Treatment Options for Breast Cancer
Breast cancer is a complex disease, and it’s different for every patient. Each treatment plan is therefore unique to each patient and tailored to their specific needs. Also due to the advancement of treatment options for breast cancer, there are now more streamlined methods to treat different types of breast cancer.
Your doctor will consider the following factors before recommending the most optimal treatment plan for your condition:
- The type of breast cancer you have
- Tumour size and area affected
- How quickly the tumour is growing or spreading (metastasizing)
- Your age, current health condition, and whether you have had breast cancer before
- Your HER2 status and the presence of other female hormones or genetic factors
The most important factor related to survival is whether the cancer has spread (metastasized) beyond the breast to other parts of your body, most commonly to the bones, lung, liver and brain. [1]
The ultimate goal of your treatment should be to eradicate the cancer and keep it from coming back. Your treatment plan may consist of more than one type of treatment. This is because different types of treatments serve different purposes and objectives.
The goal of surgery is to remove the entire tumour from the breast. There are two basic types of surgery for removing cancer from the breast:
- Lumpectomy
Lumpectomy, also referred to as breast-conserving surgery, partial mastectomy or wide excision involves removing the tumour and a rim of healthy breast tissue around it. With a lumpectomy, you get to keep your breasts but it can be significantly deforming. A lumpectomy is usually followed by radiation therapy to ensure all the cancer cells are removed.
- Mastectomy
Mastectomy involves removing the entire breast, which in many, but not all cases includes the nipple and areola. A breast reconstruction after the mastectomy can restore the look and feel of the breast.
Your chances of survival are the same, whether you choose to have a lumpectomy with radiation therapy or a mastectomy. [2]
The goal of radiation therapy is get rid of all possibly remaining cancer cells after a lumpectomy, to shrink early-stage cancer, stop the cancer from coming back or treat symptoms when the cancer has spread. [3] Radiation therapy is also referred to as radiotherapy, irradiation, or x-ray therapy. Radiation therapy involves using high-energy particles of waves such as x-rays, gamma rays, electron beams, or protons, to destroy or damage cancer cells.
Chemotherapy involves using medicines or drugs to kill or damage cancer cells that have spread outside of the primary tumour area. There are three main goals of chemotherapy which are:
- To cure and stop the cancer from coming back
- To control the growth of the cancer
- To palliate the cancer which means to ease the symptoms of the cancer
In women with large tumours, chemotherapy may be used before surgery to reduce the size or shrink the tumour so that a lumpectomy becomes an option to mastectomy. The common long term side-effects of chemotherapy include early menopause and weight gain. The most common short term side-effects include hair loss, nausea, vomiting and weakened nails.
Hormone therapy involves slowing down or stopping the growth of the tumour by preventing the cancer cells from getting the hormones like oestrogen and/or progesterone which they need to grow. Hormone therapy is usually given after breast surgery, but in some postmenopausal women, it may be administered before surgery to shrink the tumour so that a lumpectomy becomes an option to mastectomy
Targeted cancer therapy is a fairly new cancer treatment which used drugs to precisely identify and attack cancer cells. It is designed to attack a certain molecular agent or pathway involved in the development of cancer. Unlike chemotherapy, targeted therapies kill cancer cells with little harm to healthy cells. [4]
Ultimately the type of treatment plan you choose to follow is up to you. Many different women have chosen different paths, and they have survived. Being able to choose your own treatment plan empowers you and offers you some form of control over a condition that you can’t control. Ensure your doctor provides all the possible treatment options that are specially tailored to your condition and personal preference.
Citations:
1) Susan G. Komen Breast Cancer Foundation – Factors Affecting Treatment Optionshttps://ww5.komen.org/BreastCancer/FactorsthatAffectTreatmentOptions.html
2) Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 347(16):1233-41, 2002.
3) American Cancer Society – Radiation Therapyhttps://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/radiation.html
4) Susan G. Komen Breast Cancer Foundation – Types of Treatmenthttps://ww5.komen.org/BreastCancer/TypesOfTreatment.htm