Treatment for Breast Cancer

 Breast Cancer

Different types of treatment available for patients with breast cancer. Some treatments are standard (the currently used treatment), and some are tested in clinical trials. A treatment clinical trial is a study designed to improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment is the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Surgery

Most patients with breast cancer surgery to remove cancer of the breast. Some of the lymph nodes under the arm are usually out and looked under a microscope to see whether they contain cancer cells.
Breast-sparing surgery, an operation to remove the cancer, but not the breast itself, includes the following:

• Lumpectomy: Surgery to remove a tumor (lump) and a small amount of normal tissue around it.
• Partial mastectomy: Surgery to the part of the breast cancer and that some normal tissue around it has. This procedure is also called a segmental mastectomy.

Patients treated with breast-conserving surgery may also be a number of lymph nodes under the arm are removed for biopsy. This procedure is called lymph node dissection. It can be done at the same time as the breast-conserving surgery or after. Lymph node dissection is done through a separate incision.
Other forms of surgery are the following:

• Total mastectomy: Surgery to remove the whole breast that has cancer. This procedure is called a simple mastectomy. Some of the lymph nodes under the arm can be removed for biopsy at the same time as the breast or after surgery. This is done through a separate incision.
• Modified radical mastectomy: Surgery to remove the whole breast that has cancer, many of the lymph nodes under the arm, the lining of the chest muscles, and sometimes a part of the chest wall muscles.
• Radical mastectomy: Surgery to remove the breast cancer, chest wall muscles under the breast has, and all of the lymph nodes under the arm. This procedure is called a Halsted radical mastectomy.

Even if the doctor all the cancer that can be seen at the time of the delete operation, some patients may be given radiotherapy, chemotherapy or hormone therapy after surgery are any cancer cells left to kill. Treatment given after surgery to reduce the risk that the cancer will return is called adjuvant therapy.
If a patient does have a mastectomy to breast reconstruction (surgery to rebuild a breast shape after a mastectomy) may be considered. Breast reconstruction can be done at the time of mastectomy or at a later date. The reconstructed breast may be made to own (the patient nonbreast) tissue or by using implants filled with saline or silicone gel. Before the decision to implant is made, patients can call the Food and Drug Administration (FDA) Center for Devices and Radiological Health 1-888-INFO-FDA (1-888-463-6332) or visit the FDA website for more information about breast implants.

Radiotherapy

Radiotherapy is a treatment for cancer that uses high-energy x-rays or other radiation to kill cancer cells or keep growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of cancer being treated.

Chemotherapy

Chemotherapy is a treatment for cancer drugs that stop the growth of cancer cells used, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs in the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ or a body cavity, such as the abdomen, the drugs mainly for cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of cancer being treated.

Hormone Therapy

Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances produced by glands in the body and circulated in the bloodstream. Some hormones can cause certain cancers to grow. If the tests show that cancer cells have places where hormones can attach (receptors), drugs, surgery or radiation is used for the production of hormones to reduce or block the work. The hormone estrogen, which some breast cancers grow mainly by the ovaries. Treatment to stop making estrogen the ovaries is called ovarian ablation.

Hormone therapy with tamoxifen is often given to patients with early stages of breast cancer and those with metastatic breast cancer (cancer that has spread to other parts of the body). Hormone therapy with tamoxifen or estrogens can act on cells throughout the body and may increase the risk of developing endometrial cancer. Women tamoxifen have a pelvic exam every year looking for signs of cancer. Any vaginal bleeding other than menstrual bleeding, must be reported to a doctor as soon as possible.

Hormone treatment with an aromatase inhibitor is given to some postmenopausal women with hormone-dependent breast cancer. Hormone-dependent breast cancer needs the hormone estrogen to grow. Aromatase inhibitors reduce estrogen in the body by blocking the enzyme aromatase from turning androgen into estrogen.
For the treatment of early stage breast cancer, certain aromatase inhibitors may be used as adjuvant therapy instead of tamoxifen or after 2 or more years of tamoxifen. For the treatment of metastatic breast cancer, aromatase inhibitors are tested in clinical trials to compare them to hormone therapy with tamoxifen.

Targeted Therapy

Targeted therapy is a form of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Monoclonal antibodies and tyrosine kinase inhibitors are two types of targeted therapies studied in the treatment of breast cancer.
Monoclonal antibody therapy is a cancer treatment that uses antibodies in the laboratory, from a single type of immune cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, their growth, or keep them spread block. Monoclonal antibodies are given by infusion. They may only be used for or drugs, toxins, or radioactive material directly to cancer cells. Monoclonal antibodies can be used in combination with chemotherapy as adjuvant therapy.
Trastuzumab (Herceptin) is a monoclonal antibody that blocks the effects of the growth factor protein HER2, which sends growth signals to breast cancer cells. Approximately one quarter of patients with breast cancer have tumors that can be treated with trastuzumab in combination with chemotherapy.
Tyrosine kinase inhibitors are targeted therapy drugs that block signals needed for tumors to grow. Tyrosine kinase inhibitors can be used in combination with other anticancer drugs as adjuvant therapy.
Lapatinib is a tyrosine kinase inhibitor that blocks the effects of the HER2 protein and other proteins in tumor cells. It can be used to treat patients with HER2-positive breast cancer that has progressed following treatment with trastuzumab.