Understanding Breast Cancer – Treatments Breast cancer can be treated: In our last blog, we understood about breast cancer, its risk factors and how methods of early detection can help in lowering the risk involved and assist in a successful treatment for the cure. Certainly, there are several treatment options for women diagnosed with breast cancer that include surgery, chemotherapy, radiation therapy, hormonal therapy and targeted therapies. But only after consideration of the optimal treatment available for the stage and biological characteristics of the cancer, the patient’s age and preferences, and the risks and benefits associated with each treatment protocol, the treatment decisions are made by the physician. To be more precise, the most appropriate treatment depends on the woman’s risk profile and stage of disease, which can range from I-IV and is based on the tumor size, location, and involvement of lymph nodes and whether or not tumor has spread to surrounding tissue or distant organs. Most women with breast cancer will have some type of surgery. Surgery is often combined with other treatments mentioned above. The treatment options for breast cancer are as follows: Surgery:The primary goals of breast cancer surgery are to remove the cancer from the breast and to assess the stage of disease. There are three methods to do that. First is lumpectomy where cancerous tissue plus a rim of normal tissue is removed, also known as breast-conserving surgery. The second is mastectomy where all the breast tissues are removed, although muscles underneath breast are no longer removed. The third option includes lymph node removal (or axillary lymph node dissection) which takes place during time of lumpectomy or mastectomy if biopsy shows that breast cancer has spread. Other options include preventive surgeries such as prophylactic mastectomy for women at highrisk and prophylactic ovary removal to lower estrogen production in the body. Radiation therapy:Radiation is given after surgery to destroy cancer cells remaining in the breast, chest wall, or underarm area after breast-conserving surgery. Radiation may also be
needed after mastectomy in patients with either a cancer that is larger than 5 cm in size or when cancer is found in the lymph nodes. There are two types of radiation therapy. It includes external beam and internal (implantation of radioactive seeds) radiation therapy. While the former is a well-tested, long-standing treatment option, the latter has recently being developed and is still being studied for its efficacy. External beam radiation is the usual type of radiation for women with breast cancer. Radiation is focused from a machine outside the body on the area affected by cancer. Internal radiation therapy, known as brachytherapy, uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. Some patients are treated with both internal and external radiation therapies in combination. Chemotherapy:It is a systemic therapy that can be administered either before surgery, to shrink the tumor or afterwards, to reduce the risk of recurrence. For early-stage disease, it is usually administered to help remove cancer cells from the body and to reduce the risk of recurrence. For advanced-stage disease, it is given to destroy as many cancer cells as possible. The benefit of chemotherapy is dependent on multiple factors, including the size of the cancer, the number of lymph nodes involved, the presence of estrogen or progesterone receptors, and the amount of HER2/neu protein made by the cancer cells. Chemotherapy is most effective when the full dose and cycle of drugs is completed in a timely manner. Hormonal therapy:It is a treatment option for hormone receptor-positive cancers. It can be given for early-stage disease to either reduce the amount of estrogen or block its action to reduce the risk of recurrence. It can also be given for advanced-stage or metastatic disease to shrink or slow the growth of existing tumors. Hormone therapy includes aromatase inhibitors(AIs), selective estrogen receptor modulators and estrogen receptor down regulators as well as surgical treatments such as removal of ovaries and fallopian tubes. Targeted therapy:It targets cancer cell properties specifically as opposed to chemotherapy which also destroys normal, healthy cells. It includes treatments such as herceptin and tykerb, both block cancer cell growth in HER2-positive breast cancers, and avastin, which blocks growth of new blood vessels depending for cancer cell growth.
There are several treatments for curing breast cancer but it is always advisable to stay well by taking steps to reduce the risk of breast cancer or detect it early.