Breast Cancer Treatment

Breast cancer treatment begins only after breast cancer diagnosis is confirmed. This is the reason why women are encouraged to visit their doctor immediately in case they experience or feel any abnormal changes in their breast or if the changes resemble any of the aforementioned breast cancer symptoms.

The doctor starts by conducting a physical exam of the breasts to confirm breast cancer diagnosis. The usual tests conducted by the doctor to confirm diagnosis typically includes:

• Complete breast examination: During this exam, the doctor asks the patient to sit or lie down and move their arm in different directions. This is done to check for any lumps, change in shape and size of the nipples and the breasts and identify any discharge from the nipples.
• Mammogram: A diagnostic mammogram is an X-ray exam to identify tumor growth in breasts. The use of a 2D or a 3D mammogram is preferred over simple mammogram to make correct breast cancer diagnosis by reducing the chances of false positive breast cancer diagnosis cases.
• Ultrasound: A breast ultrasound makes it easier for the doctors to differentiate between a fluid-filled cyst appearing as a lump or a true mass of cells.
• Biopsy: Either one of the different biopsy techniques such as needle biopsy, mammographically-guided biopsy or MRI-guided biopsy is used to extract a piece of tissue from the suspected lump. The cells of the lump are seen under a microscope to check for cancer cells. At this point, the aggressiveness (stage) and the type are also determined.
• MRI: An MRI scan is conducted to determine the extent of cancer.

Depending on the stage and type of breast cancer diagnosed, a treatment plan is prepared. You may prepare an account of all the questions and concerns that you may have about the treatment plan and share them with the surgeon. It is important to know what is going to happen during the course of next few months. This will help set expectations out of the procedure.

Most commonly, as a part of treatment for breast cancer, a surgery is conducted to remove the cancerous lump or growth from breasts. Depending on the extent of cancer and its stage, surgery may be accompanied by another form of treatment as well, which are conducted either before or after the surgery.

The doctor decides upon a breast cancer treatment plan that is most suitable for the patient. The decision may depend upon the extent of spread, the overall health of the patient, the stage and the type of breast cancer (inflammatory, cancer during pregnancy, lobular carcinoma, ductal carcinoma and invasive breast cancer).

The team that conducts breast cancer treatment includes a surgeon, medical oncologist, and a radiation oncologist. The different breast cancer treatment options are divided into two types:

Local Treatment: This type of treatment is localized, that is, it is only used to treat one specific location or primary site affected by cancer. It does not have any impact on the rest of the body.

The following are the two types of local treatment:

Surgery:

It is the most common form of treatment that targets to remove as much cancer from the primary location as possible. There are different types of surgeries, which can be selected by the doctor depending upon the requirement.

• Mastectomy:

  In this type of breast cancer removal surgery, the entire breast is removed to eliminate cancer cells. It can involve either one or both the breasts.

• Breast-conserving surgery:

  In this type of surgery, only the part of the breast containing cancer is removed. The goal is to remove just cancer and some part of surrounding healthy tissues and leave the rest of the breast as is.

• Lymph node removal:

  This type of surgery is sometimes conducted in addition to either of the first two types of surgeries, in case cancer has spread to the nearby lymph nodes.

• Breast reconstruction:

  This type of surgery is conducted after the removal of cancer, in case the patient demands to improve the appearance of the breast mounds after the removal surgery.

Radiation therapy:

Radiation is required by some breast cancer patients, mostly in addition to other types of treatment.  It is typically used in case of patients who have undergone mastectomy, breast-conserving surgery or if cancer has spread to other parts of the body. Delivering high dose radiation to the affected part of the body helps reduce the chances of cancer recurrence.

The radiation can either be delivered externally or by placing a small radioactive pallet in the affected area internally. The latter form of radiation therapy is known as brachytherapy.

Systemic Treatment:

This type of treatment involves the used of drugs that can be administered either orally or intravenously. The choice of drugs depends on the type of systemic treatment opted for, which, in turn, is dependent upon the extent and the type of cancer.

Chemotherapy, targeted therapy, and hormone therapy are the three primary types of systemic therapy for breast cancer treatment.

Of all the three forms of systemic treatment, chemotherapy is the most common. Chemotherapy is recommended before the surgery to reduce the size of the tumor and after the surgery to kill off the remaining cancer cells. It involves the intravenous administration of specific anti-cancer drugs.

Hormone therapy is most commonly used in cases when the patient has tested HER-2 positive in the biopsy. Targeted therapy, on the other hand, is less commonly used.

Recovery after breast cancer treatment is less painful and traumatic as compared to some of the other types of critical cancers. Therefore are, however, certain changes that breast cancer patients may have to deal with after their treatment. Some of these changes include the following:

• The menstruation cycle is almost always affected by breast cancer patients during chemotherapy and radiation therapy. The patient experiences a temporary menopause that lasts for over a few months after the treatment. Therefore, the patient is expected to experience a few symptoms related to menopause, such as fatigue, mood swings, and hot flushes.
• The fertility of the woman is also affected by the treatment. Therefore, they may feel affected physically and mentally and may need a strong emotional support during the recovery period.
• In some women, the affected breast or both the breasts are removed surgically as a part of the treatment. As a result, they may lose their confidence because of their changed physical experience. However, they can opt for cosmetic surgery to regain the size and shape of their breast.
• The side effects of cancer treatment such as extreme weakness, reduce appetite, weight loss, hair loss, and reduced immunity can be painful to deal with. Other side effects such as vomiting, nausea, headache, and joint pain can be effectively managed with the help of proper medications.

The medications after cancer treatment may continue for a few years to keep the regrowth of cancer cells in check. It may take several months for the patient to recover from the after-effects of cancer treatment.