Treatment of Breast Cancer

After a diagnosis of breast cancer is made, doctors will make a calculated plan of attack using a multidisciplinary approach toward treatment. The type of treatment ultimately depends on the category of breast cancer present.  Treatment options include surgery, radiation therapy, and chemotherapy.

Surgical Options

  • Total Mastectomy – During this procedure, the doctor removes the entire breast. In some cases, both breasts are removed – this is known as a double mastectomy.
  • Partial Mastectomy – During this surgery, the surgeon removes the part of the breast affected by the tumor.
  • Modified Mastectomy – During this surgery, also known as radical mastectomy, the doctor removes the entire breast as well as the underlying lymph nodes.
  • Lumpectomy – This involves removal of the cancerous lump and the margin around the tissue.
  • Sentinel Lymph Node Biopsy – In this procedure, the surgeon removes the sentinel lymph node, which is the specific node where the tumor drains. This allows surgeons to spare some of the other nodes. The theory behind this surgery is that the sentinel node is most likely to contain the cancerous cells.

Radiation for Breast Cancer

Radiation uses energy rays to kill cancer cells and is often done after breast cancer surgery to prevent the return of cancer cells. Doctors usually wait until the tissue heals after surgery before administering radiation treatment. Radiation is typically given five days a week for approximately five to six weeks. However, in some cases, patients are given alternative schedules of treatment. For example, in hypofractionated therapy, radiation is administered over a three-week period. In this case, higher doses of radiation are given to compensate for the short schedule.

Another type of radiation used on breast cancer patients is known as brachytherapy. There are two types of brachytherapy:

  • Intracavitary Brachytherapy – Radiation is applied in the empty space left from the removal of the cancerous growth in the breast. Intracavitary brachytherapy is given twice a day for five days.
  • Intersitial Brachytherapy – Catheters (small hollow tubes) with radioactive material are inserted into the breast. After insertion, the catheters are left in place for several days.

Chemotherapy for Breast Cancer

During chemotherapy, patients are given medications that are intended to destroy the cancer cells in the body. Chemotherapy treatment is administered over a series of several months and is classified under the following two categories:

  • Neoadjuvant Chemotherapy –This therapy is used to reduce the size of the tumor before surgery. If this approach is successful, doctors can sometimes perform less invasive surgeries.
  • Adjuvant Chemotherapy – This therapy is used after surgery to eradicate remaining cancer cells. The goal of adjuvant chemotherapy is to prevent the breast cancer from returning.

Chemotherapy Medications

During chemotherapy, doctors can prescribe a variety of medications to breast cancer patients. The drugs are meant to attack and eradicate any remaining cancer cells. These medications include, but are not limited to:

  • Anthracyclines – This type of medication is used to treat early-stage breast cancer. Examples include epirubicin and doxorubicin.
  • Taxanes – These types of drugs are often used for node-positive breast cancer. Examples include pacilitaxel and docetaxel.
  • Platinum-Based Medications – These drugs are used for cancers associated with BCRA mutations and in some advanced cancers. Examples include carboplatin and oxaliplatin.

Along with the aforementioned medications, there are also drugs known as target agents. These medications are prescribed to halt the growth of cancer cells. Unlike most chemotherapy medication that is intended to kill cancer cells, these drugs aim at preventing breast cancer recurrence in the body.

Breast Cancer Prognosis

According to the October 7, New York Times Health Guide, “The 5-year survival rate for women diagnosed with cancer is 80%. Unfortunately, women in lower social and economic groups still have significantly lower survival rates than women in higher groups.” Several factors are used to determine the risk for recurrence and the likelihood of successful treatment. They include:

  • Where the tumor is located and  how it has spread
  • If the tumor is  a positive or -negative hormone receptor-
  • Tumor markers
  • The  types of genes involved
  • The size and shape of the tumor
  • The way and rate in which the tumor’s cells divide

Women with breast cancer are now living longer due to better treatment options.  Since 1990 cancer mortality rates have declined by about 25%.  If most cancers reoccur they happen within five years of treatment.