Breast cancer. It's the diagnosis virtually all women fear, and understandably so. Breast cancer strikes one of every eight women in this country and almost everyone knows someone who has been diagnosed with this disease.
However, with early diagnosis and advances in treatment, breast cancer can be treated successfully and, in many cases, cured.
At first, the treatment options can seem scary and confusing. Your surgeon or oncologist should be able to explain individual treatment recommendations in detail, but here is a brief outline of how breast cancer is generally treated.
Surgery is usually the first line of treatment for breast cancer unless the tumor is very large or has spread to other parts of the body, in which case chemotherapy may be needed first. The surgical options for breast cancer include breast-conserving surgery (also called lumpectomy or partial mastectomy) and mastectomy. Lumpectomy removes the tumor and some surrounding normal breast tissue, whereas mastectomy removes the entire breast. Which option is best depends on tumor size, breast size, and personal preference, as well as other aspects of the medical history. If mastectomy is performed, breast reconstruction can be done during the same surgery or at a later time.
During the lumpectomy or mastectomy, some of the lymph nodes in the armpit will likely be removed to determine if the cancer has spread (lymph nodes in the underarm are the first place breast cancer spreads). For early breast cancers, sentinel lymph node biopsy is a technique in which the lymph nodes that first drain the breast are identified and sampled. If cancer is not found in the "sentinel" nodes, no additional lymph nodes need to be removed. This has the advantage of faster recovery and less risk of lymphedema (swelling of the arm).
Radiation treatment is almost always used after lumpectomy, and may be used after mastectomy, to help decrease the risk of recurrence. High energy X-rays are used to treat the breast and sometimes the armpit. Radiation treatment is usually very well tolerated and has few side effects.
Chemotherapy, often given after surgery, uses anti-cancer drugs given either intravenously or by mouth. These drugs enter the bloodstream and target the cancer cells wherever they are in the body. Unfortunately, many of these drugs are not completely selective for cancer cells. When they act on other cells, such as cells lining the intestine or hair follicles, side effects like nausea and hair loss can result. The good news is that most of these side effects go away when chemotherapy is completed. Major strides have been made in developing drugs that have fewer side effects and treat the cancer more effectively.
Sometimes hormone therapy will be recommended as an additional treatment. These drugs are really "anti-hormones" which block the growth effect that estrogen may have on breast cancer cells. The side effects from these drugs are usually minimal, but they are not suitable for everyone.
Specific treatment recommendations may vary, depending on each patient's circumstances. When patients have questions about their treatment plan, they should ask their surgeon or oncologist to explain the reasons more thoroughly. The American Cancer Society is also an excellent resource for additional information.