Breast Cancer Treatment

Dhimant Patel, MD, discusses the role of clinical trials in treating breast cancer.

Breast cancer treatment requires a team effort by doctors, nurses and other health care professionals. Once your primary doctor has all the information about your breast cancer, you’ll talk with your team about the treatments you’ll need. Your treatment team may include:

Surgery

Today, most women who have breast cancer can, after discussion with their doctor, choose the surgical option that is best for them. You may choose breast conservation or mastectomy. Studies show that either option provides the same long-term survival rates. Neither option gives 100 percent guarantee that your cancer will not return at the treated site or in the other breast.

Breast conservation: A surgeon removes the breast cancer, a little normal breast tissue around the lump, and usually some lymph nodes under the arm. This procedure removes your cancer while leaving you with a breast that looks much the same as it did before surgery.

Total mastectomy: Removal of as much of the breast tissue as possible, including nipple, and some of the overlying skin

Modified radical mastectomy: Removal of as much breast tissue as possible, the nipple, including some of the overlying skin and lymph nodes in the armpit.
A total mastectomy is needed when:

  • The cancer is found in more than one area of the breast
  • The breast is too small or shaped so that removal of the entire cancer will leave little breast tissue or deformed breast
  • The woman does not want to have radiation therapy

Radiation Therapy

Breast conservation is followed by radiation therapy to the breast. High-energy radiation is used to kill cancer cells that might still be present in the remaining breast tissue. Radiation therapy can be given either to the whole breast or a focused area (brachytherapy). Whole breast radiation therapy is given five days a week for approximately six to seven weeks. Brachytherapy is given twice a day for one week.

Chemotherapy and Hormone Therapy

Help in fighting cancer cells comes from chemotherapy and hormone therapy. These treatments are chosen for your individual case: your age, whether you’re still having periods, and how willing you are to cope with possible side effects. These therapies are used for the following:

  • Prevent cancer from coming back in women who are newly diagnosed
  • Control the disease when found in other places of the body
  • Control the disease in women whose cancer has come back after previous treatment

Chemotherapy drugs travel throughout your body and slow the growth of cancer cells or kill them. They may be given through the vein or can be taken by mouth. The drugs you take will depend on the stage of the cancer at the time you are diagnosed or if the cancer returns. The length of treatment varies depending on your diagnosis.

Tests are done on breast cancer cells to decide if the cancer is sensitive to natural female hormones (estrogen or progesterone). If the test is positive, it means that the cancer cells grow when one or both of these hormones are present. You may be given a hormone blocker (a pill) that prevents your body's natural hormones from reaching the cancer.

Clinical Trials

Cancer clinical trials offer additional treatment options for some patients. Some promising new treatments may only be available in a research setting. Aurora offers access to these clinical trials of therapies that might not be widely available elsewhere.

Breast Reconstruction

Breast reconstruction is an option for any woman who has had a breast removed because of cancer. Reconstruction will not give you back your breast will all the natural feelings, but it can give you a result that looks like a breast. It can be performed immediately or anytime after a mastectomy.

Reconstruction can be done with implants (plastic sacs filled with silicone or saline), or muscle, fat and skin from another part of the body. Most women who have breast reconstruction are happy with their decision. A woman starting this process should know that it is seldom finished with one operation.

If you are thinking about breast reconstruction, discuss this with a plastic surgeon before your mastectomy. Ask you breast surgeon for a referral to an experienced plastic surgeon.