Surgery is usually the first type of treatment for breast cancer. The type of surgery you undergo will depend on the type of breast cancer you have.
Surgery is usually followed by chemotherapy or radiotherapy or, in some cases, hormone or biological treatments. Again, the treatment you'll have will depend onthe type of breast cancer.
Your doctor will discuss the most suitable treatmentplan with you. Chemotherapy or hormone therapy will sometimes be the first treatment.
Most breast cancers are discovered in the condition's early stages. However, a small proportion of women discover that they have breast cancer after it's spread to other parts of the body (metastasis).
If this is the case, the type of treatment you have may be different. Secondary cancer, also called "advanced" or "metastatic" cancer, isn't curable.
Treatment aims to achieve remission, where the cancer shrinks or disappears, and you feel normal and able to enjoy life to the full.
There are two main types of breast cancer surgery:
In many cases, a mastectomy can be followed by reconstructive surgery to try to recreate a bulge to replace the breast that was removed.
Studies have shown that breast-conserving surgery followed by radiotherapy is as successful as total mastectomy at treating early-stage breast cancer.
Breast-conserving surgery ranges from a lumpectomy or wide local excision, where just the tumour and a little surrounding breast tissue is removed, to a partial mastectomy or quadrantectomy, whereup to a quarter of the breast is removed.
If you have breast-conserving surgery, the amount of breast tissue you have removed will depend on:
Your surgeon will always remove an area of healthy breast tissue around the cancer, which will be tested for traces of cancer.
If there's no cancer present in the healthy tissue, there's less chance that the cancer will return.
If cancer cells are found in the surrounding tissue, more tissue may need to be removed from your breast.
After having breast-conserving surgery, you'll usually be offered radiotherapy to destroy any remaining cancer cells.
A mastectomy is the removal of all the breast tissue, including the nipple.
If there are no obvious signs that the cancer has spread to your lymph nodes, you may have a mastectomy, where your breast is removed, along with a sentinel lymph node biopsy.
If the cancer has spread to your lymph nodes, you'll probably need more extensive removal (clearance) of lymph nodes from the axilla under your arm.
Breast reconstruction is surgery to make a new breast shape that looks like your other breast as much as possible.
Reconstruction can be carried out at the same time as a mastectomy (immediate reconstruction), or it can be carried out later (delayed reconstruction).
It can be done either by inserting a breast implant or by using tissue from another part of your body to create a new breast.
To find out if the cancer has spread, a procedure called a sentinel lymph node biopsymay be carried out.
The sentinel lymph nodes are the first lymph nodes that the cancer cells reach if they spread. They're part of the lymph nodes under the arm (axillary lymph nodes).
The position of the sentinel lymph nodes varies, so they're identified using a combination of a radioisotope and a blue dye.
The sentinel lymph nodes are examined in the laboratory to see if there are any cancer cells present. This provides a good indicator of whether the cancer has spread.
If there are cancer cells in the sentinel nodes, you may need further surgery to remove more lymph nodes from under the arm.
Radiotherapy uses controlled doses of radiation to kill cancer cells. It's usually given after surgery and chemotherapy to kill any remaining cancer cells.
If you need radiotherapy, your treatment will begin about a month after your surgery or chemotherapy to give your body a chance to recover.
You'll probably have radiotherapy sessions three to five days a week, forthree to six weeks. Each session will only last a few minutes.
The type of radiotherapy you have will depend on your cancer and the type of surgery you have. Some women may not need to have radiotherapy at all.
The types available are:
The side effects of radiotherapy include:
Chemotherapy involves using anti-cancer (cytotoxic) medication to kill the cancer cells.
It's usually used after surgery to destroy any cancer cells that haven't been removed. This is called adjuvant chemotherapy.
In some cases, you may have chemotherapy before surgery, which is often used to shrink a large tumour. This is called neo-adjuvant chemotherapy.
Several different medications are used for chemotherapy, and three are often given at once.
The choice of medication and the combination will depend on the type of breast cancer you have and how much it's spread.
Chemotherapy is usually given as an outpatient treatment, which meansyou won't have to stay in hospital overnight. The medications are usually given through a drip straight into the blood through a vein.
In some cases, you may be given tablets that you can take at home. You may have chemotherapy sessions once everytwo to three weeks, over a period of four to eight months, to give your body a rest in between treatments.
The main side effects of chemotherapy are caused by their influence on normal, healthy cells, such as immune cells.
Side effects include:
Many side effects can be prevented or controlled with medicines that your doctor can prescribe.
Chemotherapy medication can also stop the production of oestrogen in your body, which is known to encourage the growth of some breast cancers.
If you haven't experienced the menopause, your periods maystop while you're undergoing chemotherapy treatment.
After you've finished the course of chemotherapy, your ovaries should start producing oestrogen again.
However, this doesn't always happen and you may enter an early menopause . This is more likely in women over 40, as they're closer to menopausal age.
Your doctor will discussthe impact any treatment will have on your fertility with you.
If your breast cancer has spread beyond the breast and lymph nodes to other parts of your body, chemotherapy won't cure the cancer, but it may shrink the tumour, relieve your symptoms and help lengthen your life.
Some breast cancers are stimulated to grow by the hormones oestrogen or progesterone, which are found naturally in your body.
These types of cancer are known as hormone receptor-positive cancers. Hormone therapy works by lowering the levels of hormones in your body or by stopping their effects.
The type of hormone therapy you'll have will depend on the stage and grade of your cancer, which hormone it's sensitive to, your age, whether you've experiencedthe menopause, and what other type of treatment you're having.
You'll probably have hormone therapy after surgery and chemotherapy, but it's sometimes given before surgery to shrink a tumour, making it easier to remove.
Hormone therapy may be used as the only treatment for breast cancer if your general health prevents you having surgery, chemotherapy or radiotherapy.
In most cases, you'll need to take hormone therapy for up to five years afterhaving surgery. If your breast cancer isn't sensitive to hormones, hormone therapy will have no effect.
Tamoxifen stops oestrogen from binding to oestrogen-receptor-positive cancer cells. It's taken every day as a tablet or liquid.
It can cause several side effects, including:
If you'veexperienced the menopause, you may be offered an aromatase inhibitor.
This type of medication works by blocking aromatase, a substance that helps produce oestrogen in the body after the menopause. Before the menopause, oestrogen is made by the ovaries.
Three aromatase inhibitors may be offered. These areanastrozole, exemestane and letrozole. These are taken as a tablet once a day.
Side effects include:
In women who haven'texperienced the menopause, oestrogen is produced by the ovaries. Ovarian ablation or suppression stops the ovaries working and producing oestrogen.
Ablation can be carried out using surgery or radiotherapy. Itstops the ovaries working permanently and means you'll experience the menopause early.
Ovarian suppression involves using a medication called goserelin, which is a luteinising hormone-releasing hormone agonist (LHRHa).
Your periods will stop while you're taking it, although they should start again once your treatment is complete.
If you'reapproaching the menopause (around the age of 50), your periods may not start again after you stop taking goserelin.
Goserelin is taken as an injection once a month and can cause menopausal side effects, including:
Some breast cancers are stimulated to grow by a protein called human epidermal growth factor receptor 2 (HER2). These cancers are called HER2-positive.
Biological therapy works by stopping the effects of HER2 and helping your immune system to fight off cancer cells.
If you have high levels of the HER2 protein and are able to have biological therapy, you'll probably be prescribed a medicine called trastuzumab.
Trastuzumab, also known by the brand name Herceptin,is usually used after chemotherapy.
Trastuzumab is a type of biological therapy known as a monoclonal antibody.
Antibodies occur naturally in your body and are made by your immune system to destroy harmful cells, such as viruses and bacteria.
The trastuzumab antibody targets and destroys cancer cells that are HER2-positive.
Trastuzumab is usually given intravenously, through a drip. It's also sometimes available as an injection under the skin (a subcutaneous injection).
You'll have the treatment in hospital. Each treatment session takes up to one hour, and the number of sessions you need will depend on whether you have early or more advanced breast cancer.
On average, you'll need a session once every three weeks for early breast cancer, and weekly sessions if your cancer is more advanced.
Trastuzumab can cause side effects, including heart problems. This means that it's not suitable if you have a heart problem, such as angina , uncontrolled high blood pressure (hypertension) , or heart valve disease.
If you need to take trastuzumab, you'll haveregular tests on your heart to make sure it's not causing any problems.
Other side effects of trastuzumab may include:
A great deal of progress has been made in breast cancer treatment, and more women now live longer and have fewer side effects from treatment.
These advances were discovered in clinical trials , where new treatments and treatment combinations are compared with standard ones.
All cancer trials in the UK are carefully overseen to ensure they're worthwhile and safely conducted. In fact, participants in clinical trials can do better overall than thosein routine care.
If you're asked to take part in a trial, you'll be given an information sheet and, if you want to take part, you'll be asked to sign a consent form. You can refuse or withdraw from a clinical trial without it affecting your care.
Dealing with cancer can be a huge challenge for both patients and their families. It can cause emotional and practical difficulties.
Many women have to cope with the removal of part or all of a breast, which can be very upsetting.
It often helps to talk about your feelings or other difficulties with a trained counsellor or therapist. You can ask for this kind of help at any stage of your illness.
There are various ways to find help and support. Your hospital doctor, specialist nurse or GP can refer you to a counsellor.
If you're feeling depressed, talk to your GP. A course of antidepressant drugs may help, or your GP can arrange for you to see a counsellor or psychotherapist.
It can help to talk to someone who's been through the same thing as you. Many organisations have helplines and online forums. They can also put you in touch with other people who've had cancer treatment.
Complementary therapies are holistic therapies that can promote physical and emotional wellbeing.
They're given alongside conventional treatments and include:
Complementary therapy can help some women cope with diagnosis and treatment, and providea breakfrom the treatment plan.
Your hospital or breast unit may be able to provide access to complementary therapies or suggest where you canget them.
It's important to speak to your breast cancer specialist nurse about any complementary therapy you wish to use to make sure it doesn't interfere with your conventional treatment.
Breast cancer (cancer of the mammary glands) is a condition that has been known since ancient times, and exhibits itself as one of the most prevalent conditions of the modern world. This is one of the most common types of cancer, and is often one of the main causes of death for women worldwide. Cancers of the mammary gland usually affect females, and is 100 times more likely to occur in women rather than men.
The first symptom of breast cancer most women notice is a lump or an area of thickened tissue in their breast. Most Breast lump (90%) aren't cancerous, but it's always best to have them checked by your doctor.
Read about the causes of breast cancer, which aren't fully understood. There are some risk factors that are known to affect your likelihood of developing breast cancer, however.
If you notice a lump in your breast or any change in the appearance, feel or shape of your breasts, see a doctor. If you have suspected breast cancer, either because of your symptoms or because your mammogram has shown an abnormality, you'll be referred to a specialist breast cancer clinic for further tests.
Surgery is usually the first type of treatment for breast cancer. The type of surgery you undergo will depend on the type of breast cancer you have. Surgery is usually followed by chemotherapy or radiotherapy or, in some cases, hormone or biological treatments.
Most women with breast cancer have an operation as part of their treatment. Getting back to normal after surgery can take some time. It's important to take things slowly and give yourself time to recover.
As the causes of breast cancer aren't fully understood, it's not known if it can be prevented altogether. Some treatments are available to reduce the risk in women who have a higher risk of developing the condition than the general population.
This is the story of Emma Duncan who was diagnosed with breast cancer twice in four years, once in each breast. "Now I just want to stay cancer free" she says.
Breast cancer (cancer of the mammary glands) is a condition that has been known since ancient times, and exhibits itself as one of the most prevalent conditions of the modern world.
Any woman should be able to perform regular self-examinations. It is recommended to perform this examination when you are taking a shower, or in front of the mirror, holding both arms above and behind the head in order to examine the shape and size.
In the majority of cases, breast cancer is not accompanied by any sort of pain or obvious symptoms. At times, when touching a small nodule present some pain may be felt, which is why continuous, routine self-examinations are highly recommended, especially for age groups at risk.
In the majority of cases, the disease develops in complete absence of clinical symptoms. Since it is a mostly asymptomatic disease, it is rendered even more dangerous.
During palpation using the fingertips, you may feel a round mass, usually ranging from the size of a hazelnut to the size of a walnut, or even larger. The nodule can be firm or soft, with an uneven surface, separated from the tissue around it, or attached to the tissue around it and mobile.
The most common types of breast cancer include Non-invasive breast cancer and Invasive breast cancer. Less common are Morbus Paget, Erysipelas, and Occult carcinoma of the breast.
The causes of breast cancer remain unknown. Despite this, there are several risk factors that all patients should be aware of such as age, family history, weight, giving birth, breastfeeding, and lifestyle habits.
It is important to conduct a thorough examination of both breasts as well. During the examination of the patient, the scale of the tumor (how far it has already spread, or whether it has spread) is ascertained.
Since the causes of breast cancer are not known, prevention is difficult. Nevertheless, several risk factors (weight, physical activity, less alcohol) are important to note, since they can be controlled and minimized
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.