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Does All Breast Cancer Require Chemo

How Is Madagascariensis Used In India And Madagascar

A majority of women with breast cancer do NOT need chemo

C. madagascariensis has been used for the production of rubber in both India and Madagascar. In Madagascar, the species is also used to produce fibres used for making ropes, fish nets and fishing line. C. madagascariensis is a poisonous species and has been used in committing suicide for religious purposes.

Combination Drug Therapy For Early

Combination drug therapy means that you receive more than one type of drug at a time.

Combining drug therapies allows your care team to increase the chances that your treatment will be effective against the breast cancer. If a tumor becomes resistant to one drug, your treatment may still be effective because the tumor responds to the second or third drug in the combination you receive.

Combination therapy can be given before or after breast surgery. Most women receive a combination of two or three drugs at the same time. Some of these drugs are breast cancer targeted therapies. These drugs work by targeting specific molecules involved in breast cancer development.

Here are some of the drug combinations that MSKs medical oncologists commonly prescribe:

Dose-Dense AC-T

  • Doxorubicin and cyclophosphamide, followed by paclitaxel
  • Used to treat early-stage breast cancer, particularly in younger women or women with aggressive disease
  • Given intravenously before or after surgery

Dose-Dense AC-TH

  • Doxorubicin and cyclophosphamide, followed by paclitaxel and trastuzumab
  • Used to treat early-stage HER2-positive breast cancer
  • Given intravenously before or after surgery

Dose-Dense AC-THP

  • Doxorubicin and cyclophosphamide, followed by paclitaxel, trastuzumab, and pertuzumab
  • Used to treat early-stage breast cancer
  • Given intravenously before or after surgery
  • Used to treat early-stage breast cancer
  • Given intravenously or by pill after surgery, depending on what your doctor recommends

TCHP

Will I Need Chemotherapy

Typically chemotherapy is a consideration for patients with high-risk breast cancers. Some factors that may indicate the need for chemotherapy are:

  • Lymph node involvement.
  • Tumors that are higher-grade, ER/PR-negative, HER2-negative or triple-negative .
  • Tumors that are HER2-positive.
  • Breast cancers in younger patients, especially those below the age of 40.

If you need chemotherapy, it will be given as an outpatient treatment every two to three weeks, delivered either directly into a vein or through a port.

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Wire Localization To Guide Surgery

Sometimes, if the cancer in your breast cant be felt, is hard to find, and/or is difficult to get to, the surgeon might use a mammogram or ultrasound to guide a wire to the right spot. This is called wire localization or needle localization. If a mammogramis used you may hear the term stereotactic wire localization. Rarely, MRI might be used if the mammogram or ultrasound are not successful.

After your breast is numbed, a mammogram or ultrasound is used to guide a thin hollow needle to the abnormal area. Once the tip of the needle is in the right spot, a thin wire is put in through the center of the needle. A small hook at the end of the wire keeps it in place. The needle is then taken out. The surgeon uses the wire as a guide to find the part of the breast to be removed.

The surgery done as part of the wire localization may be enough to count as breast-conserving surgery if all of the cancer is taken out and the margins are negative. If cancer cells are found at the edge of the removed tissue , more surgery may be needed.

It should be noted that a wire-localization procedure is sometimes used to perform a surgical biopsy of a suspicious area in the breast to find out if it is cancer or not.

There are other ways a surgeon can be guided to the tumor, but these techniques are newer and not used in every facility.

Moving Genomic Testing Into Practice

Many breast cancer patients can skip chemo, landmark study ...

This study is a big deal, said Dr. Timothy Byun, a medical oncologist with The Center for Cancer Prevention and Treatment at St. Joseph Hospital in Southern California, who was not involved in the study.

In an interview with Healthline, Byun said the study may result in fewer breast cancer patients getting chemotherapy, at least in European countries.

In the United States, many of us have already been using the Oncotype DX test to help guide our decisions, said Byun. It uses a 21-gene score. It gives similar information, but we dont know if theres a 100 percent correlation with the MammaPrint test.

Byun referred to the recent TAILORx Trial using the 21-gene test. It found that low-risk patients did well without chemotherapy.

That study showed the test could select a cohort of patients with a 99 percent chance of five-year survival without distant metastasis. For those women, the risks of chemotherapy arent justifiable.

Researchers are still waiting for this data to mature, cautions Byun.

We know that when oncologists see patients after surgery, we look at traditional clinical indicators to guide our decision-making process as to benefits and harms of chemotherapy, he said.

With the information currently available, its likely that some breast cancer patients get unnecessary chemotherapy.

Theres a caveat, according to Byun. Genomic studies, for the most part, have included only estrogen-receptor positive breast cancer patients.

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The Pressure Of Patient Expectations

A majority of surveyed physicians reported that patients want the most aggressive treatment, even if the benefit is small, and that it takes more effort to tell patients that they do not need radiation than it does to recommend it.

Its important to recognize that this is a controversial area, says Shumway. You cant say that offering radiation to older women is wrong. It really is a patient-driven decision, and it depends on the patients own values and preferences, in addition to her risk of recurrence and overall health.

As the point of first contact for breast cancer patients, surgeons have a tremendous influence on how patients choose treatment options.

Which is why Shumway thinks they could play a crucial role in counseling older women about options for less aggressive therapy.

The population is aging, and this is going to be an issue that affects more women, says Shumway. There is increasing attention given to considerations that are unique to older patients and in this case, their vulnerability for overtreatment.

Shumways future work will focus on developing interventions to help patients make fully informed decisions and understand the concept of competing causes of mortality.

Learn more about breast cancer and breast cancer treatment:

Study: More Breast Cancer Patients Can Safely Skip Chemotherapy

A federally funded study has found that many women with the most common type of early stage breast cancer likely do not need chemotherapy after surgery. The study was presented June 3, 2018 at the American Society of Clinical Oncology meeting in Chicago, and simultaneously published in the New England Journal of Medicine. It is likely to change the way many newly diagnosed breast cancer patients are treated.

“With results of this groundbreaking study, we now can safely avoid chemotherapy in about 70% of patients who are diagnosed with the most common form of breast cancer,” said Kathy Albain, MD, a co-author of the study. “For countless women and their doctors, the days of uncertainty are over.”

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What Happens During Chemotherapy For Breast Cancer

Most people receive chemotherapy for breast cancer through one of their veins . You may receive chemotherapy as one short injection or as an infusion. Infusions last longer and usually take place in a hospital or specialized infusion center.

When you get to the infusion center, your nurse administers your chemotherapy drugs and any additional medications you need. For example, you may also receive an anti-nausea medication before the chemotherapy drugs.

During the infusion:

  • Your nurse accesses your CVC or starts an IV.
  • You may read, watch television or visit with others during your treatment. Chemotherapy infusions may last a few hours or more.
  • Your nurse flushes the IV line or CVC with a saline solution and removes it.
  • You wait in a recovery area for about 30 minutes to make sure you do not have a negative reaction to treatment.
  • Feeling Unwell Or Tired

    Do I Really Need Chemo Breast Cancer Awareness Month Discussion

    Many women do not feel as healthy after chemo as they did before. There is often a residual feeling of body pain or achiness and a mild loss of physical functioning. These changes may be very subtle and happen slowly over time.

    Fatigue is another common problem for women who have received chemo. This may last a few months up to several years. It can often be helped, so its important to let your doctor or nurse know about it. Exercise, naps, and conserving energy may be recommended. If you have sleep problems, they can be treated. Sometimes fatigue can be a sign of depression, which may be helped by counseling and/or medicines.

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    When Is Chemotherapy Used To Treat Early

    The first treatment for early-stage breast cancer usually includes surgery and sometimes radiation. Your doctor may also talk to you about added treatment, such as chemotherapy and hormone therapy, that may help keep cancer from coming back.

    It isn’t possible for all women to know for sure who will benefit from added treatment. But if you have early-stage, estrogen receptor positive breast cancer with no cancer in the lymph nodes, you may have a gene test. Gene tests, such as the Oncotype DX, may be done on the cancerous tissue that was removed to look for tumor markers. These tests can give your doctor important information about whether chemotherapy will help you.

    The type of added treatment you have depends on the stage and classification of your breast cancer:

    How Is Chemotherapy For Breast Cancer Given

    Chemo drugs for breast cancer are typically given into a vein , either as an injection over a few minutes or as an infusion over a longer period of time. This can be done in a doctors office, infusion center, or in a hospital setting.

    Often, a slightly larger and sturdier IV is required in the vein system to administer chemo. These are known as central venous catheters , central venous access devices , or central lines. They are used to put medicines, blood products, nutrients, or fluids right into your blood. They can also be used to take out blood for testing.

    There are many different kinds of CVCs. The most common types are the port and the PICC line. For breast cancer patients, the central line is typically placed on the side opposite of the breast cancer. If a woman has breast cancer in both breasts, the central line will most likely be placed on the side that had fewer lymph nodes removed or involved with cancer.

    Chemo is given in cycles, followed by a rest period to give you time to recover from the effects of the drugs. Chemo cycles are most often 2 or 3 weeks long. The schedule varies depending on the drugs used. For example, with some drugs, chemo is given only on the first day of the cycle. With others, it is given one day a week for a few weeks or every other week. Then, at the end of the cycle, the chemo schedule repeats to start the next cycle.

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    How Can I Reduce My Risk For Invasive Ductal Carcinoma

    Like most cancers, knowing your family history can help you take preventative steps, such as early screenings and mammograms. Even though invasive ductal carcinoma cant be prevented altogether, there are steps you can take to lower your risk:

    • Maintain a healthy body weight.
    • Dont smoke.

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    What Are Some Of The Possible Risks Or Complications

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    Minor complications include:

    • Slight swelling of the breast during radiotherapy. This usually goes away within six to 12 months.
    • The skin becomes darker during the course of radiotherapy, similar to tanning from the sun. In most cases, this also fades gradually over six to 12 months.
    • Most women will have aches or pains from time to time in the treated breast or the muscles surrounding the breast, even years after treatment. The reason why this happens is not clear however, these pains are harmless, although annoying. They are NOT a sign that the cancer is reappearing.
    • Rarely, patients may develop a rib fracture years following treatment. This occurs in less than one percent of patients treated by modern approaches. These heal slowly by themselves.

    More serious complications include:

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    Treatment For Stage 2 Breast Cancer

    The most common for stage 2 breast cancer is surgery.

    Surgery

    In most cases, treatment involves removing the cancer. The person may undergo a lumpectomy or mastectomy. The doctors and the individual can decide based on the size and location of the tumor. The surgeon may also remove one or more lymph nodes.

    Combination therapy

    A doctor may recommend a combination of radiation therapy, chemotherapy, and hormone therapy to people with stage 2A or 2B breast cancer.

    Neoadjuvant therapy

    In some cases, a doctor may recommend neoadjuvant therapy, which is chemotherapy before surgery to reduce the size of a tumor.

    are 3A, 3B, and 3C.

    3A breast cancer is an invasive breast cancer where:

    • There is no tumor in the breast, or a tumor of any size is growing alongside cancer found in four to nine axillary lymph nodes or the lymph nodes by the breastbone.
    • A person has a tumor greater than 5 cm. They also have clusters of breast cancer cells in the lymph nodes that are between 0.22 mm in diameter.
    • The tumor is larger than 5 cm. The cancer has also spread to one to three axillary lymph nodes or the lymph nodes near the breastbone.

    Stage 3B breast cancer is invasive breast cancer where:

    • A tumor of any size has spread into the chest wall or skin of the breast, causing swelling or an ulcer to develop.
    • Cancer cells may also be present in to up to nine axillary lymph nodes.
    • They may be present in lymph nodes by the breastbone.

    Common Chemotherapy Drugs For Breast Cancer

    Chemotherapy drugs used to treat early breast cancer include:

    These drugs are often used with others like carboplatin, cyclophosphamide , and fluorouracil .

    These drugs are often used with others like carboplatin , cyclophosphamide , and fluorouracil .

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    How Can Invasive Ductal Carcinoma Of Breast Be Prevented

    The following measures may help in reducing the risk for Invasive Ductal Carcinoma of Breast :

    General lifestyle changes:

    • Maintain a healthy weight and exercise regularly physical activity can reduce risk, especially in post-menopausal women
    • Implement and follow a well-balanced diet a high intake of fiber via fresh fruits and vegetables can reduce the risk
    • Drink alcohol in moderation limit to one or two drinks a day
    • Limit combination hormone therapy used to treat symptoms of menopause. It is advised that individuals be aware of the potential benefits and risks of hormone therapy
    • Cancer screenings can help detect any breast cancer, at its earliest stages
    • Learn to do âbreast self-examsâ, in order to help identify any unusual lumps, signs in the breasts

    In women with a high risk for developing Invasive Ductal Carcinoma of Breast , the physician may suggest the following:

    • Preventative medications: The medications tamoxifen and raloxifene are estrogen-blocking drugs that can help prevent the onset of breast cancer in women at high risk. Both drugs have potential side effects including being at a higher risk for blood clots
    • Preventative mastectomy: Prophylactic mastectomy, a procedure to surgically remove healthy breasts, is another possible preventative option for women, at a high risk for breast cancer

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    What To Expect After Chemo

    Nearly 70 percent of early breast cancer patients may not need chemotherapy: Study

    Once youâre home, you need to take care of yourself and take steps to manage chemo side effects. These include:

    • Take medications the doctor prescribed for side effects.
    • Stay away from anyone with a cold or infection — chemo makes it harder for your body to fight germs.
    • Drink lots of fluids for the first 8 hours to move the medicine through your body.
    • Manage bodily fluids and waste that may have traces of chemo. Usually, this means flushing the toilet twice.

    Youâll see your doctor every 4 to 6 months for the next 5 years after treatment ends.

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    Why Is Chemotherapy Used For Breast Cancer

    Not everyone who has breast cancer needs chemotherapy. Depending on the cancer stage, your oncologist may recommend chemotherapy:

    • Before surgery : You may have chemotherapy to shrink a tumor. This option could make it possible to have a less-extensive surgery. It may also allow healthcare providers to discover more about the biology of the cancer itself by how it responds to chemotherapy.
    • After surgery : Sometimes, cancerous cells remain in your body but dont show up on imaging tests. Your healthcare provider may recommend chemotherapy after surgery to kill any remaining cancer cells. This treatment can also reduce the risk of the cancer from returning .
    • For advanced cancer: If breast cancer has spread to other parts of your body , chemotherapy may be the main treatment.
    • For IBC: Inflammatory breast cancer doesnt have a lump that a surgeon can remove easily. Chemotherapy often is the first treatment for IBC.

    Immunotherapy As An Emerging Treatment

    Immunotherapy is a relatively new treatment option, and while it hasnt been approved by the Food and Drug Administration for breast cancer yet, its a promising area.

    Immunotherapy works by raising the bodys natural defenses to fight off the cancer. It has fewer side effects than chemotherapy and is less likely to cause resistance.

    Pembrolizumab is an immune checkpoint inhibitor. Its a type of immunotherapy that has shown particular promise in the treatment of metastatic breast cancer.

    It works by blocking specific antibodies that make it harder for the immune system to fight the cancer. This allows the body to fight back more efficiently. A 2016 study found 37.5 percent of patients with triple-negative breast cancer saw a benefit from the therapy.

    Because immunotherapy isnt FDA approved yet, treatment is mostly available through clinical trials at this time.

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