A Guide to Treatment for Breast Cancer

A Guide to Treatment for Breast Cancer

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Breast cancer is treated in a variety of ways, and each stage of the disease is addressed. The majority of patients require a cocktail of two or more therapies.

Following diagnosis, your doctor will determine the stage of your cancer. They’ll choose the finest therapy options based on your condition, as well as other factors such as age, family history, hereditary mutation status, and personal medical background.

Early-stage breast cancer therapies may not be helpful in advanced cases.

Breast cancer surgery

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Treatment for breast cancer varies, and it is offered at every stage of the disease. The majority of individuals require a combination of two or more therapies.

Your doctor will determine the stage of your cancer following diagnosis. After determining your treatment options, they will choose the finest therapy choices based on your condition, as well as other criteria such as age, family history, genetic abnormality status, and personal medical history.

Early-stage breast cancer treatments may not be beneficial for advanced-stage disease.

The vast majority of women who have breast cancer will have surgery to remove cancer cells or tumors from their breasts and other afflicted regions.

Lumpectomy and mastectomy are the two most common surgical procedures for breast cancer. The option to utilize is determined by a number of variables, including:

  • Tumors can be benign or malignant, and some may be quite large. Personal preference plays a role in tumor size and location. Genetic predisposition is another aspect to consider.

At the time of surgery, a lymph node biopsy is usually conducted.

Mastectomy

The surgical removal of the entire breast is known as a mastectomy. It’s necessary if cancer is discovered throughout the breast. Some patients will have a double or bilateral mastectomy, in which both breasts are removed. Surgery to rebuild the breast may be done at any time following the mastectomy or after.

Lumpectomy

The surgeon removes the cancerous cells and preserves the rest of the breast during a lumpectomy, also known as breast-conserving surgery. It’s an option if the disease is localized to one part of the breast. An outpatient lumpectomy may be done. This means you can go home immediately after surgery and won’t have to remain in a hospital overnight.

Reconstructive

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A plastic surgeon uses an artificial implant or a flap of tissue from another part of the body to form a breast shape in breast reconstruction surgery. Breasted reconstructive surgery is generally performed immediately following a mastectomy or lumpectomy, although it may also be done months or years later. Prosthetic reconstruction and tissue flap restoration are the two types of reconstructive operations.

A plastic surgeon uses an artificial implant filled with salt or silicone to create the form of a breast in prosthetic restoration. A tissue flap procedure is performed by a plastic surgeon who transplants tissue from different parts of your body, such as your stomach, back, thighs, or buttocks, to restore the shape of your breasts.

Radiation therapy

Radiation therapy is a form of targeted therapy that uses high-energy X-rays to destroy cancer cells and prevent them from spreading. It’s usually given in the early phases of breast cancer, following lumpectomy for stage 0 breast cancers, and may be combined with other therapies. This therapy has been found to lower the risk of cancer recurrence. Radiation treatment is typically given 5 days per week for 5 to 7 weeks spread over 5 to 7 weeks.

Chemotherapy

Chemotherapy is a kind of cancer therapy that aims to destroy cancer cells throughout the body using strong medicines. It’s generally given intravenously or orally as a pill, but it can also be given directly into the spinal fluid surrounding the spinal cord. not everyone who has breast cancer requires chemotherapy. It’s usually advised prior to surgery to minimize tumor size, making surgery easier to perform, or after surgery to eliminate any remaining cancer cells.

Chemo is also a common component of the therapy for advanced, metastatic breast cancer that has spread throughout the body. It’s being used as a core treatment in those with advanced, metastatic breast cancer who have progressed to other parts of their bodies.

There are several chemotherapy treatments for breast cancer, including:

  • docetaxel (Taxotere)
  • doxorubicin (Adriamycin)
  • cyclophosphamide (Cytoxan)

You might be given a combination of several chemotherapy medications.

Chemo is a powerful cancer therapy that kills rapidly dividing cells. Chemotherapy medications are generally given via an IV or injection at a doctor’s office, hospital, or infusion center. To give your body time to recover between cycles of chemotherapy, they’re usually given in cycles of 2 to 3 weeks with a rest period in between.

The length of chemotherapy treatment is determined by the efficacy of the therapy and your body’s tolerance to it.

Hormone therapy for breast cancer

Breast cancer is usually hormone-receptor-positive. Breast cancer cells thrive by adhering to hormones such as estrogen and progesterone. Hormone therapy, commonly known as an endocrine treatment, prevents these hormones from interacting with the tumor cells, halting their spread.

Hormone therapy is a treatment that aims to alter hormones levels and prevent estrogen from connecting with cancer cells. There are several types of hormone therapy, but the majority aim to change estrogen levels and prevent them from attaching to cancer cells.

Hormone therapy is often used after surgery to decrease the chance of cancer returning, but it may also be used before surgery. It’s a long-term treatment that lasts between 5 and 10 years.

Targeted therapy for breast cancer

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A form of chemotherapy called “targeted therapy” is used to destroy all cancer cells in the body. Targeted therapy medicines go after cancer cells throughout the body rather than just one or a few at a time, and they are less hazardous than traditional chemotherapy.

HER2-positive breast cancers are frequently treated with targeted therapies. These are tumors that contain an excess of the protein HER2, which encourages tumor cell growth.

The following are some of the most common targeted treatment drugs for HER2-positive breast cancers:

  • Monoclonal antibodies, such as trastuzumab (Herceptin), are man-made proteins that target and bind to HER2 proteins in order to prevent cells from proliferating.
  • Antibody-drug conjugates such as ado-trastuzumab emtansine (Kadcyla or TDM-1) bind to HER2 proteins on cancer cells, allowing chemotherapy to reach them.
  • HER2 protein-targeted cancer therapies, such as Lapatinib (Tykerb), inhibit the activity of these enzymes.

At the same time, endocrine therapy has also been used to treat hormone receptor-positive breast cancer.

Biomarkers that can be used to predict a person’s response to therapy. The following are examples of targeted therapy medicines for people with hormone receptor-positive tumors:

  • Giving the disease a boost is an exciting possibility. The drug, which works through stimulating BRCA1/2, has been found to be effective against several types of cancer. GDC-0131 and EKB-5351 are CDK4/6 inhibitors that block CDK proteins in cancer cells and limit their growth.
  • His lab is developing molecules that target mTOR in cancer cells to prevent them from dividing and growing. This therapy is expected to improve the effectiveness of hormone therapy drugs.
  • A compound that inhibits the PI3K enzymes in cancer cells, which helps to keep them from growing.

TNBC is a form of breast cancer that is neither HER2 positive nor hormone-receptor positive. As a result, it does not respond to

The following is a list of targeted therapy medications that may be used to treat TNBC

  • Chemotherapy drugs are linked to antibodies that bind to proteins in breast cancer cells and allow them to be reached.

Breast cancer treatment by stage

Stage 0 (DCIS)

Noninvasive breast cancer (NIC) or ductal carcinoma in situ (DCIS) is the term used to describe cancer within the milk duct, which has not yet metastasized.

Stage 0 breast cancer can become invasive and spread throughout the ducts. Early treatment can prevent you from getting invasive breast cancer. Surgery, such as a lumpectomy and mastectomy, followed by radiation may be used to treat early disease.

Stage 1

Stage 1A breast cancer is diagnosed when the primary tumor is 2 centimeters or less and the axillary lymph nodes are unaffected. In stage 1B, cancer has been discovered in lymph nodes and the tumor isn’t in the breast or its size is less than 2 centimeters.

The first and second stages of invasive breast cancer are known as 1A and 1B. Surgery, along with one or more additional treatments such as radiation or hormone therapy, may be required.

Stage 2

In stage 2A, the tumor is less than 2 centimeters in size and has spread to between one and three nearby lymph nodes. It’s also between 2 and 5 centimeters in diameter, but it hasn’t metastasized.

Stage 2B refers to a tumor that is between 2 and 5 centimeters in size and has spread to one or more nearby lymph nodes. It may also be bigger than 5 centimeters and have yet to spread to any lymph nodes.

You’ll most likely need a combination of surgery, chemotherapy, and one or more of the following: targeted therapy, radiation, or hormone treatment.

Stage 3

  • The treatments for stage 3 are usually a combination of therapies, such as
  • Hormones are sometimes used in combination with other treatments. Chemotherapy, targeted therapy for HER2-positive tumors, and hormone therapy for hormone receptor-positive tumors are all examples of systemic therapies.
  • The goal of breast cancer treatment is to cure the disease. Breast cancer surgery involves removing the entire breast, either completely or in part, through a modified radical mastectomy as an alternative to treating IBC with chemotherapy. If cancer responds to chemotherapy, surgery may not be possible; instead, other chemotherapies or radiation therapy will be used.
  • Chemo. Chemotherapy is a treatment that stops or destroys cancerous cells while leaving normal, healthy cells unharmed. It’s an effective way to reduce the risk of recurrence for many types of cancer when used as part of a comprehensive approach called combination therapy (chemotherapy with other medications). -> Radiation treatment. Adjuvant radiation, which is given after surgery and lowers the likelihood of cancer returning, is one type of radiation therapy.

Stage 4

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Patients with stage 4 cancer have usually received systemic therapy, although surgery and radiation are options in select circumstances. Systemic treatment may include the following:

  • endocrine therapy, or endocrine therapy (for hormone receptor-positive tumors)
  • Targeted therapy (for HER2-positive cancers)

Inflammatory breast cancer treatment

Inflammatory breast cancer (IBC) is a rare and aggressive kind of breast cancer that develops when tumor cells block lymphatic vessels on the skin. IBC cases are classified as at least stage 3 breast cancer in all instances. If the disease has spread (been transferred) to other regions of the body, it’s classed as stage 4. The treatment for IBC depends on its degree of advancement.

Immunotherapy as an emerging treatment

Immunotherapy is relatively new cancer therapy, and while it hasn’t been authorized by the Food and Drug Administration (FDA) for use in breast cancer yet, it’s an interesting area. immunotherapy works by boosting the body’s natural defenses against cancer. It has fewer negative effects than chemotherapy and is less likely to result in resistance. Pembrolizumab is an immune checkpoint inhibitor medication. Metastatic breast cancer has shown particular promise with this type of immunotherapy.

Immunotherapy works by inhibiting certain antibodies that make it more difficult for the immune system to battle cancer. This allows the body’s defenses to be more effective. A 2016 research showed that immunotherapy was helpful in 37.5% of patients with triple-negative breast cancer. Because immunotherapy is not yet FDA approved, most treatment is still available through clinical trials at this time.

Complementary and alternative treatments

Vitamins, herbs, acupuncture, and massage are all alternative or complementary treatments that some people with breast cancer may be interested in pursuing.

These procedures are utilized in addition to traditional breast cancer therapy to treat cancer or alleviate symptoms and adverse effects of conventional treatments such as chemotherapy. You may try any of these therapies at any point during your breast cancer journey.

Examples of alternative therapy include:

  • Massage can assist you to relax by relaxing your nervous system.
  • To help with nausea, make a cup of peppermint tea.
  • Using marijuana to alleviate pain

Although alternative medicines may help you feel more at ease, it’s vital to remember that many of them are unproven and might be hazardous to your health. To be on the safe side, talk with your doctor about any alternative treatments you’re interested in pursuing.

Pain management

Pain caused by advanced breast cancer that has spread to other areas of the body might include bone pain, muscular discomfort, headaches, and discomfort around the liver. Pain management should be discussed with your doctor.

Acetaminophen and nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen, are two options for dealing with pain that is mild to moderate. An opioid-like morphine, oxycodone, hydromorphone, or fentanyl may be used if the discomfort is severe in a later stage.

In recent years, a growing number of cancer patients have used cannabis to manage pain and nausea caused by their malignancies. Major observational research of cancer sufferers who used cannabis for 6 months showed fewer patients reporting severe discomfort and less opioid use.

Factors impacting breast cancer treatment

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The breast cancer stage is important, but other aspects may influence your treatment choices as well.

Age

Because breast cancer is more aggressive in younger individuals, the outlook is typically worse in those under 40. The choice between lumpectomy and mastectomy may be influenced by a person’s body image and perceived risk reduction.

In many cases, several years of hormone therapy for hormone-positive breast cancer is necessary for young people. This can help prevent a relapse or spread of breast cancer in this group. Ovarian suppression, in addition to hormonal therapy, is sometimes suggested for premenopausal women.

Pregnancy

Pregnancy has an impact on how cancer is treated. Breast cancer surgery is usually safe for pregnant women, however, chemotherapy may be postponed until the second or third trimester. Hormone therapy and radiation treatment might harm an unborn kid, therefore they are not suggested throughout pregnancy.

Tumor growth

Treatment also depends on how fast the cancer advances and spreads. If you have an advanced form of breast cancer, your doctor may propose a more aggressive treatment plan, such as surgery with a combination of other therapies.

Genetics and family history

Breast cancer treatment may be influenced by whether or not you have a family history of the disease or if you carry a gene that raises your risk of getting it. Patients who meet any of these criteria can opt for preventive surgery, such as a bilateral mastectomy.

Clinical trials

Clinical trials are research projects in which patients volunteer to take new medicines, drug therapies, and procedures under the watchful eye of doctors and researchers. Clinical trials are an important stage in finding new breast cancer therapy options.

The following are some of the most common emerging therapies being investigated in clinical trials for breast cancer:

  • TNBC is a malignancy that frequently originates in the breasts. PARP-inhibitors, which prevent protein used to mend DNA damage that occurs during cell division, are being researched and utilized for this cancer.
  • It is not possible to get pregnant by taking testosterone as a supplement alone. However, if a man has engaged in testosterone therapy for an extended period of time or is experiencing low levels of sex drive, he should have regular testing done by his doctor to ensure that his hormone and sexual function are normal. In truth, there are no human studies on whether testosterone supplementation raises the risk of prostate cancer due to this lack of research. This means individuals who use these drugs must undergo thorough medical examinations before starting treatment.
  • The following treatments and tests are being used to either reduce or prevent androgen synthesis in TNBC patients.

If you’re interested, inquire with your oncologist about any current clinical trials.

Is there a breast cancer cure?

Metastatic breast cancer, or breast cancer that has spread to distant areas of the body, currently has no cure. However, early stages of breast cancer that are still confined are very manageable — over 99 percent of individuals who have treatment for stage 1 breast cancer survive for at least 5 years after diagnosis, according to the American Cancer Society.

Outlook

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The clinical course of breast cancer is influenced, to a significant extent, by the stage at diagnosis. The sooner you are diagnosed, the better your prognosis will be. As a result, it’s critical to pay attention to any changes in your breasts. It’s also crucial to have regular mammograms. Discuss with your doctor which screening schedule is best for you. In this complete guide to breast cancer, learn about screening programs and more.

Breast cancer has numerous types and stages, although the treatment will be tailored to your specific requirements. In addition to the disease stage at diagnosis, your doctors will consider the kind of breast cancer you have as well as other health factors. They’ll alter your therapy regimen based on how well you tolerate it.

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