name":"Radiation therapy","url":"https://www.sutterhealth.org/services/radiation-oncology"},{"@type":"MedicalProcedure","name":"Targeted therapy"}],"publisher":{"@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org"},"datePublished":"2026-10-27T11:49:25-07:00","dateModified":"2026-10-27T11:49:25-07:00"} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/services/breast-cancer#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Services","item":"https://www.sutterhealth.org/services"},{"@type":"ListItem","position":3,"name":"Breast cancer services"}]} ``` ```json {"@context":"https://schema.org","@type":"VideoObject","name":"3D Mammograms: Breast Cancer Screening Starting at Age 40","thumbnailUrl":"https://cf-images.us-east-1.prod.boltdns.net/v1/static/817826402001/9e56ea3e-1465-49ac-95b9-5ec9a09cb7a8/b6c6a3aa-e2a0-4229-bd85-a906b3e8fa36/1280x720/match/image.jpg","uploadDate":"2021-07-16T21:01:41.074Z","embedUrl":"https://players.brightcove.net/817826402001/79bcaa57-54d7-453c-9f1f-8ab3ef7b15de/index.html?videoId=6263997084001","description":"Breast cancer is one of the most common cancers that affect women. But with early detection, it can be treated more easily than ever before. Spend a minute with Xin Li, M.D., Ph.D., to learn how 3D mammograms can help you.","duration":"PT57S","transcript":"Breast cancer is one of\nthe most common cancers\nthat affect women.\nThe reality is one in eight\nwill be diagnosed with it\nat some point in their lives.\nThe good news is detection and treatment\nhave improved.\nNow when it’s caught early,\nwe are able to treat it\nmore effectively than ever before.\nWith 3D mammograms,\nwe can get a clear picture\nof your breast.\nThese pictures give us precise\ndetail focused images\nto help with detection.\nThe most important thing here,\nstarting at age 40, making screening\na priority for you and your loved ones.\nKnow and understand your risk.\nRemember, mammograms can save lives."} ``` ```json {"@context":"https://schema.org","@type":"VideoObject","name":"Mammogram Screening: What to Expect and How to Prepare","thumbnailUrl":"https://cf-images.us-east-1.prod.boltdns.net/v1/static/817826402001/8c794d14-d0ba-4746-abae-40f95486e47b/8aafbe04-6a31-40fe-8a01-66f0ec83cf93/1280x720/match/image.jpg","uploadDate":"2022-07-21T19:42:39.217Z","embedUrl":"https://players.brightcove.net/817826402001/79bcaa57-54d7-453c-9f1f-8ab3ef7b15de/index.html?videoId=6309847056112","description":"Breast cancer is one of the most common cancers that affect women. But with early detection, it can be treated more easily than ever before. Rita Kwan-Feinberg, M.D., MPH, FACS, shows you what to expect when you get your mammogram.","duration":"PT1M24S","transcript":"Routine mammograms are an important\nscreening tool to catch breast cancers when they're easiest to treat.\nOn the day of your exam, avoid wearing any deodorant, powder,\nlotion or perfume, as these can interfere with your imaging.\nYour normal clothes are fine to wear, though two piece outfits make it easier.\nYou'll have a private area to dress from the waist up, then slip on a simple gown.\nWe’ll provide a locker for your belongings.\nSutter uses modern digital equipment with low dose\nradiation to perform 2D and 3D mammography.\nStaff will help you position your breast\non the equipment gently to minimize discomfort.\nWe take a few images to ensure a full picture,\nasking you to hold your breath and stay still for a few seconds each.\nMammogram screenings take about 15 minutesonce the exam starts,\nso give yourself about 30 to 45 minutes for the entire appointment.\nA radiologist will evaluate your images and compare them to past images\nif available.\nIf you have normal results, we’ll message\nyou in My Health Online or send them by mail.\nIf an area needs more imaging, we'll call you about next steps.\nGo to My Health Online or call your doctor to book your mammogram, today.\nRemember, mammograms save lives."} ``` ```json {"@context":"https://schema.org","@type":"VideoObject","name":"Breast Cancer: Pretreatment Exercises","thumbnailUrl":"https://cf-images.us-east-1.prod.boltdns.net/v1/static/817826402001/bf892adf-9d55-439a-9746-7e042f50e8a2/a2f4e61c-f08c-400f-a163-7cde10c8c731/1280x720/match/image.jpg","uploadDate":"2022-10-31T17:23:40.349Z","embedUrl":"https://players.brightcove.net/817826402001/79bcaa57-54d7-453c-9f1f-8ab3ef7b15de/index.html?videoId=6314691695112","description":"Finding your strength before breast cancer treatment starts with you, but you’re never alone. Tiffany De Asis, P.T., CLT, is here to help you find yours with this series of at-home exercises.","duration":"PT9M34S","transcript":"[MUSIC PLAYING]\n\nHi, I'm Tiffany De Asis, physical therapist\nand certified lymphedema therapist\nat Mills-Peninsula Medical Center in San Mateo.\nI'm going to show you how to do exercises\nto do prior to your breast cancer surgery\nto help make you stronger, more flexible,\nand help make recovery easier.\nFirst, we're going to do scapular protraction\nand retraction.\nWe're going to do two sets of 10 repetitions.\nAnd what that is, is you are squeezing the shoulder blades\nby bringing your shoulder blades back and down\nand then going the other direction and around\nyour shoulders all the way.\nAnd then bring it back, and then around them forward again.\nBack stays neutral, and you're just moving from the shoulder\nblades.\n[MUSIC PLAYING]\n\nNow we're going to do front raises and lateral raises,\ntwo sets of 10 repetitions in each direction.\nSo you're going to take 2-pound dumbbells.\nIf you don't have dumbbells at home,\nyou can use a filled water bottle or a soup can,\nsomething you can grip onto.\nYou're basically going to take both arms here and lift them up\nto about 90 degrees.\nOK.\n[MUSIC PLAYING]\n\nJust make sure that your shoulders are back\nand your shoulders aren't up in your ears.\nThere you go.\n[MUSIC PLAYING]\n\nOK, So for the next exercise, these are the lateral raises.\nAnd your just basically going to do the same thing.\nYou're just bringing them out to the side\nand still at 90 degrees.\nIf it's too hard to bring your arms\nall the way out to the side, you can bring them a little\nforward.\n[MUSIC PLAYING]\nAnd the same thing, make sure your shoulder\nblades are back and down.\n[MUSIC PLAYING]\n\nThe next exercise we're doing is side-lying\nshoulder external rotation with 2-pound weights,\n2 sets of 10 repetitions.\nYou're going to lie on your right side.\n\nAnd what we're going to do is, you're going to take a towel,\nfold it or roll it up, and put it\nunderneath your elbow for support.\nArm rests kind of right on your stomach there.\nYou're going to grab onto a 2-pound weight.\nAnd it could be 1 pound.\nIt could be a water bottle, anything\nthat has a little bit of resistance there.\nAnd before you lift the arm up, you're\ngoing to squeeze your shoulder blades back, and then lift up.\nAnd again, a comfortable range.\n[MUSIC PLAYING]\nIf it's painful, stop.\n\nPerform these exercises twice a day, or morning and night,\nand they will help you to improve your strength\nand flexibility to prepare you for surgery.\nSo now that you've had surgery, I'm\ngoing to show you exercises you can do post-op\nto help maintain your range of motion\nand decrease pain and tightness.\nYou can start these exercises once your drains have\nbeen removed and once you've been cleared by your surgeon.\nAll of these exercises should be pain-free.\nSo if you feel pain, stop before you feel the pain.\nYou should move into a stretch and a pull, but not pain.\nThe first exercise you're going to do is cane shoulder flexion.\nYou will hold 3 seconds at end range,\nand we will do 2 sets of 10 repetitions.\nSo this exercise, we're going to do using a cane.\nYou can use the dowel like this.\nYou can use a golf club, an umbrella, a wrapping paper\ntube, anything long that you can have both hands on.\nYou're going to lie down just like this.\nOr if it's too hard for you to lie down.\nYou're going to elevate, you could put a couple of pillows\nunder your head if it's too hard for you to lay down just yet.\nYou can also do these exercises sitting up.\nBut I think it's a little bit easier at first\nto do it lying down.\nSo you're going to take both hands on the cane,\nand you're going to lift the arms overhead.\n\nYou want to keep the motion pain-free.\nSo stop if you feel pain.\n[MUSIC PLAYING]\n\nAnd if it's too hard for you on the surgical side,\nyou can use the non-surgical side\nto help lift the other side if it's too hard for you.\n\nIf you have a hard time moving your right arm, which\nis the surgical side, you're going\nto grab on with both hands.\nKeep your elbows straight.\nYou can relax as much as you want,\nor you can have it help along as much as you like,\nas long as you're not feeling any pain.\nThis arm does the work, the non-surgical side.\nOK.\nGo ahead and lift up, yeah, just like that.\nStop right before you feel that pain.\nAnd then, as you loosen up, as it gets a little bit easier,\nthe surgical side can assist a little bit more.\n[MUSIC PLAYING]\n\nAlso too, when you get to the very end,\nyou can hold for about two, three seconds.\nThere we go, just that you can and you get a little bit more\nof a stretch, and then come back.\n\nThe next exercise is cane shoulder abduction.\nHold three seconds at end range, 2 sets of 10 repetitions.\nThis is going to be that very similar exercise.\nWe're using the cane as well, except now we're\ngoing to move your arm out to the side.\nSo if your right side is your surgical side,\nyou're going to grab on to the cane,\nkind of like this with your thumb pointing out.\nYour arms are going to be the level of your trunk\nor even a little bit above if it's too hard to have it flat.\nYou're going to use the non-surgical hand to help push\nthe arm out to the side.\nSo that one holds on that way.\nThis one, you can actually-- whatever angle\nis easiest for you to push up.\nAnd this arm can stay--\nelbow can stay straight, and you can bend this non-surgical side\nto help lift up.\nAnd see how it can push it out to the side?\n[MUSIC PLAYING]\n\nAnd again, the surgical side can help as much\nas you're comfortable with.\n[MUSIC PLAYING]\n\nNow we're going to do a hand-behind-the-head pec\nstretch.\nHold 15 to 20 seconds for a nice stretch,\nand repeat 2 to 3 times.\nYou basically want to get your hands behind your head,\nbut it might be hard, difficult at first.\nIf that's too difficult for you to come all the way out,\nyou actually want to bring your arms closer to your--\nyour elbows closer to your ears.\nAnd you're basically going to slowly bring the arms back\ntowards the pillow.\nAnd then you might, if this is still hard, you might even\nwant to bring them in and out, back and forth,\nuntil it feels comfortable and less tight.\nAnd then, when it feels less tight,\nthen you can hold it at the end.\nOnce you feel comfortable, hold it 15, 20 seconds.\n[MUSIC PLAYING]\n\nNext exercise-- shoulder blade squeezes,\n2 sets of 10 repetitions.\nIt's going to help improve your posture.\nIt helps stretch the chest and help decrease\nsome of the pain and the guarding\nthat you have on your surgical side.\nYou can do this standing or sitting.\nBut you're going to squeeze the shoulder blades together\nby drawing your shoulder blades back and down.\n\nAnd the one thing you want to watch for\nis to make sure that you're not arching your back.\nSo your back stays in neutral.\nAnd just isolate for just the shoulder blade.\n[MUSIC PLAYING]\n\nAnd lastly, we will do wall slides,\n2 sets of 10 repetitions.\nI have two pillowcases here so it makes it easier\nto slide up and down the wall.\nYou can use a towel.\nYou don't have to use anything, but sometimes your hand\nsticks on the wall, which is why I am\nhaving you use the pillowcases.\nSo one hand here, one hand here, and you're basically\ngoing to slide up a wall and try to increase\nsome of that range of motion.\nAnd you can lean into it to get a little bit more of a stretch,\nand then come right back down.\n[MUSIC PLAYING]\n\nThen you can just hold again two to three seconds,\nand then come right back.\n\nPain-free motion-- are only going to the point\nwhere you feel a stretch, but not pain.\nAnd then leaning into it at the end\nthere gets a little bit more of a stretch,\nand you can hold that for two to three seconds.\n\nPerform these exercises once your drains have been removed\nand you've been cleared by your surgeon.\nDo them twice a day, morning and night,\nand they will help to bridge the gap from the time of surgery\nuntil you are able to get in for an appointment\nwith physical therapy.\nAnd remember, once you get your referral from your doctor,\nplease schedule your appointment right away so that there\nis no delay in care.\n[MUSIC PLAYING]"} ``` ```json {"@context":"https://schema.org","@type":"VideoObject","name":"Lymphedema: Understanding and Reducing Your Risk","thumbnailUrl":"https://cf-images.us-east-1.prod.boltdns.net/v1/static/817826402001/4fdcadf7-6367-4ac4-b859-0a73fad79bb5/688b0b5e-6589-4875-899c-405c99532b93/1280x720/match/image.jpg","uploadDate":"2020-11-16T21:38:01.848Z","embedUrl":"https://players.brightcove.net/817826402001/79bcaa57-54d7-453c-9f1f-8ab3ef7b15de/index.html?videoId=6210194273001","description":"People who have had or are going to have surgery for cancer can learn how to reduce their risk of developing Lymphedema.","duration":"PT24M54S","transcript":"LIZZIE: Hi, my name is Lizzie.\nAnd I'm a clinical coordinator here at Sutter.\nWe are here today to offer this video class\non cancer-related lymphedema specifically\nabout understanding and reducing your risk of developing it.\nIf you have questions, please call your doctor's office.\n\nThe content is not intended to be\na substitute for professional medical advice, diagnosis,\nor treatment.\nAlways seek the advice of your physician\nor other qualified health provider\nwith any questions you may have regarding a medical condition.\nI want to talk a little bit about this class.\nIt can be a lot to take in.\nWe do recommend that you watch and listen to the whole video.\nBut it is OK to press Pause at any time, take a break,\nand come back later.\nWe have divided it into two parts.\nThe first part is about lymphedema\nso you understand what it is.\nThe second part includes things that you\ncan do to reduce your risk of developing it.\nFor questions about your specific medical care\nor lymphedema, contact your surgeon,\nyour medical oncologist, or your primary care provider.\nWe have two talented people from our Sutter team\nwho will be giving you the information about lymphedema.\nYou can see pictures of them here.\nSaskia Thiadens has been an oncology nurse\nfor over 25 years specializing in lymphedema.\nIn 1987, she opened the first lymphedema clinic\nin the United States and the following year\nfounded the National Lymphedema Network,\na nonprofit organization.\nIn 2018, she started a screening and early detection program\nfor cancer-related lymphedema at California Pacific Medical\nCenter in San Francisco.\nCorinna Lowe received her doctorate of physical therapy\nfrom the University of Washington.\nShe is a Lymphology Association of North\nAmerica-certified lymphedema therapist.\nWith that being said, I would like to hand this presentation\nover to Saskia.\nSaskia?\nSASKIA THIADENS: Thank you so much, Lizzie,\nfor this kind introduction.\nThis webinar is designed to educate and help you\nin reducing the risk of developing lymphedema following\nyour cancer surgery.\nOver the past two to three decades,\nthere has been an increase in interest\nin the lymphatic system and lymphedema\nin the medical community.\nThere are now thousands of dedicated certified lymphedema\ntherapists, screening and education programs\nfor cancer-related lymphedema in cancer centers\nthroughout the US.\nThere's lots of up-to-date and evidence-based research\nin clinical diagnostic, genetics,\nand psychosocial issues published\nin peer-reviewed journals about lymphedema.\nThis webinar is designed to help you\nin understanding the function of the lymphatic system\nand how to reduce the risk of lymphedema\nfollowing your cancer surgery.\nSo what is lymphedema?\nLymphedema is swelling caused when your lymphatic system is\nblocked or damaged.\nIt can happen after you've had lymph nodes removed.\nFor those who want a little more information,\nit's actually an accumulation of protein-rich lymphatic fluid\nin the connective and supporting tissues within the body\nwhen there is damage to the lymphatic system.\nIt's mostly seen in arms and legs\nbut can also occur in the breast, head and neck, abdomen,\nand genitalia.\nIt can develop days, months, or years following your cancer\nsurgery and is a chronic lifelong condition.\nSome people may want to know why they should take this class.\nWell, most likely, you're here because your cancer surgeon\nor cancer specialist or primary care\nphysician has recommended it.\nIf you've been diagnosed with cancer\nand will be having surgery, or you have already had surgery,\nit is helpful to know about the lymphatic system\nand how to reduce your risk of developing lymphedema.\nThis class may help remind you of signs and symptoms\nof lymphedema.\nBecause like a lot of medical conditions,\nit's better if you can catch it early.\nIf you already have lymphedema, this class\nmay help you learn how to better manage it as well.\nWe wanted to give you an overview of lymphedema.\nAccording to the American Cancer Society,\nthere are nearly 17 million cancer survivors in the US.\n1.8 million new cancer patients are diagnosed each year\nin the US.\n975,000 or almost 1 million of these new cancer patients\nare at risk for lymphedema.\nAnd one in three of those, which is about 325,000 people,\nwill develop it.\nEducation and awareness with patients, their doctors,\nand their lymphedema specialist is an important factor\nin preventing lymphedema or preventing\nworsening of symptoms if it has already existed.\nSo we are happy to be here today to help educate and inform you.\nLymphedema can impact the quality of life.\nSome patients who develop it say that it can impact ability\nto perform everyday activities, which are\ncalled functional limitations.\nIt can also impact family relationships,\nincrease levels of depression and anxiety,\nand hurt people's self-esteem.\nIt can cause issues at work, sometimes called\nvocational issues.\nIt can also be a reminder to people\nof their cancer experience.\nLymphedema can be a financial issue as well.\nSince it also is a lifelong condition again,\nthe idea is to catch it as early as possible\nor to prevent it from getting worse.\nSo there are a couple of types of lymphedema.\nOne is called primary.\nAnd you can see this described here on the left.\nThis happens when people are born with a compromised\nlymphatic system.\nLymphedema can happen at birth in these cases,\noften in puberty or later in life.\nStudies show that there are genetic components\nof primary lymphedema, which means that some people may have\na gene passed down from their parents or grandparents\nthat may makes them more likely to get it.\nThe second type of lymphedema is in the second column here.\nAnd it's called secondary lymphedema.\nIn the United States, at least 90% of lymphedema is secondary,\nor it happens because of a known cause such as cancer surgery.\nThe lymph nodes are removed.\nIt can also happen by being indirectly triggered\nby infection or trauma.\nThe lymphatic system is a vital part of our immune system.\nIt helps protect and maintain our body fluid\nby filtering and draining lymph and waste products away\nfrom each body region and helps the body\nfight bacteria and viruses.\nIt produces cells of the immune system\nthat are vital in fighting bacteria and viruses.\nThe lymphatic system consist of lymph vessels, lymph nodes,\nand lymphoid organs such as your tonsils, the spleen,\nintestinal wall, and bone marrow.\nLymph fluid is collected through lymph capillaries.\nIt is then transported through lymph vessels to lymph nodes\nand empties in the thoracic duct, the largest lymph\nvessel in the chest, where it mixes back with the blood.\nEssentially, your lymph nodes act as a filtering station.\nYou can see from this picture that the lymphatic system\nis a network of tiny vessels and small, bean-shaped organs\ncalled lymph nodes.\nNodes are located in various areas of the body.\nBut some of the key lymph nodes following cancer surgery\nare in the armpit, which receive fluid from arm, chest, back,\nand breast, inguinal nodes, which are in the groin area,\nand we see fluid from the leg, lower abdomen,\ngluteal fold of the buttock and genitals.\nOther areas are in the neck along the windpipe\nnext to the lungs and in the abdomen or stomach area\nand in the pelvis.\nWe talked about the lymph system.\nBut now we are going to talk about actual lymph nodes.\nThe size of a lymph node is about two to 25 millimeter,\nwhich is about the size of a pea or a bean.\nWe have approximately 400 to 600 nodes in the body.\nAnd 50% are in the abdomen or stomach area.\nThere are also nodes in the neck region, in the bend of the hip,\nand in the armpit.\nTheir function is to act as a filtering station\nand help fight bacteria and toxins.\nThey produce white blood cells to fight infections and enhance\nthe body's immune system.\nAnd they help keep fluid volume in the body balanced.\nThey also recognize and respond to foreign cells,\nincluding cancer cells.\nTo explain more, I want to talk about the difference\nbetween the flow of lymph fluid and blood.\nLymph runs along the way parallel\nto the circulatory system and is a high protein fluid\nwhile our blood circulates or pumps through our body\nand is low in protein.\nYou can see from this picture on the left\nthat we produce 2.4 liters of lymph fluid a day,\nwhich is equal to about half a gallon of milk per day.\nThis in comparison to blood, we circulate about 5 liters\nof blood per minute, which is equal to about 1\nand 1/2 gallons of milk.\nSo now that we know more about what lymphedema is,\nlet's talk about why it occurs.\nIt happens when the lymphatic system is compromised.\nAnd the fluid exceeds the amount of fluid\nthe lymph system can transport.\nSo it happens when the lymphatic system can no longer\nmove normal lymph fluid.\nAn abnormal amount of protein-rich fluid\ncollects in the tissue, which makes it show visible swelling.\nLeft untreated, it becomes stagnant or stops moving.\nThis decreases oxygen in your tissue, impairs tissue healing,\nand increases risk of infection.\nHere are the stages of lymphedema.\nStage 0 is not visible.\nBut the ability for the lymph system to move fluid\nhas decreased.\nStage 1 is where there is pitting edema.\nThis means when it is pressed by fingertips,\nthe area indents and holds the indentation.\nUsually, in the morning, it looks normal.\nStage 2 is where it becomes irreversible.\nIt is characterized by spongy tissue\nthat when pressed by finger tips bounces back\nwithout any indentation.\nAnd there is visible swelling.\nIn stage 3, limb is characterized by swelling\nthat is irreversible.\nAnd the limb is very large.\nThere are some types of cancer that are more associated\nwith lymphedema than others.\nThese are cancers that sometimes require a lymph node removal\nand/or radiation.\nThey're breast cancer, gynecological, melanoma, colon\nand rectal, genital, urinary, and head and neck cancers.\nWhat are the risk factors for lymphedema?\nFor surgical treatment, some risk factors\nare removal of a tumor, lymph node removal, the length and/or\nlocation of the surgical incision,\nand if a seroma or pocket of fluid develops.\nRadiation therapy can cause scarring to the lymphatics\nand increase the risk of lymphedema.\nAnd the dose and location of radiation also has an impact.\nSo how often does lymphedema occur?\nMore than 50% of cancer patients are at risk for limb lymphedema\nwith 1 in 3 developing it.\nIt really is specific for each individual.\nIf you look at the chart here, you can see on the left\nthat if you have a cental lymph node removed,\nwhich is anywhere from one to three lymph nodes,\nyou have a lower risk for developing lymphedema.\nThe sentinel lymph node is the first lymph node\nto which cancer cells are mostly spread from the primary tumor.\nIn the chart on the right, you will\nsee that it says that if you have axillary lymph node\nremoval, which is 10 to 20 lymph nodes,\nthat your risk of developing lymphedema is higher.\nIn general, the more lymph nodes you have removed,\nthe higher your risk for lymphedema.\nI mentioned it on the previous slide,\nbut radiation can also cause scarring\nto lymphatics, which can increase\nthe risk for lymphedema.\nNow I'm very happy to introduce and turn over the presentation\nto my friend and colleague Corinna Lowe.\nCorinna?\nCORINNA LOWE: Thank you, Saskia.\nYou might be wondering when are you at risk of lymphedema\nand if there is a time when that risk goes away?\nYou're at risk of developing lymphedema immediately\nafter cancer surgery, weeks, months, and years\nafter cancer treatment.\nOnce someone is at risk of developing lymphedema,\nthey're always at risk.\nWe do know that if someone gets lymphedema,\nit usually happens in the first few years after treatment.\nPersonal risk factors for developing lymphedema\ninclude mobility or the lack of movement, obesity,\nand a body mass index of more than 30.\nBased on evidence, there are four things\nthat trigger lymphedema--\ninfection, injury, restriction like a shirt that is too tight,\nand extreme temperature such as a hot tub or sauna.\nThe lymphatic system is roughly divided\ninto quarters with each quarter having a drain.\nLymphedema can occur in a section\nwhere the cancer treatment occurred\nand where that drain was damaged.\nFor example, if a person had right breast cancer treatment,\nthey are at risk of developing lymphedema\nin their right breast, right arm, right armpit,\nright chest down to their belly button,\nand the right side of their back.\nIf a person had cancer treatment on their right leg,\nthey're at risk of developing lymphedema in their right foot\nand leg, right groin, right lower abdomen,\nright lower back, and genitals.\n\nLet's talk about how to reduce your risk of lymphedema.\nThe goal is to catch or detect lymphedema as soon as possible.\nThere are screening and early detection programs\nfor cancer-related lymphedema in cancer centers\nthroughout the United States.\nA certified lymphedema therapist can help with early detection.\nOne way to reduce your risk of lymphedema\nis to keep your skin healthy.\nKeeping your skin healthy reduces the risk of infection.\nAnd we know that infection can be a trigger for lymphedema.\nWhat does good skin care mean?\nIt means using lotion daily, use sunscreen,\nwear gloves to avoid skin injuries when gardening,\navoid cutting your cuticles, and wear\nwell-fitting, closed-toe shoes.\nTreat insect bites and cuts aggressively.\nYou should wash with soap and water.\nUse triple antibacterial ointment.\nFrequently, patients ask, can my affected arm\nbe used for blood pressure or a lab draw?\nBecause every patient's anatomy is different,\nyour surgeon is the only one who can\nanswer that question for you.\nConstriction is something that is\nso tight it could reduce or block\nthe normal flow of your lymph fluid.\nAnd it is a good idea to avoid doing that on your limb\nthat is at risk of lymphedema.\nYou should avoid wearing tight clothes or jewelry\non your at-risk limb.\nAnother example is a tight watch which\ncan reduce the normal flow of your lymph fluid.\nTalk to your doctor about any questions you have about this.\nExercise can reduce your risk of lymphedema.\nSimple movements help drain lymphatic fluid\nby moving the skin and the lymphatic vessels\nbelow the skin.\nExercise also uses your muscles like a pump\nto move lymphatic fluid.\nTo start exercising, talk to your doctor about an exercise\nprogram.\nStart slow.\nTake frequent breaks.\nProgress slowly.\nBe consistent.\nMovement should be pain-free.\nBody weight management is another way\nto decrease your risk of developing lymphedema.\nWeight loss decreases the demand on your lymphatic system.\nConsider working with a team to address your relationship\nwith food, your activity level, and the food you eat.\nConsult with a certified lymphedema\ntherapist to assess your need for a compression sleeve\nor stocking and its appropriate fit.\nCommon times compression garments\nare worn in the prevention stage is when exercising or flying.\nI am now going to pass the presentation back to Saskia.\nSaskia?\nSASKIA THIADENS: Let's talk for a minute\nabout preparing for surgery if you\nare to have an axillary or sentinel node dissection.\nIf your doctor or surgical team instructs you differently,\nfollow their advice.\nIn general, it is best to wear a front-opening camisole\nwith pockets for surgical drain and loose clothing.\nBring a travel pillow, and wear comfortable sneakers\nor closed shoes.\nAnd make sure to have a friend or relative drive you\nto and from your surgery.\nWhat if you're having a sentinel lymph node\ndissection in your groin area?\nWell, it's very similar.\nBut again, if your doctor or surgical team may instruct\nyou differently.\nIf this happens, follow their advice.\nWear loose clothing and underwear.\nAnd avoid tight elastic around your waist or panties.\nWear comfortable, well-fitted shoes or sneakers and socks\nwithout tight elastic band.\nAlso, bring two travel pillows.\nAnd again, make sure to have a friend\nor relative drive you to and from your surgery.\nFollowing your surgery, there are some specific breathing\nand exercises your doctor may advise\nyou to recover from surgery and to reduce\nthe risk of developing lymphedema.\nThese exercises can be done at home and/or\nwith a certified lymphedema therapist.\nMost important is to rest your body\nand allow your lymphatic system to heal.\nBe sure to follow whatever instructions your doctor\ngives you.\nWe just have a few more minutes left in this webinar.\nSo I would like to summarize the ways\nyou can reduce your risk of developing lymphedema.\nThe list is practice good skin care.\nAvoid constriction.\nTreat insect bites and cuts aggressively.\nGet daily exercises.\nManage body weight.\nAsk your doctor about getting a compression sleeve\nor stocking if needed.\nPrepare for your surgery.\nAnd follow the instructions that your doctor gives you\nafter surgery for specific movements you\nshould do to recover and prevent lymphedema.\nBe sure to call your doctor if you experience\na sensation of fullness and heaviness\nin the affected limb, your skin feeling\ntight, if there is a decreased motion or flexibility\nin the arm or leg, difficulty fitting clothing on the arm\nor leg, ring, watch, or bracelet tightness,\nand swelling in the arm or leg.\nInfection and inflammation can be\na trigger for early lymphedema.\nAnd patients should follow the signs of infection closely.\nCall your doctor if your skin is warm to the touch,\nred or discolored, or is tender and painful.\nIf you have a fever or have an increase in swelling,\nyou should also call your doctor.\nAfter you or your doctor have determined you have lymphedema,\nand you need treatment, ask for a referral\nto a certified lymphedema therapist.\nYour doctor should be able to refer you\nto a lymphedema therapist who is certified by the Lymphology\nAssociation of North America.\nYou can see their website address on this slide.\nIn behalf of Corinna and myself, I\nwould like to thank you for listening and watching\nthis webinar.\nThe slide that follows this one has\na list of resources for you.\nAs always, for questions about your specific medical care\nor lymphedema, contact your surgeon,\nyour medical oncologist, or your primary care provider.\nWe wish you all good health, and thank you very much.\nIf you are interested in getting more information\nabout lymphedema, you can go to any of these trusted sources.\nWe have listed the National Lymphedema Network,\nthe Lymphatic Education & Research\nNetwork, and the Lighthouse Lymphedema Network.\nThe next link is to a site that described the Lymphedema\nTreatment Act, which is a federal bill that\nwas passed 2019.\nIt is meant to improve insurance coverage for the medically\nnecessary and doctor-prescribed compression supplies\nthat are the cornerstone of lymphedema treatment.\nLast but not least, we have a link to a lymphedema blog.\nThank you again."} ```