Treating Breast cancer
Fighting breast Cancer
Breast cancer Awareness
What Are The Best Breast Cancer Treatments?
Breast cancer treatment
The goal of treating early and locally-advanced breast cancers (stages I, II and III) is to get rid of the cancer and keep it from coming back.
Treatment includes some combination of:
These treatments are designed to remove the cancer from the breast and destroy any cancer that might still be in the body.
Treatment Options
Your breast cancer treatment plan
Your breast cancer treatment plan is based on both medical and personal choices.
Together, you and your health care provider make breast cancer treatment decisions. After you get a recommended treatment plan from your provider, take time to study your treatment options and make thoughtful, informed decisions. Each treatment option has risks and benefits to consider along with your own values and lifestyle.
Your treatment is tailored to:
- Your specific breast cancer (the biology of the tumor)
- The stage of the breast cancer
- Your overall health, age and other medical issues
- Your personal preferences
Because of the differences between tumors and between people, your treatment plan may differ from another’s, even though you both have breast cancer.
Breast cancer treatment can be divided into local and systemic therapy.
The Importance Of Treatments
The importance of following your breast cancer treatment plan
Completing your breast cancer treatment plan (called adherence or compliance) is very important. People who complete the full course of treatment have a higher chance of survival.
Sometimes completing your treatment plan may be hard, but there are things you can do to make it easier.
First, tell your health care provider right away if you have any side effects. Your provider may be able to help. Having fewer side effects can help you complete your treatment plan.
Sticking to your treatment plan can be very hard for long-term treatments, such as hormone therapy.
Planning ahead can help you juggle your treatment and daily life. For example, if you have trouble remembering to take your medicine, a daily pillbox or setting an alarm on your watch or mobile device (you may be able to download an app) may help [1].
ALWAYS REMEMBER: Early Detection is Critical For Survival
Types Of Therapy
Local therapy
Local therapy removes the cancer from a limited (local) area, such as the breast, chest wall or lymph nodes in the underarm area.
It also helps ensure the cancer doesn’t come back in that area.
Local therapy involves surgery, with or without radiation therapy to the breast area.
Systemic therapy (adjuvant therapy)
The goal of systemic therapy is to get rid of cancer cells that may have spread from the breast to other parts of the body. These cells are too small to see on scans or to measure with lab tests.
Systemic therapy uses drug therapies that travel throughout the body to get rid of cancer cells. It includes chemotherapy, hormone therapy and targeted therapy.
Some drug therapies are given by vein (through an IV) and others are given in pill form.
Because systemic therapy is used in addition to (an adjunct to) breast surgery, these treatments are often called adjuvant therapy.
Learn about factors that affect treatment options.
Standard Treatment are methods experts have
approved, accepted and are widely used
Local Therapy
Surgery
What Are The Goals Of Breast Cancer Surgery?
The first step and most common form of treatment for breast cancer is surgery. Surgery involves removing the tumor and nearby margins. The margin is the surrounding tissue that might be cancerous. The goal of surgery is to remove not only the tumor, but also enough of the margin to be able to test for the spread of the cancer. Once the removed tissue is checked, your post-operative report should tell you if you had “clear margins,” (meaning the tissue farthest away from the breast was free of any cancer cells.)
Some people with Stage 2 or Stage 3 cancer may receive chemotherapy first, which is known as “pre-operative “ or “neoadjuvant*” chemotherapy. The goal is to shrink the tumor. By making it smaller first, you may have the option of a breast-conserving surgery or lumpectomy instead of a mastectomy.
*The term adjuvant means “helper” or “enhancer.” Neo means “new” or “at the onset.” So a neoadjuvant therapy is a helper therapy delivered at the beginning of treatment.
How Will I Know What Kind Of Surgery Is Right For Me?
Either your doctor or a breast surgical oncologist (a breast surgeon specializing in breast cancer surgeries) will advise you regarding the surgery options to consider based on specific information about your breast cancer. You can discuss and compare the benefits and risks of each option and describe how well each possible choice can achieve the goal of ridding your body of the primary breast cancer.
Lumpectomy
What Is A Lumpectomy?
A lumpectomy usually removes the least amount of breast tissue. The surgeon removes the cancer and a small portion or margin of the surrounding tissue, but not the breast itself. Even though the lumpectomy is the least invasive breast cancer surgery, it can still be very effective, and further surgery may not be needed.
What happens when more tissue needs to be taken?
A partial mastectomy requires the surgeon to remove a larger portion of the breast than in the lumpectomy — perhaps a whole segment or quadrant of tissue — in order to eliminate the cancer. Occasionally, the surgeon will remove some of the lining over the chest muscles as well.
Mastectomy
What Is A Mastectomy?
In the past, breast cancer surgery often required removing the entire breast, chest wall, and all axillary lymph nodes in a procedure called a radical mastectomy. While radical mastectomies are less common today, there are instances in which this surgery is the best option to treat the cancer.
If the cancer is detected early enough, there are usually options that will remove the cancer while preserving breast tissue. The common options are a lumpectomy (most often followed by breast radiation treatments) and a partial mastectomy.
omy usually removes the least amount of breast tissue. The surgeon removes the cancer and a small portion or margin of the surrounding tissue, but not the breast itself. Even though the lumpectomy is the least invasive breast cancer surgery, it can still be very effective, and further surgery may not be needed.
What happens when more tissue needs to be taken?
A partial mastectomy requires the surgeon to remove a larger portion of the breast than in the lumpectomy — perhaps a whole segment or quadrant of tissue — in order to eliminate the cancer. Occasionally, the surgeon will remove some of the lining over the chest muscles as well.
While radical mastectomies are less common today, there are instances in which this surgery is the best option to treat the cancer.
Lymph Node Removal
In addition to your surgical procedure, such as a lumpectomy or mastectomy, your doctor may wish to remove and examine lymph nodes to determine whether the cancer has spread and to what extent. Your doctor will use one of two procedures for this, either a sentinel lymph node biopsy/removal or an axillary node dissection. We’ll define these terms below.
How Does The Lymph System Relate To Breast Cancer?
Although breast cancer is not easily controlled, the spread of breast cancer is sometimes predictable. The cancer cells spread through a customary path, out from the tumor and into the surrounding lymph nodes, before they progress throughout the body.
What is the sentinel node?
The sentinel lymph node (and in some cases there are several grouped together) is the first node “downstream” from the cancer in the lymph circulatory system. If the cancer were to travel away from the breast tumorand into the lymphatic system, this node would be the first one to show evidence of breast cancer.
Sentinel Node Biopsy
What Is A Sentinel Node Biopsy?
A sentinel lymph node biopsy is a procedure to examine the lymph node closest to the tumor because this is where the cancer cells have most likely spread. First, the surgeon will want to identify the “sentinel lymph node,” the lymph node (or nodes) closest to the tumor. To be able to identify the sentinel lymph node, the surgeon will inject dye or radioactive substances into the tissue near the tumor. The lymph nodes that are the most susceptible to the cancer’s spread will be marked by the dye or radioactive substance. During surgery, the nearest lymph nodes will be removed and checked for the presence of cancer cells.
A biopsy is nearly always taken from the sentinel node, and the breast surgeon typically removes the sentinel node as well for dissection.
What Is An Axillary Node Dissection?
This procedure is a method for determining if the cancer has spread to more than one of your lymph nodes. Axillary node dissection removes some of the the axillary lymph nodes, which are the lymph nodes located in the underarm. Once removed, they are dissected and examined.
Do The Lymph Nodes Always Need To Be Removed?
Not always, especially when there is no evidence of any cancer in the lymph system. A mastectomy or lumpectomy operation will most often include either a sentinel node biopsy or an axillary node dissection. Both procedures involve a separate incision for lumpectomy patients. Following surgery, the pathologist will test the lymph nodes to determine whether the cancer has spread past the breast. When some evidence of cancer is found in the lymph system, recents standards are as follows:
For patients who are having a lumpectomy and the sentinel node is positive for cancer:
Effective in mid 2012, the standard of care was changed to no longer require women with early stage breast cancers to have a full dissection and removal of the lymph nodes under the arm. Instead radiation to the underarm can be planned.
For patients who are having a mastectomy surgery and have a positive sentinel node:
For these women, the standard of care remains the same, calling for the node removal and dissection of the axillary (or underarm) nodes. The additional nodes removed at the time of the breast cancer surgery will be examined by the pathologist in the following days to determine if others beyond the sentinel node contained cancer or not. If cancer cells are found in those lymph nodes, other cancer treatments will be considered.
The risk of developing lymphedema
continues for the rest of your life.
Lymphedema
What Is Lymphedema?
Lymphedema is a chronic condition that is caused by a disruption or damage to the normal drainage pattern in the lymph nodes. It most often causes swelling of the arm, but it can also affect the breast, chest, and sometimes even the legs. The swelling, caused by an abnormal collection of too much fluid, is called lymphedema. Removing the axillary lymph nodes increases your risk for developing lymphedema.
The risk of developing lymphedema continues for the rest of your life, so it is imperative that you are aware of these risks. Often it is best to learn about preventative measures for lymphedema before surgery so you will know the signs and symptoms to look for and can discuss treatment options with your physician.
After lymph node surgery, if you experience unusual and painful swelling, you should immediately notify your doctor to monitor it. There is no cure for lymphedema, but your doctor can take steps to reduce swelling and maintain that reduction. With proper health care, good nutrition, and exercise, it may be possible for you to reduce the effects of lymphedema.
Palliative care is a very important part of your treatment.
Treatment Management
Managing side effects (palliative care) and supportive care
Managing side effects and supportive care are important parts of breast cancer treatment.
- Palliative care aims to prevent or relieve side effects (such as pain or nausea).
- Supportive care includes palliative care as well as care of your emotional, social, spiritual and practical needs.
How age affects your treatment plan
No matter your age, your treatment plan depends on many factors, such as tumor stage, tumor grade, hormone receptor status and HER2 status.
Your overall health and other health conditions also play a role.
For example, if you have heart disease, some medications used to treat breast cancer can do more harm than good.
All of these things, as well as your age, are considered when planning your treatment.
Young women
Young women with breast cancer may have special concerns about early menopause and loss of fertility due to treatment.
Learn about these issues for young women with breast cancer.
Your health care team
Throughout your treatment and beyond, you will get care from many health care providers.
Your health care team may include:
- Physicians involved in cancer treatment (oncologists, surgeons, radiation oncologists)
- Physicians involved in other care for people with breast cancer (radiologists, pathologists, genetic counselors and others)
- Nurses
- Dietitians
- Social workers
- Physical therapists
- Palliative care or pain specialists
- Patient navigators
- Pharmacists
- Other providers
These professionals may be involved in your care during diagnosis, treatment and recovery.
The Process
Staying organized |
It may be helpful to use a notebook, 3-ring binder or other organizer to keep track of your breast cancer treatments and health care team. You may want to include:
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The costs related to breast cancer treatment
can quickly become a financial burden.
Financial & Insurance
Insurance issues and financial assistance
Insurance issues (such as what to do if a claim is denied) can be a major concern while you are being treated for breast cancer.
Paying for medications and other out-of-pocket expenses can also be a burden.
Learn about insurance and financial assistance programs.
Transportation, lodging, child care and elder care assistance
If you need help getting to and from treatments or if you (or your family) need a place to stay overnight while getting treatment, there are programs that can help.
There are also programs to help with the cost of child care and elder care while you are undergoing treatment.
Financial Impact Of Breast Cancer
Patient Experiences
Remember: Most hospitals offer Financial Advisors
to help you deal with the treatments finances
What Can be Done To Lower the Costs
Dr. Jay K. Harness
Articles Sources
Cancer research UK – Treatments
breastcancer.org – Treatment and Side effects
Cancer.net – Breast Cancer Types Of Treatments
Breast Cancer Care – Going through Breast Cancer Treatment
Maurer Foundation for Breast Health Education – Search: Treatments
American Cancer Society –Treating Breast Cancer
innovation.org – Treatment Approaches
National Health Services UK – Breast Cancer Treatments
Susan G. Komen – Breast Cancer Treatment: Introduction