Breast cancer is identified by rapidly dividing cells in the breast. There are many treatment options for breast cancer that can completely remove cancerous cells with no or little side effects. The choice of treatment depends upon the stage of cancer, age, the reason for cancer, lifestyle, weight, type of breast cancer (malignant and metastatic tumors) and health status. Patients should have a satisfactory meeting with their doctor before the selection of treatment. Ask questions if something is unclear.
Types of treatments
- systemic therapy (targeted therapy, chemotherapy, hormone therapy)
- Radiation therapy (x-rays, proton radiations)
Surgery is an operation carried out by an oncologist to remove infected tissues, cells, and tumors. It is usually prescribed and most effective at early stages when tumor size is small. And it is also proved effective when the tumor is fast growing and spreading in the body. But in case of spreading tumor, some treatments are carried out before surgery known as Neoadjuvant therapy. It helps to shrink the tumor in one area and can be removed easily. Radiation therapy, hormone therapy, and chemotherapy are used as neoadjuvant therapy.
Types of surgery
- Lumpectomy (breast-conserving surgery)
Lumpectomy is a partial mastectomy in which the tumor is removed along with some healthy cells from the breast. Healthy cells are removed in order to minimize the chances of breast cancer. Lymph node evaluation is important after surgery because tumors often attack lymph nodes. Radiation therapy is prescribed after surgery to kill remaining cells in the lymph nodes. For this purpose, a dye or radioactive element is injected through nipples. When dye approaches the infected cell, it turns its color.
Mastectomy is the complete removal of the breast through surgery. It is done for fast-growing and spreading tumors. Reconstructive surgery is done for reconstruction of the breast after mastectomy. Sometimes reconstructive surgery and mastectomy are carried out at the same time by an oncologist.
Radiation therapy uses high energy radiations to kill cancerous cells. X-rays are particularly used for this purpose.
Types of radiation therapy depending upon the method of treatment
- External beam radiation therapy is carried out by giving radiation from a machine.
- Intraoperative radiation therapy uses a probe for radiations.
- Brachytherapy is a type in which a radioactive source is placed in the tumor.
Radiation therapy can be given before or after surgery. If radiation therapy is given before surgery it is called Neoadjuvant radiation therapy. And after surgery, it is known as adjuvant radiation therapy.
Types of radiation therapy depending upon the source of radiations
- X-ray therapy uses x-rays as a source of radiation to destroy tumors.
- Proton therapy uses proton as a source of radiations. It is a highly energetic beam which can decrease the amount of radiation.
It consists of all treatments taken by veins or mouth that approach to the cancer cells through the bloodstream.
Categories of systemic therapy
- hormonal therapy
- targeted therapy
Chemotherapy uses drugs to kill cancer cells. These drugs are given in the form of a pill, an injection, and a capsule. Chemotherapy can be used before or after the surgery. Chemotherapy which is carried out before surgery is called Neoadjuvant chemotherapy. It can shrink spreading tumors and helps in surgery. The chemotherapy which is done after surgery is known as adjuvant chemotherapy. Specific drugs are given for chemotherapy. The names of some drugs are:
A patient can use these drugs separately or in the combination of drugs. It is observed that drugs become more effective when these are used in combination. It is based on the logic that resistance to one drug will be overcome by another drug.
Hormonal therapy is effective when cancer is caused by hormones. This is also called endocrine therapy because it involves endocrine hormones. Breast cancer is caused by an increased level of estrogen or progesterone. In hormonal treatment, such drugs are taken which suppress the hormones. When the hormone is blocked then the growth of cancer cell can be prevented. Hormonal therapy can be given before or after the surgery.
Tamoxifen is the most common drug used for hormonal therapy. It can prevent estrogen binding to tumor cells. It can decrease the risk of recurrence in other breasts and local areas. It is approved from FDA for breast cancer treatment.
Targeted therapy is the type of systemic treatment which targets the genetics of cancer. For example, it focuses on gene, tissue, and proteins that favor cancerous cells. Its mode of action is different from other treatments. It can cure breast cancer without damaging healthy cells. Doctors carry out many tests to find out most effective targets on tumors. Recent studies are trying to find out molecular targets on tumor cells. Some targeted therapies are: