Local Breast Cancer Treatments
Local treatments are directed at the original tumor location.
Surgery
Surgery removes a tumor or, in the case of reconstruction, repairs the breast. For an early stage breast cancer diagnosis, the two main surgical choices are mastectomy or lumpectomy. A decision on the type of surgery to select is very personal.
Mastectomy: removal of the entire breast. This typically includes the nipple and areola. But not the skin of the breast. Nipple-sparing mastectomies – in which the nipple and areola are not removed – may be an option in certain patients. A prophylactic mastectomy is the removal of a healthy breast. It may be recommended if you have a BRCA1 or 2 mutation. If desired, a breast can be rebuilt with breast reconstruction surgery.
Lumpectomy : removal of the tumor and surrounding area of tissue only. The rest of the breast is left intact. If you choose a lumpectomy, you will also need radiation therapy.
Radiation
Radiation therapy uses high-energy x-rays directed at the breast, surrounding tissue and lymph nodes to kill any cancer cells that may have remained behind after surgery. You will also be treated with radiation if you have lymph node removal or a lumpectomy. Radiation therapy is typically administered daily for a period of days . It only lasts a few minutes. It is not safe during pregnancy.
Breast Cancer Treatment Options Availability
Now, having discussed the treatment options, lets discuss the availability of these treatments across various countries:
India: India is one of the most trusted countries for cancer treatment. There are various well-equipped hospitals in India that can perform various diagnostic procedures as well give every treatment to breast cancer patient.
Singapore: Singapore also has hospitals that can perform most of the diagnostic as well as treatment procedures for breast cancer patients.
Israel: Hospitals in Israel offer various diagnostic and treatment modalities the for treatment of breast cancer. Treatments like surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy are available in hospitals in Israel.
Turkey: Turkey also offers various diagnostic procedure as well as treatment forms like surgery, radiotherapy, chemotherapy, targeted therapy and immunotherapy for breast cancer patients.
UAE: Hospitals in UAE have the infrastructure to provide facilities for the diagnosis and treatment of breast cancer. Treatments like surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy are available in hospitals at UAE.
Know The Early Signs And Symptoms First
While breast cancer may be prevalent in women of all ages, it can be a tricky disease to find. Most commonly, the only sign of breast cancer’s presence is a lump or mass. And while it’s possible to feel lumps or masses in your breasts, other changes in your health can also be signs of breast cancer.
As the American Cancer Society explains, the early signs of breast cancer include2:
- Changes to your skin or nipple, like redness, scaliness, or thickening
- Dimpling on your skin that looks like an orange peel’s texture
- Nipple retraction
- Swelling of the entire or part of the breast
- Breast or nipple pain
- Nipple discharge
Knowing these signs and symptoms of breast cancer will allow you to notify your doctor as soon as changes happen. Catching breast cancer early on can improve your prognosis, and it can also help dictate which treatment is right for you.
Now that you’re aware of these common symptoms, learn more about the currently available treatment options.
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Stage 0 Breast Cancer
Stage 0 is the lowest-risk breast cancer stage. In this stage, breast cancer is detected before it spreads from the milk duct. Ductal carcinoma in situ is an example of stage 0 breast cancer.
Treatment may include surgery to remove the breast cancer, possibly followed by radiation or hormonal therapy if the cancer is hormone receptor-positive. Hormonal therapy may include tamoxifen or a type of drug known as an aromatase inhibitor, which is taken for five years after surgery to lower the risk of the breast cancer recurring.
The surgeon may remove just the tumor, via breast conservation surgery, or the entire breast, if the cancer is large or has been detected in several spots in the milk ducts.
Local Therapy For Breast Cancer
Local therapies treat the tumor, without affecting the rest of the body. Types of local therapy include breast cancer surgery and radiation therapy.
Surgery for Breast Cancer
Surgery involves the removal of the entire tumor from the breast. There are two types of surgery to remove breast cancer:
- Lumpectomy. A lumpectomy, or breast-conserving surgery, removes the tumor and a small area of healthy tissue around the tumor. Most of the breast remains, allowing the breast to look as close to pre-surgery as possible. This is generally an option for women who have early or non-invasive breast cancer.
- Mastectomy. A mastectomy is a surgery to remove the entire breast, along with other nearby tissue. There are several types of mastectomies, based on how the surgery is done and how much additional tissue is removed. This is an option for women who are unable to have radiation therapy or those who have genetic factors that increase the chance of second cancer, among others.
Radiation Therapy for Breast Cancer
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Symptom Signature Of Breast Cancer Individual Symptoms
A total of 2316/2783 of symptomatic women with breast cancer were included in the analysis . Among them, 2543 symptoms were recorded, averaging 1.1 symptoms per woman. A total of 56 distinct presenting symptoms were reported in the study population , in 95 unique phenotypes. Breast lump was the most common symptom, recorded in about four-fifths of all women . The next most commonly reported presenting symptoms were nipple abnormalities , breast pain , and breast skin abnormalities .
Dealing With Visible Side Effects Of Treatment
You may be able to see some of the side effects of breast cancer treatment, and this can take an emotional toll. But thereâs a lot you can do to overcome them, and that can help you feel better.
Breast changes
If you’ve had a mastectomy, you can use an external prosthesis instead of, or before, breast reconstruction surgery. You tuck it into a bra or attach it to your skin with double-sided tape.
If you chose to get one:
- Ask your doctor for a prescription for an external prosthesis. Then, it can usually be covered by insurance.
- Ask your oncologist for referral to a specialized store that sells external prostheses. You may also find them in some lingerie departments.
- Make an appointment with a breast prosthesis consultant and allow yourself about an hour to get fitted.
- Try a variety of them to see which feels and looks the best on you.
Some chemotherapy kills fast-growing cells like hair follicles, whether those cells are cancer or not. Hair loss is different for everyone, and it depends on the type of chemo you’re taking. Radiation and hormonal treatments may also cause this side effect.
If you lose hair from chemo, it’s likely to fall out within 1 to 2 weeks of starting treatment. It may thin or fall out almost all at once. It’s common to lose hair over your whole body, not just on your head. This means you may lose eyelashes and eyebrows as well as arm, leg, and pubic hair.
Here are some other tips that may help:
Arm swelling
Weight gain or loss
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Treatment For Breast Cancer Stages 13
People with stage 1 breast cancer will usually undergo surgery first and then receive radiation therapy. If the cancer is at stage 2 or 3, a doctor will prescribe some drug therapies before surgery.
If a person starts any therapy before surgery, doctors call it neoadjuvant therapy. Any therapy that comes after surgery is called adjuvant therapy.
Some factors affect what treatment a person receives. These include:
- hormone receptors on the cancer cells
- HER2 proteins on the cancer cells
- cancer progression
Drug therapies before and after surgery include:
- chemotherapy
- targeted therapy that targets HER2 proteins
- hormone therapy
A healthcare professional may recommend a combination of the above treatments.
Stage 2 Breast Cancer
Stage 2 breast cancers are larger than stage 1 tumors, and the cancer cells have spread and have been found in a few nearby lymph nodes.
If you are in stage 2, your cancer may be categorized as stage 2A or 2B. The secondary classification is based on the tumors size and spread. Treatment typically starts with breast-conserving surgery or a mastectomy. Your surgeon may remove some lymph nodes to examine the spread of the cancer cells. Radiation is often needed because the cancer has begun spreading to your lymph nodes.
Your care team may recommend systemic therapies, such as chemotherapy, HER2 drugs or hormone therapy, before and/or after surgery.
Pre-surgery treatments may help shrink a tumor enough that it may be removed through a breast conservation procedure.
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Cancer Treatment Premature Menopause And Infertility
About a quarter of the nearly 285,000 women diagnosed with breast cancer in the U.S. each year have not gone through menopause.
Some chemotherapy and hormone therapy drugs that treat breast cancer can cause permanent or temporary infertility or early menopause. Women who havenât yet gone through menopause should use birth control while having these treatments, because some chemotherapy drugs are linked with birth defects.
Chemotherapy-induced menopause happens in 10% to 50% of women younger than 40 and in 50% to 94% of women over 40. After chemotherapy, you may have months or even years of uneven ovarian function.
Radiation therapy wonât cause infertility unless it is directed at both ovaries. Depending on the type and extent of the breast cancer, your ovaries may be surgically removed or radiated to lower the amount of estrogen that your body makes. This will cause permanent infertility.
Women with breast cancer who want to start or expand a family later on should consider options to keep fertility before beginning treatment. These include:
Black Women And Chemotherapy Side Effects
Black women are often more likely to experience chemotherapy side effects, for unknown reasons. Studies show that neuropathynerve damage that can show up as weakness, numbness or throbbing pain, and itching in the hands and feet during chemotherapy treatmentis twice as likely in Black women compared with White women.
Most of the time neuropathy disappears after chemotherapy, but sometimes it can be permanent.
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What Are The Types Of Breast Cancer
The most common types of breast cancer are:
- Infiltrating ductal carcinoma. This cancer starts in the milk ducts of the breast. It then breaks through the wall of the duct and invades the surrounding tissue in the breast. This is the most common form of breast cancer, accounting for 80% of cases.
- Ductal carcinoma in situ is ductal carcinoma in its earliest stage, or precancerous . In situ refers to the fact that the cancer hasn’t spread beyond its point of origin. In this case, the disease is confined to the milk ducts and has not invaded nearby breast tissue. If untreated, ductal carcinoma in situ may become invasive cancer. It is almost always curable.
- Infiltrating lobular carcinoma. This cancer begins in the lobules of the breast where breast milk is produced, but has spread to surrounding tissues in the breast. It accounts for 10 to 15% of breast cancers. This cancer can be more difficult to diagnose with mammograms.
- Lobular carcinoma in situ is a marker for cancer that is only in the lobules of the breast. It isn’t a true cancer, but serves as a marker for the increased risk of developing breast cancer later, possibly in both or either breasts. Thus, it is important for women with lobular carcinoma in situ to have regular clinical breast exams and mammograms.
Stage 4 Breast Cancer
Stage 4 means the breast cancer has spread to other organs or areas of the body, such as the brain, bones, lung and/or liver. In these cases, your team may recommend a systemic therapy such as hormone therapy or chemotherapy, or targeted drugs such as those that block HER2, immunotherapy or some combination of all these options.
Your treatment plan may also include surgery and/or radiation. While this diagnosis may be scary, its important to know that your cancer care team has more tools to treat stage 4 breast cancer than ever before. Make sure to discuss all the options with your doctor.
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Genetics And Family History
Treatment for breast cancer may depend partly on having a close relative with a history of breast cancer or testing positive for a gene that increases the risk of developing breast cancer.
Patients with these factors may choose a preventive surgical option, such as a bilateral mastectomy.
Clinical trials are studies in which patients volunteer to try new drugs, combinations of drugs, and methods of treatment under the careful supervision of doctors and researchers. Clinical trials are a crucial step in discovering new breast cancer treatment methods.
Emerging treatments for breast cancer being studied in clinical trials include:
- PARP inhibitors that block protein used to repair DNA damage that occurs during cell division are being used and tested for TNBC.
- Drugs that block androgen receptors or prevent androgen production are being used and tested for TNBC.
If youre interested, ask your oncologist for information about available trials.
Radiotherapy For Breast Cancer
Radiotherapy uses high energy x-rays to kill cancer cells. You usually have 3 weeks of radiotherapy after having breast conserving surgery. But in some hospitals, you may have this treatment over a shorter time.
Some people might have radiotherapy after a mastectomy. This depends on the stage of the cancer.
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Estrogen Receptor Blockers Estrogen Receptor Blocker Drugs Attach Directly To And Block The Estrogen Receptors On Cancer Cells So That The Cancer Cells Cant Use Estrogen They Do Not Affect The Level Of Estrogen In The Body Estrogen Receptor Blockers Are Also Called Selective Estrogen Receptor Modulators
Tamoxifen
Tamoxifen is the most commonly used anti-estrogen drug. It is used in post-menopausal and premenopausal women. Tamoxifen is given by mouth as a pill.
Tamoxifen is the hormonal therapy drug used most often to lower the risk that DCIS or LCIS will lead to an invasive breast cancer.
Tamoxifen very slightly increases the risk for uterine cancer, deep vein thrombosis and stroke. Doctors will carefully weigh these risks against the benefits of giving this drug before they offer it to women who have a personal or a strong family history of these conditions. Usually the benefits of taking tamoxifen outweigh these risks.
Fulvestrant
Fulvestrant is an anti-estrogen drug that reduces the number of estrogen receptors on breast cancer cells. It is given as an injection into the muscles of the buttocks.
Fulvestrant is used in post-menopausal women if the breast cancer has grown after they were treated with tamoxifen. It is also used in postmenopausal women with locally advanced or metastatic breast cancer that have never been treated with hormonal therapy.
Types Of Available Breast Cancer Treatment Options
The most commonly available breast cancer treatment options include the following:
In addition to external-beam radiotherapy, there are others forms of radiotherapy. When radiation is given in the operating room by using a probe, it is called intra-operative radiation therapy. Brachytherapy is another type of radiotherapy in which radiation is given by placing radioactive substance in-between the tumor. Hypo-fractionated radiation therapy is the radiotherapy in which a higher daily dose of radiation is given to the whole breast so as to shorten the overall length of treatment.
Radiation therapy can be given before or after surgery depending upon the cancer stage. It is called neoadjuvant radiation therapy if radiation is given before surgery and adjuvant radiation therapy if it is given after surgery. It is given as a specific number of treatments over a decided period of time, for example, 5 days a week for 5 to 6 weeks
Systemic Therapy: Systemic therapy is the type of cancer treatment that is given either by mouth or through a vein. In this form of treatment, drugs enter the bloodstream and reach cancer cells to kill them. It is mainly of three types:
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Stage 1 Breast Cancer
If you have stage 1 breast cancer, the tumor is small and has not spread to your lymph nodesor if it has, this spread has only just begun.
Surgery is typically the first choice for stage 1 breast cancer, whether its breast conservation surgery or a mastectomy. Your doctor will likely remove lymph nodes during the surgery to prevent the spread of breast cancer cells. You may be able to opt for breast reconstruction after a mastectomy.
Your doctor also may suggest radiation in addition to the breast conservation surgery, to target cells that may have been left behind and to lower your chances of a recurrence. Radiation is usually not needed after a mastectomy in this stage.
If your cancer is ER-positive or PR-positive, your doctor may recommend hormone therapy as well. It is typically taken for five years to lower the chances of your cancer reoccurring. If your breast cancer is HER2-positive, drugs that block this protein may be prescribed for up to one year.
Chemotherapy may also be an option if your tumor is larger than one cm , growing quickly and/or is hormone receptor-negative, HER2-positive, and has other qualities suggesting its aggressive.
What Are The Options For Breast Cancer Treatment
If youve been diagnosed with breast cancer, your treatment will depend on your test results and type of cancer. Usually, you will have more than one type of treatment and the order will be personalised according to your diagnosis.
- How do oncologists work out the best treatments?
Your specialty team will do a variety of tests to determine what type of cancer you have and how likely it is to respond to various treatment options. Through mammogram, ultrasound, biopsy, microscopic examination, blood tests and other scans, they will work out the stage and the grade . They may understand whether the cancer is resistant to certain treatments, what cancer subtype it is and what its hormone receptor status is.
Genetic and biomarker testing will help determine whether there are any genetic mutations or cancer biomarkers that will show whether one treatment would work better than another. You may like to be involved in deciding on your treatment. Or you may prefer the doctor to advise the best way to go. You may also like to get a second opinion.
You can question your treatment options and make the best decision for you and your family.
Here are some treatment options you may have.
- Treatments for breast cancer
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