Treatment of breast cancer always involves surgery, because the tumor has to be removed. In addition, chemotherapy, radiotherapy and hormone therapy are used in the treatment of breast cancer, depending on the form of the cancer and its stage. What determines the choice of a method of breast cancer treatment?
Breast cancer - treatmentmust be started immediately after finding the presence of the lesion and diagnosing the tumor. Surgery to remove a neoplastic lesion is always necessary. This is the basictreatment for breast cancer.
Breast cancer treatment - types of surgery
- Conserving surgery (BCT or breast conserving therapy). It is performed when the cancer is lobular (formed from the cells of the mammary gland) and is detected in the pre-invasive in situ stage. During this procedure, only the tumor is excised with a margin of he althy tissue. After the procedure, only strict observation is applied (oncological checks every six months). If the cancer is of the ductal type (formed from the cells lining the milk ducts), depending on the size of the tumor and the results of the histopathological examination, conservative surgery may be performed without removing the lymph nodes, and radiotherapy or removal of the entire breast (also preserving the lymph nodes).
- Sparing surgery in invasive cancer (when lymph nodes are involved or distant metastases already exist). The neoplastic lesion and regional lymph nodes are removed. After such an operation, radiotherapy is necessary
- Mastectomy, i.e. removal of the entire breast. The operation is performed when conservative treatment in invasive breast cancer is impossible, and sometimes for cosmetic reasons: when the breast is small and its partial operation will be more disastrous than removing the entire breast.
Breast cancer treatment: chemotherapy
Chemotherapy treatment is used both after surgery and before. It all depends on the size of the neoplastic lesion, the condition of the lymph nodes and the presence of metastases to other organs.
- Induction chemotherapy, i.e. before surgery. It is performed when the neoplastic lesion is large (more than 5 cm in diameter), there are cancer cells in at least 3 lymph nodes and when there are distant metastases. Induction chemotherapy can reduce tumor size andmake the operation safer. Induction chemotherapy is sometimes used before sparing surgery, when the cancer is advanced, but only locally.
- Chemotherapy after surgery. It is used in the case of invasive cancer. Chemotherapy can be started immediately after surgery or with a certain interval, but not longer than 8 weeks.
Treatment of breast cancer: radiation therapy
It consists in irradiating the place from which the tumor was removed and sometimes also the area of the lymph nodes with a beam of ionizing radiation. Radiotherapy is always given after invasive cancer-sparing surgery to minimize the risk of recurrence. It is also used after mastectomy, when the risk of recurrence is high or when cancer cells are found in more than 4 lymph nodes. There are two types of radiation therapy.
- Teletherapy - when the radiation source is outside the patient's body. Then the radiation doses are also lower. However, there is a greater risk of irradiation of neighboring organs: the heart or lungs, and of damaging the skin. Telotherapy lasts about 5 weeks.
- Brachytherapy. is a more modern type of radiotherapy. A radioactive isotope that emits ionizing radiation is placed, through a special tube inserted into the body, in the immediate vicinity of the site from which the tumor was removed. Radiation is administered precisely to the sick places and in higher doses. Brachytherapy requires a hospital stay of 5-7 days.
Breast cancer treatment: hormone therapies
It is used in cases where the cancer is hormone-dependent (hormone receptors ER + and / or PR + are present on the surface of the tumor). Hormonal treatment is used in elderly women regardless of the presence of hormone receptors.
Targeted treatment of breast cancer: HER-2 receptor blockade
Targeted therapy consisting in blocking the activity of HER-2 receptors is used in patients with diagnosed presence of these receptors on the surface of the tumor and overexpression of the HER-2 gene.