When it comes to breast cancer care, there are many doctors that specialize in three areas of treatment including surgery, medical and radiation oncology. All these areas and experts work together in a multidisciplinary team in order to provide patients with the best treatment of breast cancer possible. Aside from cancer experts, these teams also include a number of other professionals such as nurses, assistants, social workers, counselors, nutritionists, and others.
Table of Contents
- Breast Cancer Treatment
- Surgical Options
- Other Breast Cancer Treatment Options
- Breast Cancer Care
Breast Cancer Treatment
The main factor for the treatment of breast cancer is the behavior and biology of breast cancer. Some tumors are large and spread slowly while some are small but grow really fast. Therefore, every breast cancer care is personalized to an individual and their needs. There are several key factors to be considered:
- Stage of the tumor
- Type and subtype of the tumor
- Hormone receptors status
- Genomic markers
- Age of the patient
- General health of the patient
- Patient’s choice and preferences
- Patient’s menopausal condition and status
- Inherited breast cancer genes
When it comes to breast cancer in an early-stage, experts generally recommend a surgery that will remove the tumor. This surgery will also include some tissue removal in order to make sure that the tumor is removed to its entirety. The tissue being removed is usually located in the cancer’s surroundings and is often not infected. The main goal of the surgery is to remove visible cancer, but it is a known fact that the microscopic cells can still remain in the body, in the location of the removed tumor or elsewhere. There are situations where this can be solved with the following treatment options, but in some situations, another surgery is needed.
If breast cancer is discovered later and the cancer is already large in size, neoadjuvant therapy is recommended. This includes systemic treatment such as hormonal therapy and chemotherapy, to be later followed by surgery.
When it comes to having some smaller treatments prior to surgery, this may result in several benefits:
- The patient may avoid having a mastectomy and have breast-conserving surgery instead, due to the tumor-shrinking because of the pre-surgery treatments
- The procedure may be easier to perform
- Trying out some of the commonly used treatments can help medical personnel find the best treatment for breast cancer of the individual
- Clinical trials offer many new treatment options
Surgery can be defined as the process of removing the tumor and the surrounding tissue. Additionally, surgery is used to examine the underarms and axillary lymph nodes.
In general, there are more surgical options for people with a smaller breast tumor. The types of surgeries that can be performed are:
This procedure consists of tumor removal and some cancer-free margin of healthy surrounding tissue removal. In the process of lumpectomy, most of the breast remains and just a small part is removed. In most cases, especially those of invasive cancer, radiation therapy is recommended after surgery. This is done in order to make sure the remaining breast tissue is not infected.
Another treatment for breast cancer is the surgical removal of the breast in its entirety. There are several types of this kind of surgery and the proper one is determined by a doctor. It is an individual treatment decision to be made since a doctor may decide to preserve the skin (skin-sparing mastectomy) or the nipple (total skin-sparing mastectomy.
3. Lymph node removal
Cancer cells can also be found in the lymph nodes in some cases. The important thing to do here in order to treat breast cancer is to determine whether the axillary lymph nodes near the infected breast contain cancer.
This biopsy procedure includes the removal of one or a few lymph nodes. This procedure is performed to lower the risk of several side effects such as arm swelling, numbness, and arm movement problems. The biggest issue here is that these problems are actually long-lasting and can severe the whole life of the patient. When it comes to sentinel lymph node biopsy, the surgeon removes up to three lymph nodes that receive drainage from the breast. Then, an examination of these nodes follows, performed by pathologists in order to find cancer cells. If the sentinel lymph node is cancer-free there is a big chance that all remaining nodes will also be cancer-free. If this lymph actually shows signs of cancer, the surgeon may decide to perform a dissection that will remove more lymph nodes, depending on the cancer stage.
When it comes to axillary lymph node dissection, many lymph nodes are removed from under the arm, later examined by a pathologist for cancer cells. The number of nodes being removed can vary depending on the individual. This type of treatment for breast cancer is preferred in cases where there is obvious evidence of lymph nodes cancer before any surgery is performed. However, any surgeon may decide to perform a sentinel lymph node biopsy for patients that need a mastectomy.
4. Plastic or reconstructive surgery
Women who have been through mastectomy often consider having breast reconstruction or so-called plastic surgery. This is a surgical procedure where a surgeon creates a breast from tissue removed from another part of the body of the patient or simply by using synthetic implants. The surgeon that performs these types of surgeries is called a plastic surgeon.
There is a choice of having a reconstructive surgery at the same time as the mastectomy in order to avoid having continuous surgical procedures performed on the body. This procedure is called immediate reconstruction. Also, this type of reconstructive surgery can be performed after a lumpectomy in order to improve the overall appearance of the breast after the surgery. This is also called oncoplastic surgery and can also be performed by the majority of breast surgeons.
There is also an external breast form that some women use as an alternative to reconstructive surgery. These prostheses are made of soft material and fit into a mastectomy bra. The purpose of these breasts is to provide the patient with a natural appearance.
When it comes to breast cancer care, women are encouraged to discuss the adequate surgical option with a doctor. A surgery that is more aggressive in nature may often cause complications, so one may choose to have a combination of other less invasive treatments instead. Of course, this depends both on the condition of the cancer and the opinion of the doctor.
In cases of an extremely high risk of reoccurring cancer or developing a new one in the other breast, a bilateral mastectomy is recommended. This means that both breasts of the patient are removed.
Other Breast Cancer Treatment Options
The standard radiation therapy that is recommended, after a lumpectomy, is external-beam radiation therapy. This therapy is usually given Monday through Friday for a duration of 5 or 6 weeks and often includes whole breast radiation followed by one focused on the exact spot where the tumor was located. The second part of this treatment of breast cancer is also called a boost and is usually introduced to women suffering from invasive breast cancer. The reason for this is to reduce the recurrence risk in the breast.
In cases where cancer is located in the lymph nodes under the patient’s arm, this type of therapy may also be recommended and given to the same side of the neck or underarm. Radiation may also be recommended to a patient that went through a mastectomy.
Partial irradiation of breasts
This type of radiation therapy is performed directly to the tumor area, most often after the surgical procedure of lumpectomy. Targeting a particular breast area instead of the entire breast usually shortens the radiation therapy duration.
Intensity-modulated irradiation of breasts
This is the more commonly used type of radiation therapy and is considered to be a more advanced way to irradiate the breast. The intensity can vary and is decided upon in order to better target the breast cancer, by spreading the radiation evenly throughout the entire breast. Some of the side effects are peeling and burns, which can be more commonly found in women with medium to large breasts.
2. Systemic therapy
Systemic therapy is normally taken through a vein or by mouth. This is a way of targeting the entire body by getting something into the bloodstream to be further distributed throughout the entire body. Generally speaking, there are three main categories of this type of therapy:
Chemotherapy includes the use of drugs being inserted into the body in order to destroy the remaining or existing cancer cells. This is actually a process where the cells are stopped from dividing and growing. This is something that should be determined and described by an oncologist.
There are two most common ways of giving chemotherapy: intravenous tube and a pill. However, not every person who had been diagnosed to have cancer needs chemotherapy. The doctor should decide on the best treatment possible for the condition of the tumor of the individual. When deciding whether one should use this treatment for breast cancer, one must look into the type, stage of breast cancer, the likeliness of chemotherapy working well and the overall goals of treatment.
Chemotherapy may be given both prior and after surgery. Additionally, it can be recommended in cases of breast cancer recurrence.
This type is also referred to as endocrine therapy and is recommended for tumors that test positive for estrogen or progesterone receptors, metastatic breast cancer cases, and early-stage tumors. The blockage of the hormones can help prevent the cancer from recurring. Additionally, hormonal therapy can help shrink metastatic breast cancer and improve the symptoms of cancer.
Women who have gone through the process of menopause are often prescribed this type of therapy. They are given the option to start therapy with an AI for 5 years or switch from tamoxifen to AI after 2 to 3 years.
Targeted therapy targets the specific genes of cancer, the proteins and tissue environment that actually contribute to the survival of existing cancer. These are very focused, carefully performed treatments and are known to block the growth and prevent cancer cells from spreading.
Not all tumors have the exact same targets and doctors have to go through extensive research and perform many tests in order to identify both proteins and genes in a tumor.
Breast Cancer Care
Both cancer and its treatments can cause unwanted symptoms and even side effects. A highly important part of breast cancer care is to relieve these side effects and symptoms; something called a supportive care approach. Any person, regardless of the type of cancer, treatment type or age needs this process and people often receive both cancer treatment and care at the same time.
This treatment often includes medication, relaxation, emotional support, nutritional support, and other methods. Additionally, one may consider complementary and alternative methods for breast cancer care, such as vitamins, special diets, acupuncture, herbs, and massages.
When it comes to breast cancer, there is no specific breast cancer cure. The difficulty with this disease is determining the right treatment and proper care in order to fight it, so do not be afraid to ask for a second or third opinion. When suffering from breast cancer and in need of treatment of breast cancer, make sure to discuss every step of the way with a proper, professional cancer care team. If they gather their knowledge and focus it on your condition, they can help you learn and choose the right method for improving your health. The important thing is to stay both emotionally and physically stable trough the whole period and this is why breast cancer care is always recommended as equally important to cancer treatment. Make sure you are provided both when fighting this disease. The right expertise combined with your willingness to live can lead to a successfully performed treatment of cancer and you may be able to live your life as a healthy, worry-free person.