Breast Cancer Treatment: Options at Different Stages
According to the Centre for Disease Control, Breast cancer affects around 264,000 women annually in the United States.
Several treatment options are available to manage the disease, depending on the stage and type of cancer.
Breast cancer treatment aims to remove cancer cells and prevent the spread of cancer to other parts of the body.
This article will explore the different breast cancer treatments and the combination therapies performed at different stages.
Surgery
Surgery involves the removal of the tumor and surrounding tissue from the breast.
The main goal of breast cancer surgery is to remove the tumor as much as possible while preserving its appearance.
It prevents cancer from spreading to other body parts or reduces the risk of cancer recurrence.
Several types of surgical procedures may be performed depending on the stage and type of breast cancer.
Mastectomy
Mastectomy is a surgical treatment where the whole breast is removed.
It is primarily performed when the tumor has spread throughout the breast.
Different types of Mastectomy are performed depending on the spread and size of the tumor.
Double Mastectomy is performed in women who opt for or require both breast removal.
Lumpectomy
Lumpectomy, also known as breast-conserving surgery, is the removal of the cancerous lump and a small amount of surrounding tissue from the breast.
It is recommended for women with early-stage breast cancer who have small tumors and whose cancer has not spread to other parts of the breast.
A lumpectomy aims to remove the cancer while preserving the appearance of the breast.
Reconstructive
Breast reconstructive surgery is performed to recreate the shape and size of one or both breasts.
It is performed immediately or a few days after a Mastectomy, Lumpectomy, or other breast cancer treatment involving breast tissue removal.
The procedure involves using various techniques, including implants, tissue expanders, and tissue flaps, to rebuild the breast mound and restore a natural shape.
Chemotherapy
It is a breast cancer treatment that uses special medicines to shrink or kill cancer cells.
The therapy is given orally through pills, intravenously, or directly administered into the spinal fluid surrounding the spinal cord.
Chemotherapy is recommended before the surgery to shrink the size of tumors.
In some cases it is also recommended after the surgery to prevent recurring cancer.
In advanced or metastatic breast cancer, Chemotherapy is given as central treatment.
Hormonal therapy
Breast cancer grows in response to the hormones Estrogen or Progesterone.
Hence, hormonal therapy is aimed at blocking these hormones to slow or stop the growth of cancer cells.
The therapy may be used alone or in combination with other treatments such as surgery, radiation therapy, or Chemotherapy.
This treatment may involve using drugs such as Tamoxifen, prescribed in women before menopause.
Aromatase inhibitors such as Anastrozole(Altraz) or Exemestane (Xtane) are commonly prescribed for postmenopausal women.
Targeted therapy
Targeted therapy triggers the immune system to work against the cancer cells, sparring the healthy cells.
It works by identifying specific molecules or proteins involved in the growth and spread of cancer cells and then using drugs or other treatments to block or inhibit these targets.
Targeted therapies are commonly used for tumors that express specific proteins, such as HER2-positive breast cancer, which overexpresses the HER2 protein.
Radiation therapy
Radiation therapy uses high-energy radiation to kill cancer cells and shrink tumors.
It is often used after Lumpectomy to help destroy any remaining cancer cells and reduce the risk of cancer recurrence.
During the therapy, a machine delivers targeted doses of radiation to the affected breast or chest wall for several weeks.
The treatment is painless, but it may cause some side effects, such as fatigue, skin irritation, and swelling.
Stage-wise Breast Cancer treatment
Breast cancer treatment options may vary at different stages.
There are four stages of breast cancer according to the size, nature, and spread of the tumor.
The treatment options according to the stages of breast cancer are,
Stage 0
Stage 0, or ductal carcinoma in situ, is when the tumor is confined in the milk ducts.
Early treatment like surgery, radiation therapy, or hormone therapy can be performed to prevent cancer from becoming invasive.
Stage 1
This stage comprises two stages, 1A and 1B, and is early invasive breast cancer.
At this stage, as well surgery with radiation or hormone therapy can be recommended.
Stage 2
At stage 2, the tumor increases and can reach up to 5 cm.
The treatment options may include surgery, Chemotherapy paired with another treatment option like radiation or hormonal therapy.
Stage 3
Breast cancer treatment at this stage typically involves an extensive combination of therapies according to the type of cancer.
- Systemic therapy: Chemotherapy, Targeted therapy for HER-2-positive cancer, and hormone therapy for hormone-receptor-positive cancer
- Surgery: If cancer improves through Chemotherapy, surgery is the next step for the treatment. In stage 3 cancer, the tumor has spread throughout the breast. Hence, the entire breast is removed surgically.
- Radiation therapy: Adjuvant radiation, a form of radiation therapy, is used after surgery to lessen the chances of the cancer returning.
Stage 4
Patients with stage 4 breast cancer are commonly treated with systemic therapies.
These systemic therapies may include Chemotherapy, targeted or hormonal treatment.
Pain management
Breast cancer that has spread to other body regions can cause pain in the bones, muscles, and brain and discomfort around the liver.
Doctors may prescribe Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), such as Brufen (Ibuprofen), for mild to moderate pain.
For severe pain in a later stage of cancer, your doctor may recommend an opioid such as Morphine, Hydromorphone, or Fentanyl.
Conclusion
Breast cancer is a severe disease that requires prompt diagnosis and effective treatment to improve patient outcomes.
Several treatment options are available, including surgery, radiation therapy, Chemotherapy, targeted therapy, and hormone therapy.
Each treatment option has its benefits and risks, and the choice of treatment depends on the stage and type of cancer and the patient’s overall health.
Patients must work closely with their doctors to determine the most appropriate treatment plan for their needs.
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