Breast cancer treatment
Breast cancer treatment
Diagnosis
Includes tests and procedures used to diagnose breast cancer include the following:
* Breast examination.
Your attending physician will examine both breasts and the lymph nodes below the armpit, and be sensitive to any lumps or other abnormalities.
• Mammography.
Mammography is an X-ray of the breast. Mammography is often used to screen for breast cancer. If abnormalities are detected in your mammogram, your attending physician may recommend a diagnostic mammogram for further evaluation of abnormalities.
* Ultrasound on the breast.
Ultrasound uses sound waves to produce images of structures located deep inside the body. Ultrasound can be used to determine whether a new breast bulge is a solid lump or a fluid-filled cyst.
* Extract a sample of breast cells for testing (biopsy).
Biopsy is the only definitive method of diagnosing breast cancer. During a biopsy, your doctor uses a special needle-guided X-ray device or other imaging test to extract a group of tissue from the suspected area. Often, a small metal mark is left at the site inside your chest so that the area can be easily identified in future imaging tests.
Biopsy samples are sent to the lab for analysis where experts determine whether the cells are cancerous. The biopsy sample is also analyzed to determine the type of cells in breast cancer, how serious (degree) the cancer is, and whether the cancer cells contain hormone receptors or other receptors that can influence your treatment options.
* Magnetic resonance mammography (MRI).
The MRI device uses magnetic and radio waves to create images from the inside of the breast. You are given a dye injection before an MRI mammogram. Unlike other types of imaging tests, MRI does not use radiation to create images.
Other tests and procedures can be used according to your condition.
Classification of breast cancer stages
Once the doctor diagnoses breast cancer, it determines the stage and size of the cancer. Knowing the stage of cancer helps to predict the course of the disease and determine the best treatment options.
Complete information about the stage of cancer may not be available until after breast cancer surgery.
Tests and procedures used to determine the stage of breast cancer may include:
* Blood tests, such as a comprehensive blood count
* Other mammograms for signs of cancer
* Magnetic resonance mammography
• Bone scan
• Computerized tomography (CT)
• Positron emission tomography (PET)
Not all women will need all these tests and procedures. The doctor selects the appropriate tests based on your particular health condition taking into account possible new symptoms.
The stages of breast cancer range from 0 to 4, with the number 0 referring to cancer that is limited to the milk ducts or is not metastatic. Stage 4 breast cancer, also called metastatic or metastatic breast cancer, refers to the spread of cancer to other areas of the body.
When classifying the stage of breast cancer, doctors also take into account the degree of cancer, the presence of tumor markers such as estrogen receptors, progesterone and HER2 protein, and proliferation factors.
Treatment
Your doctor determines breast cancer treatment options according to the type of breast cancer you have, its stage, degree and size, and whether cancer cells are sensitive to hormones. The doctor also takes into account your overall health and personal preferences.
Most women undergo breast cancer surgery, and many also receive additional treatments after surgery, such as chemotherapy, hormone therapy or radiotherapy. Preoperative chemotherapy can also be used in specific cases.
Breast cancer has many treatment options, and you may be confused by the difficulty of making complex decisions about your treatment. Consideration should be given to seeking a second opinion from a breast oncologist at a breast cancer centre or clinic. Talk to another lady faced a similar decision.
Breast cancer surgery
Include the procedures used to treat breast cancer:
* Removal of breast cancer (lumpectomy).
During a lumpectomy, which may be referred to as conservative breast surgery or extensive local resection, the surgeon removes the tumor and a small portion of the healthy tissue surrounding the tumor.
Lumpectomy surgery may be recommended to remove small tumors. Some people with larger tumors may undergo chemotherapy before surgery to reduce the size of the tumor, and achieve complete removal by performing a lumpectomy.
• Removal of the entire breast (mastectomy).
Mastectomy surgery is an operation to remove the entire breast tissue. Most mastectomy procedures remove all breast tissue, namely lobules, ducts, adipose tissue, and some skin, including the nipple and areola (a simple or total mastectomy procedure).
May be surgical techniques and newer options in specific cases to improve the appearance of the breast. Mastectomies with retention of the skin and nipple are increasingly common operations for breast cancer.
• The removal of a limited number of lymph nodes (node biopsy Sentinel).
The surgeon will discuss with you the role of removed lymph nodes, which receive the first lymphatic drainage of the tumor, to determine whether the cancer has spread to the lymph nodes or not.
If no cancer is found in those lymph nodes, the probability of finding cancer in any of the remaining lymph nodes is low and the other nodes do not need to be removed.
* Removal of many lymph nodes (ablation of axillary lymph nodes).
Your surgeon will discuss with you the role of removing more lymph nodes in the armpit if cancer is found in the sentinel lymph nodes.
• Resection of both breasts.
Some women with breast cancer in one breast may choose to have the other (proper) mastectomy (preventive mastectomy of the other side) if they have a high risk of cancer in the other breast due to a genetic or strong family history.
Most women never get breast cancer in one breast if they have cancer in the other breast. Discuss with your doctor the risk of breast cancer, as well as the benefits and risks of this procedure.
Recognize the complications of breast cancer surgery procedures that you choose. Breast cancer surgery carries risks of pain, bleeding, infection and swelling of the arm (lymphedema).
You may choose breast reconstruction after surgery. Discuss with your surgeon your options and your preferences.
Think about consulting with a plastic surgeon before breast cancer surgery. Options for you may include breast reconstruction (with silicone or water) or reconstruction using tissue from your body. These procedures can be performed during mastectomy or later.
Radiotherapy.
Used during radiation therapy pack high energy, such as X-rays and protons, to kill cancer cells. Radiation therapy is usually performed using a large machine that directs beams of energy into the body (external radiation beams). But radiation therapy can also be performed by introducing radioactive substances into the body (internal radiotherapy).
It is common to use external radiotherapy of the entire breast after resection of a lump from it. Internal breast radiotherapy may be an option after mastectomy if you have a low risk of cancer recurrence.
Doctors may also recommend radiotherapy to the chest wall after mastectomies in case of large breast cancers or cancers that have reached the lymph nodes.
Can radiation therapy for breast cancer from three days to six weeks, as required by the treatment plan. An oncologist determines which treatment is best based on the condition, type of cancer and location of the tumor.
Side effects of radiation therapy include fatigue and the appearance of a red sunburn-like rash in the place of radiation. Breast tissue may also appear swollen or hard to the touch. In rare cases, more serious problems may occur, such as damage to the heart or lungs, and in very rare cases, new cancers may occur in the treated area.
Chemotherapy
During chemotherapy drugs are used to destroy the cells grow rapidly, such as cancer cells. If you are at high risk of cancer returning or spreading to other parts of your body, your doctor may recommend chemotherapy after surgery to reduce the likelihood of cancer returning.
Chemotherapy is sometimes given before surgery to women with large breast tumors. The goal is to reduce the size of the tumor to a size that is easier to remove with surgery.
Chemotherapy is also used for women whose cancer has already spread to other parts of the body. Your doctor may recommend chemotherapy to try to control the cancer and reduce the symptoms that it causes.
The side effects of chemotherapy depend on the type of drugs it contains.
Common side effects include hair loss, nausea, vomiting, fatigue and increased risk of infection. Rare side effects can include: early menopause, infertility (before menopause), heart and kidney damage, nerve damage, and blood cell cancer in very rare cases.
Hormone therapy
Hormone therapy — perhaps more appropriately called hormone blocking therapy — is often used to treat hormone-sensitive breast cancers. Doctors refer to these cancers as cancers of the estrogen receptor (ER) positive type and progesterone receptor (PR) positive type.
Hormone therapy or other treatments can be started before or after surgery, reducing the chances of cancer returning. If the cancer has already spread, hormone therapy may reduce its spread and help control it.
Treatment methods used in hormone therapy include:
* Drugs that block the connection of hormones to cancer cells (selective estrogen receptor modulators)
* Drugs that stop the body manufacturing estrogen after menopause (aromatase inhibitors)
• Undergo surgery or take medication to stop the production of hormones in the ovaries
The side effects of hormone therapy vary according to the specific treatment of your condition, but can include heat flashes, night sweats and vaginal dryness. Serious side effects include the risk of bone weakness and blood clots.
Treatment with targeted agents
Immunotherapy
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