Chemotherapy For Breast Cancer
Chemotherapy uses anticancer drugs to destroy cancer cells. Many women with breast cancer have chemotherapy. Your healthcare team will consider the type of breast cancer you have and your personal needs to plan the drugs, doses and schedules of chemotherapy. You may also receive other treatments to help lessen the side effects of chemotherapy.
Chemotherapy is given for different reasons. You may have chemotherapy to:
- shrink a large tumour before surgery when the cancer hasnt spread outside the breast or lymph nodes
- destroy cancer cells left behind after surgery and reduce the risk that the cancer will come back
- treat cancer that comes back
- relieve pain or control the symptoms of advanced breast cancer
Chemotherapy is usually a systemic therapy. This means that the drugs travel through the bloodstream to reach and destroy cancer cells all over the body, including those that may have broken away from the primary tumour in the breast.
Chemotherapy is generally given every 3 weeks. Sometimes it is given every 2 weeks . Studies have shown that a dose-dense regimen may further lower the risk that breast cancer will come back and it may improve survival.
How Does Radiation Therapy Work
Radiation therapy uses special high-energy X-rays or particles to damage a cancer cells DNA. When a cancer cells DNA is damaged, it cant divide successfully and it dies.
Radiation therapy damages both healthy cells and cancer cells in the treatment area. Still, radiation affects cancer cells more than normal cells. Cancer cells grow and divide faster than healthy cells and also are less organized. Because of this, it’s harder for cancer cells to repair the damage done by radiation. So cancer cells are more easily destroyed by radiation, while healthy cells are better able to repair themselves and survive the treatment.
The treatment area may include the breast area, the lymph nodes, or another part of the body if the cancer has spread.
Radiation treatments are carefully planned to make sure you receive the greatest benefits and the fewest side effects possible.
- Brachytherapy/Internal Radiation
- Internal radiation, called brachytherapy by doctors, uses a radioactive substance sealed in seeds or tiny tubes that are placed inside your body directly into the cancer or the place where the cancer was. Read about brachytherapy.
Another type of radiation therapy, called intraoperative radiation therapy, is a type of partial-breast radiation. With intraoperative radiation therapy, the entire course of radiation is delivered at one time during breast cancer surgery. Read more about intraoperative radiation therapy.
What Diagnosis Requires Chemotherapy
When considering the right treatment for you, Dr. Gorman will take into account the stage and characteristics of the diagnosis.
Chemotherapy generally begins after surgery to rid the body of any cancerous cells. However, if the tumor is at an advanced stage, Chemo may be used to reduce the size before removing it.
Below is a list of the various stages of breast cancer and what might be expected:
Early Stage Breast Cancer
In early stages, chemo is necessary if:
- Cancer has spread to the lymph nodes.
- Test results are hormone-receptor-negative and HER2 positive.
Advanced Stage Breast Cancer
Advanced stages are treated with chemo to destroy cancerous cells. Chemo medicines run throughout the entire body and are beneficial in killing cells that have spread to other areas, known as Metastatic cancer.
Many Chemotherapy medicines are available, and Dr. Gorman and your medical oncologist will determine the right medication for you based on your specific needs.
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Sex Contraception And Pregnancy
You can still have sex during treatment. Its thought that chemotherapy drugs cant pass into vaginal fluids or semen, but this cant be completely ruled out as chemotherapy drugs can pass into the blood and some other body fluids. Most treatment teams will advise using barrier methods of contraception, such as condoms during treatment, and for a few days after chemotherapy is given.;
If you havent been through the menopause, its important to use contraception because chemotherapy drugs can harm a developing baby in the first three months of pregnancy. Its still possible to become pregnant even if your periods become irregular or stop completely.
Your specialist will usually recommend barrier methods of contraception, such as condoms. The contraceptive pill is not usually recommended because it contains hormones. Emergency contraception such as the morning after pill can still be used.
An interuterine device can be used as long as its not the type that releases hormones. If you have a coil in place that does release hormones, such as the Mirena or Jaydess, when youre diagnosed, you may be advised to have this removed.
Find out more about how breast cancer and its treatment can affect;sex and intimacy;and read our;tips on how to manage these changes.
Many With Early Breast Cancer May Not Need Chemo
HealthDay Reporter
SUNDAY, June 3, 2018 — A majority of women with an early form of a common breast cancer may be able to skipchemotherapy, depending on the results of a comprehensive gene test.
The new study of nearly 7,000 women found that use of the already available Oncotype DX gene test could pinpoint those women who needed chemotherapy, and those who did not.
The women had a specific type of breast tumor known as “hormone receptor-positive, HER2-negative, and axillary node-negative.”
The findings could be a game-changer in breast cancer care, researchers and experts said.
“Half of all breast cancers are hormone receptor-positive, HER2-negative, and axillary node-negative,” noted study author Dr. Joseph Sparano, who helps direct clinical research at the Albert Einstein Cancer Center in New York City.
“Our study shows that chemotherapy may be avoided in about 70 percent of these women when its use is guided by the test, thus limiting chemotherapy to the 30 percent who we can predict will benefit from it,” Sparano said in a news release from the American Society of Clinical Oncology .
His team is scheduled to present the study findings Sunday at the ASCO annual meeting, in Chicago, and the study is also being published simultaneously in the New England Journal of Medicine.
One oncologist agreed that the “highly anticipated” findings could transform care.
New England Journal of Medicine
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What Does It Mean To Have Stage 1 Breast Cancer
In Stage 1 breast cancer, cancer is evident, but it is contained to only the area where the first abnormal cells began to develop. The breast cancer has been detected in the early stages and can be very effectively treated.
Stage 1 can be divided into Stage 1A and Stage 1B. The difference is determined by the size of the tumor and the lymph nodes with evidence of cancer.
Breast Cancer: Types Of Treatment
Have questions about breast cancer? Ask here.
ON THIS PAGE: You will learn about the different types of treatments doctors use for people with breast cancer. Use the menu to see other pages.
This section explains the types of treatments that are the standard of care for early-stage and locally advanced breast cancer. Standard of care means the best treatments known. When making treatment plan decisions, you are strongly encouraged to consider clinical trials as an option. A clinical trial is a research study that tests a new approach to treatment. Doctors want to learn whether the new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug and how often it should be given, a new combination of standard treatments, or new doses of standard drugs or other treatments. Some clinical trials also test giving less treatment than what is usually done as the standard of care. Clinical trials are an option to consider for treatment and care for all stages of cancer. Your doctor can help you consider all your treatment options. Learn more about clinical trials in the About Clinical Trials and Latest Research sections of this guide.
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Targeted Therapy For Breast Cancer
Targeted therapy refers to a variety of drugs that enter the bloodstream and treat cancer throughout the body. Targeted therapy drugs aim to attack cancer cells without harming healthy cells, and tend to have fewer side effects than chemotherapy drugs.
Targeted therapies are often used to treat HER2-positive breast cancers. These are cancers that have an excess of a protein called HER2 that promotes the growth of cancer cells.
Common targeted therapy drugs for HER2-positive breast cancers include:
- Monoclonal antibodies like trastuzumab are synthetic antibodies designed to attach to HER2 proteins and stop cells from growing.
- Antibody-drug conjugates like ado-trastuzumab emtansine attach to HER2 proteins on cancer cells and help chemotherapy reach them.
- Kinase inhibitors like Lapatinib block HER2 proteins.
Targeted therapies are also used to treat hormone receptor-positive breast cancer along with hormone therapy.
Common targeted therapy drugs for people with hormone receptor-positive cancers include:
- CDK4/6 inhibitors, which block CDK proteins in cancer cells to stop them from dividing and slow cancer growth.
- mTOR inhibitors, which block mTOR proteins in cancer cells to stop them from dividing and growing. This treatment is believed to help hormone therapy drugs work more efficiently.
- PI3K inhibitors, which block the PI3K proteins in cancer cells and helps prevent them from growing.
Common targeted therapy drugs for people with TNBC include:
Its Not Like The Movies
Lets just debunk this myth right now. Sitting in the chemo chair is not like the movies. At least not the ones that I have seen, where youre sitting right next to someone else getting chemo. Its also not like the newest episode of New Amsterdam where Max gets chemo and is sitting there playing cards with his chemo friends. I was like, Oh cool, maybe Ill make friends like he did.
But honestly yall, Im glad it isnt like the movies. I wasnt sure if I was going to feel up to entertaining or making friends with others. This is completely new to me and I wanted to tackle this by myself, no social strings attached! My sister, husband, and one close family friend are the only people who come with me to my treatments.
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Ovarian Ablation Or Suppression
In women who have not;yet experienced the menopause, oestrogen is produced by the ovaries.
Ovarian ablation or suppression stops the ovaries working and producing oestrogen.
Ablation can be done using surgery or radiotherapy. It;permanently stops the ovaries from working and means you’ll experience the menopause early.
Ovarian suppression involves using a medicine called goserelin, which is a luteinising hormone-releasing hormone agonist .
Your periods will stop while you’re taking it, although they should start again once your treatment is complete.
If you’re;approaching the menopause , your periods may not start again after you stop taking goserelin.
Goserelin comes as an injection you have once a month.
Feeling Unwell Or Tired
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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What Are Chemotherapy And Targeted Therapy In Her2
Chemotherapy involves the use of anticancer medications that kill cancer cells present in any part of the body. The medications can be given in the form of intravenous therapy or as oral pills. It is given in cycles of two to three weeks for three to six months. The total period and the type of medications depend on how well you tolerate the therapy. There is a gap between two cycles to recover from the chemotherapy.
Targeted therapy in HER2-positive cancer refers to the drugs directed at HER-2 proteins or receptors. Hence, it is also known as HER2-directed therapy. The therapy is typically initiated after the course of chemotherapy is completed.
Where To Find Breast Cancer Treatment Near Me
Breast cancer patients should consult with their doctors and specialists to determine the best options for treatment. Neoadjuvant therapy may work best for some patients but others may require more traditional chemotherapy after their mastectomy. No matter what type of breast cancer they have, all patients need a customized therapy to avoid undertreatment or overtreatment. Your doctor or specialist can put together the right therapy and treatment options to provide you the best possible outcome.
For lab work and consultation about breast cancer and surgery options, get in touch with the BASS Medical Group experts. We offer laboratory exams that can determine your cancer diagnosis and provide other types of medical assistance as needed. Contact us today for more details.
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Who Is A Good Candidate For Neoadjuvant Therapy
Patients should meet a few requirements to be a candidate for neoadjuvant therapy. The size of the tumor, the type of breast cancer they have, and whether lymph nodes are involved are all things a doctor will consider before suggesting this form of treatment. Some forms of breast cancer are more likely to respond well to neoadjuvant therapy.
Unless a tumor is small and there is no lymph node involvement, most patients who have eitherHER2-positive breast cancer or triple-negative are good candidates for using chemotherapy either before or after their mastectomy.
With the best outcomes, this therapy can eliminate all visible tumors from the breast and produce what is known as a pathologic complete response to the treatment. That means the doctor will find no trace of the invasive tumor in the breast or the lymph nodes after the patient has received treatment.
Women who have estrogen receptor-positive breast cancer, which is the most common type, may not be good candidates for neoadjuvant therapy. Instead, these patients may benefit from anti-estrogen treatment to help shrink their tumor before surgery.
What Are The Types Of Breast Cancer Treatment
Some treatments remove or destroy the disease within the breast and nearby tissues, such as lymph nodes. These include:
Surgery. For most people, the first step is to take out the tumor. An operation called lumpectomy removes only the part of your breast that has cancer. Itâs sometimes called breast-conserving surgery. In a mastectomy, doctors remove the whole breast. There are different types of mastectomies and lumpectomies.
Radiation therapy. This treatment uses high-energy waves to kill cancer cells. Most women under age 70 who have a lumpectomy get radiation, too. Doctors also might recommend this method if the disease has spread. It helps destroy any cancer cells that the surgeon couldnât remove. Radiation can come from a machine outside your body, or you might have tiny seeds that give off radiation placed inside your breast where the tumor was.
Other treatments destroy or control cancer cells all over your body:
Chemotherapy uses drugs to kill cancer cells. You take the medicines as pills or through an IV. Most people get it after surgery to kill any cancer cells left behind. Doctors also prescribe it before surgery to make tumors smaller. Chemo works well against cancer, but it also can harm healthy cells.
Immunotherapy uses your own immune system to target cancer. The drugs atezolizumab and sacituzumab govitecan-hziy have been approved to treat triple-negative breast cancer that has spread.
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Is Chemotherapy Necessary Before Or After Breast Cancer Surgery Or At All
A recent study found that breast cancer has been highly over treated with chemotherapy and doctors can now confidently provide an alternative treatment known as Endocrine Therapy.
However, each patient is different with a unique set of circumstances. Chemotherapy is necessary in advanced stages, as well as early stages when specific characteristics are present, such as spreading to the lymph nodes or other body parts.
Screening For Breast Cancer
Women aged between 50 and 74 are invited to access free screening mammograms every two years via the BreastScreen Australia Program.
Women aged 40-49 and 75 and over are also eligible to receive free mammograms, however they do not receive an invitation to attend.
It is recommended that women with a strong family history of breast or ovarian cancer, aged between 40 and 49 or over 75 discuss options with their GP, or contact BreastScreen Australia on 13 20 50.
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Why Might Your Doctor Recommend Chemotherapy
Your doctor might recommend chemotherapy after surgery if:
- You are younger than 35. Women younger than 35 usually have a more aggressive type of breast cancer.
- Your breast cancer was bigger than a pea. Breast cancers that are at least 1 cm are more likely to come back later.
- Your breast cancer has spread to the lymph nodes under your arm. If that’s the case, there is a bigger chance that the cancer may also have spread to other places in your body.
- Your breast cancer is HER-2 positive or triple-negative. These types of cancer tend to grow faster and spread more quickly.
Your doctor may use a genetic test to find your risk for having your cancer come back. This information can help you and your doctor decide about chemotherapy.
Treating Stage Iii Breast Cancer
In stage III breast cancer, the tumor is large or growing into nearby tissues , or the cancer has spread to many nearby lymph nodes.
If you have inflammatory breast cancer: Stage III cancers also include some inflammatory breast cancers that have not spread beyond nearby lymph nodes. Treatment of these cancers can be slightly different from the treatment of other stage III breast cancers. You can find more details in our section about treatment for inflammatory breast cancer.
There are two main approaches to treating stage III breast cancer:
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