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.
Meeting Your Breast Surgeon
Typically, your first appointment will be with one of our fellowship-trained breast surgeons at Valley-Mount Sinai Comprehensive Cancer Care within 1-3 days of your call or referral.
During this visit we will:
- Review your medical history and perform a physical exam
- Discuss evidence-based recommendations for treatment
- Finalize your treatment plan
Our providers take special care to allow you unrushed time to understand all the information covered in this discussion. We are here to provide an evidence-based treatment plan based your diagnosis. These options could include lumpectomy or mastectomy using advanced oncoplastic methods.
Your nurse navigator will provide you with an educational binder that will help you organize your next steps. The binder contains important information, phone numbers and space to keep your medical reports.
After this visit, your treatment plan may require additional testing, such as imaging and/or biopsies . You may also need additional consultationssuch as for genetic counseling or fertility services. If so, our nurse navigator will help you coordinate those appointments.
What Is Breast Reconstruction
Breast reconstruction may help restore the look and feel of the breast after a mastectomy. Many women who have had a breast removed opt for breast reconstructionin some limited cases, at the same time as the mastectomy, but more often after the mastectomy procedure. With immediate reconstruction, a surgeon performs the first stage to rebuild the breast during the same operation as the mastectomy. A method called skin-sparing mastectomy may be used to save enough breast skin to cover the reconstruction.
Breasts may be rebuilt using saline implants or autologous tissue . Most breast reconstructions performed today use breast implants. For some reconstructions, more than one surgery may be needed.
Mastectomy with reconstruction done on the same day is an option for many women, but the best approach for an individual should be determined through a discussion of various options between the patient and her surgeon.
The decision to have reconstruction is a personal one. Some women choose not to have reconstruction. Others believe it helps their appearance and recovery.
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A Few Questions And Answers
What types of cancers do oncologists diagnose and treat?
Basically an oncologist will treat all types of cancers, although many will specialise in one particular area. These include:-
- Brain tumors
- Tumors of the head and neck
- Sarcomas
In brief, can you re-cap the role of the oncologist?
An oncologist should be there for every step of the process following a cancer diagnosis.
Firstly, an oncologist plays a vital role in the actual diagnosis of cancer in a patient . Secondly, they play a vital role in treatment and therapy. For example, surgery, chemotherapy, radiotherapy and medications. Thirdly, an oncologist is involved with the follow-up of cancer patients to assess the efficacy of treatment.
Finally, in some cases, the oncologist will be part of the palliative care of patients with terminal malignancies.
Most importantly, the oncologist explains all aspects of care and supports a patient through this very difficult time. Ultimately, the oncologist is responsible for giving the best possible care and treatment for cancer patients.
What investigations will I have to diagnose cancer
Well, investigations needed for the diagnosis will very much depend on the location of the cancer.
Below are some common investigations:-
- Biopsy or resection,
- Endoscopy
Chemotherapy And The Oncologist
A medical oncologist plays an important role in the treatment of breast cancer.
Furthermore, the oncologist chooses, prescribes and administers chemotherapy. Chemotherapy is usually taken orally in the form of a prescription drug.
The oncologist has a good clinical and scientific knowledge of all the different types of breast cancer.
Furthermore, the oncologist has a strong understanding of the risk of recurrence, and the overall prognosis for any given presentation of breast cancer.
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What To Expect At The Surgical Oncologist
Before a biopsy or surgery, you meet with a surgical oncologist to discuss options and learn about procedures. Your surgical oncologist will determine if a biopsy or cancer surgery is a good fit for you and if specialty procedures are necessary.
If you will be getting a biopsy, your preparation will depend on the kind of biopsy you are having. The surgical oncologistâs office will let you know what to do to prepare and can answer questions you have about the procedure.
If surgery is necessary, a nurse may contact you with instructions on how to prepare for surgery. The nurse will let you know if additional tests such as blood tests are necessary before surgery.
Following surgery, you will be given instructions regarding:
- Pain management
How Is Medical Oncology Involved In Breast Cancer Treatment
Optimal breast cancer management is complex, specialized and requires a multidisciplinary approach from many specialists, including medical oncology, radiation oncology, surgery, pathology, radiology, genetic counseling, nurses and more. These specialists collaborate to review each patients case to develop a treatment strategy that follows evidence-based guidelines and considers the patients individual needs.
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Questions To Ask The Medical Oncologist
Were Her2 Tests Performed On My Tissue Sample
HER2 is a type of growth signal receptor, or antenna that may be present on your breast cancer cells. About 25 percent of breast cancers are HER2-positive, meaning the cancer cells make too much of a protein called HER2/neu, which indicates that the cancer may be more aggressive. If your cancer is HER2-positive, this helps doctors better predict whether the cancer may respond to certain targeted therapies.
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Should Breast Cancer Patients Have Their Lymph Nodes Removed
Lymph nodes are small glandular structures that filter tissue fluids. They filter out and ultimately try to provide an immune response to particles and proteins that appear foreign to them. There are thousands of these nodes scattered in groups throughout the body. Each cluster is more or less responsible for the drainage of a particular region of the body.
The lymph nodes under the arm are the dominant drainage recipients from the breast. When cancer cells break free from breast cancer, they may travel through the lymph tubes to the lymph nodes. There, the cancer cells may establish a secondary growth site. The presence of cancer cells in the lymph nodes proves that cancer cells have traveled away from the primary breast tumor. Therefore, the presence or absence of cancer cells in these regional nodes is an important indicator of the future risk of recurrence. This information is often important in making decisions about whether to use chemotherapy and what type of chemotherapy should be employed.
Unfortunately, removal of the lymph nodes also carries a potential risk of lymphedema, a condition that may cause the arm to swell. Lymphedema can occur early after surgery or many years later. It can be a difficult and disabling condition. Here again, there are tradeoffs in risk. When more lymph nodes are removed, more accurate information about tumor spread is obtained and the chance for tumor recurrence is less. But there is a greater incidence of lymphedema.
Will I Need Surgery And What Kind Should I Have
This is an important question but the answer may be less than definitive. It will vary from patient to patient and you may have more than one choice.
According to the American Cancer Society, most women with breast cancer have some type of surgery. But some breast cancers cant initially be surgically removed. In other cases, whether to operate and the type of surgery may depend on the cancers stage, the tumors size and location, the size of your breast and your personal preference.
In women whose breast cancers are operable, the choices are breast-conserving surgery or mastectomy. Mastectomy is the removal of most or all breast tissue and possibly nearby lymph nodes. Within each of those two broad categories are further options. Talk with your oncologist and breast surgeon. If you have any doubts, you may choose to seek a second opinion.
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What Is Inflammatory Breast Cancer
Considered a rare disease, inflammatory breast cancer typically forms in the soft tissues, blocking lymph vessels in the breast skin. Thatâs why the breast often becomes firm, tender, itchy, red and warm, from the increase in blood flow and a build-up of white blood cells. IBC differs from other forms of breast cancer, especially in symptoms, prognosis and treatment. The term inflammatory is not meant to reflect whatâs happening inside the breast, only in how the breast appears. When an infection or injury causes the breasts to become inflamed, they often become tender, swollen, red and itchy, but the underlying cause is not inflammation.
The Oncologist Treatment And Clinical Trials
In more advanced-stage breast cancers, treatment will most likely involve the use of chemotherapy. Chemotherapy is also given for early breast cancers pre-surgery and is not just prescribed for advanced breast cancers.
It is mainly large drug companies that create clinical trials. Trials test new treatments and chemotherapy.
However, dedicated cancer clinics and university-affiliated hospitals are often also research-oriented.
This is generally a good thing because oncologists who follow and participate in clinical trials will be up-to-date on the latest research information and science.
This is important because reports on breast cancer clinical trials on the internet are often up to five years behind current research. Your oncologist should know all the latest information.
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Choose An Oncologist Today
If you have a cancer diagnosis, it is important for you to visit the oncologist soon. Knowing more about the initial consultation will help you better prepare. Bringing along a friend or family member can help make this difficult time easier. Contacting an oncologist is your first step toward treatment.
Get more information here: or call Lindenberg Cancer & Hematology Center at
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Should I Consider Genetic Testing
Genetic testing may help determine if your cancer resulted from an inherited gene mutation. Genetic counseling may help you understand the risks, benefits and limitations of genetic testing in certain situations. A genetic counselor, doctor or other health care professional trained in genetics may help you and your family understand your test results and other findings, such as a genetic risk factor for another disease like diabetes or heart conditions.
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Lifestyle Modifications And Secondary Prevention Of Breast Cancer
Although we cant prevent cancers, you can implement the following lifestyle habits to lower the risks of first and second breast cancer. For example, you can:
- Avoid smoking.
- Exercise and avoid prolonged sitting.
- Avoid drinking alcohol.
- Follow a healthy diet.
In addition, we can perform tests to help us detect cancers in their early stages, or before you start experiencing any symptoms. We refer to these tests as secondary prevention of breast cancer. These include:
Mammograms: If you dont have any symptoms, you can get a screening mammogram to look for early signs of breast cancer. You can get a diagnostic mammogram if you have breast cancer symptoms or your doctor has seen a change on the screening mammogram. Diagnostic mammograms can treat women who have received a breast cancer diagnosis in the past.
Ultrasonography: Breast ultrasounds can indicate whether there are any breast changes and fluid-filled cysts that we cant see on a mammogram. They can be helpful in identifying cysts that can be cancerous.
Magnetic Resonance Imaging : If you have a high risk of developing breast cancer, we may recommend getting the usual annual mammograms and a screening MRI. You can also get a breast MRI if you have been diagnosed with cancer, as this helps us to determine the size of the cancer.
Roles Of Your Treatment Team
Treatment of breast cancer involves a team of many different specialists.
Surgical oncologist – This doctor performs surgery to remove cancerous tumors from the body. He or she also provides expertise on biopsy techniques, imaging guidance, and what role, if any, for surgery to aid in the treatment of more advanced disease.
Medical oncologist – This doctor is responsible for ordering tests to determine the grade and stage of the breast cancer. He or she also makes evidence-based decisions regarding type, and duration of chemotherapy, hormone therapy, and targeted biologic therapy to treat the cancer.
Radiation oncologist – This doctor applies radiation to treat cancer. Using an evidence-based approach, he or she is responsible for recommending, prescribing and supervising therapeutic radiation.
Nurses – Nurses provide cancer care to patients in a variety of settings, including the cancer treatment centre, hospitals and the community. They are the central point of contact for the patient throughout diagnosis and treatment, and they facilitate quality, timely care. The role of the nurse will be different at each cancer treatment centre and may include navigation, accompaniment, referrals, health education, and counselling. The role of the nurse is to understand the health needs of clients and make sure that they receive optimal care.
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Getting To Know The Patient
The oncologist is concerned about the patients welfare and wants the person to feel comfortable. The doctor will go over the patients concerns and answer any questions the patient may have about the impending treatment and procedures. The two will have a conversation about the patients goals and needs. They will also discuss any anxiety and fears the person may have. It may also be helpful for the oncologist to know the patients hobbies, interests, work and family.
Surgery For Breast Cancer
Most women with breast cancer have some type of surgery as part of their treatment. There are different types of breast surgery, and they may be done for different reasons, depending on the situation. For example, surgery may be done to:
- Remove as much of the cancer as possible
- Find out whether the cancer has spread to the lymph nodes under the arm
- Restore the breasts shape after the cancer is removed
- Relieve symptoms of advanced cancer
Your doctor may recommend a certain operation based on your breast cancer features and your medical history, or you may have a choice about which type of surgery to have. Its important to know your options so you can talk about them with your doctor and make the choice that is right for you.
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If The Cancer Comes Back
If cancer does return, your treatment options will depend on where it comes back, what treatments you’ve had before, and your current health and preferences. For more information on how recurrent cancer is treated, see Treatment of Recurrent Breast Cancer.
Its important to know that women who have had breast cancer can also still get other types of cancer. In fact, women who have had breast cancer are at higher risk for certain other cancers. Because of this, its important to follow the American Cancer Society guidelines for the early detection of cancer, such as those for colorectal cancer and cervical cancer. To learn more about the risks of second cancers and what you can do about them, see Second Cancers After Breast Cancer.
Chemotherapy For Breast Cancer
Chemotherapy uses anti-cancer drugs that may be given intravenously or by mouth. The drugs travel through the bloodstream to reach cancer cells in most parts of the body. Sometimes, if cancer spreads to the spinal fluid, which surrounds and cushions the brain and spinal cord, chemo may be given directly into in this area .
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