What is the treatment for breast cancer?

Treatment of breast cancer is highly complex, and is predominantly dependent on how early the cancer is diagnosed, and at what stage it is detected.

Different combinations of treatment involving the following may be performed:

1. Surgery
2. Hormone therapy
3. Chemotherapy
4. Radiotherapy
5. Biological therapy

These methods of treatment may be applied as a combination or individually.

Determining if a single type of treatment or a combination is necessary depends on how the cancer is detected and its stage. If the cancer is discovered during routine examinations, and the stage is not determined, then the treatment is different.

In order to decide how the cancer should be treated, a physician considers the following factors:

1. The stage of development of the cancer
2. The current condition of the patient’s health
3. Whether or not the patient is menopausal

It could occur that the breast cancer that has developed is a secondary cancer (a metastasis from a primary cancer in another part of the body). This happens in a small proportion of patients that may have other metastases in the body. In this case, treatment is entirely different. Depending on different protocols, chemotherapy may be conducted before surgery, or only chemotherapy may be conducted if the cancer is inoperable.

Surgery

Surgery is usually the first step of treatment before the onset of chemotherapy and hormone therapy.

Surgery consists in:

1. Removing the cancer mass, and this is called partial mastectomy.
2. Total removal of the breast. This is called total radical mastectomy. If during previous examinations infected axillary nodes have been detected they are emptied out during surgery.

While deciding which method should be used, whether only the cancerous mass is going to be removed, or the entire breast, the surgeon considers the following:

1. The type of cancer present
2. The size of the tumor and where it is placed
3. The size of your breast

The surgeon removes the tumor thoroughly, attempting to leave behind only the healthy tissue. Eliminating the presence of cancer cells around the cancer node, reduces the chance that the cancer may return. If the cancer mass is very large and is occupying a significant part of the breast, and if cancer cells have been discovered in axillary lymph nodes during routine examinations, a total mastectomy is usually performed.

Following such a radical procedure, the patient may undergo plastic surgery and insert prosthetics in order to remodel the breasts.

Radiotherapy

Radiotherapy is used to kill cancer cells, and by means of controlling the dosage one can control the effects of the therapy. If the patient has undergone surgery or chemotherapy, radiotherapy usually starts approximately a month later. This therapy is conducted three or five days a week for three to six weeks.

Following radiotherapy the patient may experience the following:

• Irritation of the skin over the breasts, or darkening of the skin
• Fatigue
• Swelling in the arm (this occurs due to the blockage of the lymph vessels)

Chemotherapy

Chemotherapy involves the usage of chemicals which harm and kill cancer cells. Chemotherapy may be used in cases when the cancer is inoperable in order to reduce the size of the cancer mass and to minimize the chances of cancer cells rapidly spreading to other tissues. This treatment may be applied following surgery in order to minimize the chances of any remaining cancer cells. Chemotherapy may also be used in cases when the cancer reoccurs, or to treat the metastases that may occur following a radical operation.

Chemotherapy may be in the form of an intravenous injection which patients may receive at a hospital, or it may be in the form of a tablet which the patient takes once every two to three weeks for four to eight months.

During chemotherapy several side effects may occur:

• Leucopenia  (a decrease in white blood cells, leukocytes)
• Due to the above, a lowered resistance to infection
• Decreased apetite
• Nausea and vomiting
• Hair loss
• Fatigue

Hormone therapy

At different stages in the development of a female, the hormone balance undergoes several important changes. In certain women, these changes cause uncontrolled proliferation of cells, which lead to the formation of cancers. Hormone therapy consists in lowering the levels of estrogen in the organism.

Hormone therapy is usually indicated for usage in cases of recurring or metastasizing mammary cancer, or other schemes/protocols may be used, depending on the menstrual cycle. Hormone therapy is employed as an additional treatment in conjunction with surgery and radiotherapy.

In some cases, in order to terminally halt the production of estrogen, extreme measures may have to be taken, and the ovaries or adrenal glands may be removed.

Biological therapy

Many types of breast cancer are stimulated by the elevated levels of a protein called HER2. Biological therapy facilitates the halt of the production of HER2, which aids in the strengthening of the immune system in order to fight cancer.

This medication is called Herceptin or trastuzumab.