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Breast Cancer Treatment

A. JABBAR DENTAL CLINIC KARACHI

Sadia Khan

Overview

Disclaimer: This article is solely for educational purposes. Please consult a doctor to make an informed decision based on your specific circumstances. 
&nbsp;

1 in 7 women is diagnosed with breast cancer in their lifetime. In rare cases, men are also diagnosed with breast cancer. Early detection increases the likelihood of recovery; the earlier it is detected, the better the chances of treating it before it spreads to other parts of the body<a href="#accordion">[1]</a>.

There are a few things you should understand about breast cancer treatment if you or someone you love has been diagnosed with the disease.

To begin with, breast cancer treatment options are determined by a number of factors, including<a href="#accordion">[4]</a>:

<ul>
	<li>The stage of the tumor</li>
	<li>The subtype of the tumor</li>
	<li>Presence of known mutations</li>
	<li>Genomic test results (if appropriate)</li>
	<li>The overall health, age, and personal preferences of the patient</li>
	<li>The menopausal status (in women) 
	&nbsp;</li>
</ul>

Understanding breast cancer treatment

<ol>
	<li>
	<h5>Surgery</h5>
	</li>
</ol>

The first-line treatment for breast cancer, surgery removes the tumor and surrounding tissue. The main types of breast cancer surgery include: 
&nbsp;

<ul>
	<li>Lumpectomy</li>
</ul>

Also known as breast-conserving surgery, lumpectomy only removes the tumor and a small margin of the surrounding tissue.

A lumpectomy followed by radiotherapy is reportedly as successful as a total mastectomy for treating early-stage breast cancer<a href="#accordion">[1]</a>.

<ul>
	<li>Mastectomy</li>
</ul>

The entire breast is removed in this procedure. Mastectomies are classified into three types: total mastectomy, modified radical mastectomy, and skin-sparing mastectomy.

It is often followed by reconstructive surgery. If there&rsquo;s no evidence of cancer spreading to the lymph nodes, a mastectomy is followed by sentinel lymph node biopsy<a href="#accordion">[1]</a>.

<ul>
	<li>Sentinel Lymph Node Biopsy</li>
</ul>

The lymph nodes closest to the tumor are removed and examined during this type of surgery to see if the cancer has spread. The sentinel lymph nodes are part of the axillary lymph nodes, which are located beneath the arms.

&nbsp;

<ol start="2">
	<li>
	<h5>Radiation Therapy</h5>
	</li>
</ol>

Radiotherapy uses controlled doses of radiation to kill cancer cells and minimize the risk of recurrence. Radiotherapy can be external beam radiation or brachytherapy, and it can include chest-wall radiotherapy, breast radiotherapy, lymph node radiotherapy, and breast boost. It may be recommended after a lumpectomy or mastectomy to kill any remaining cancer cells.

&nbsp;

<ol start="3">
	<li>
	<h5>Chemotherapy</h5>
	</li>
</ol>

Chemotherapy employs drugs to either kill or inhibit the growth of cancer cells. It is often used to treat breast cancer that has spread beyond the breast. It may also be used to shrink tumors before surgery. These drugs can be administered intravenously or orally.

Chemotherapy for secondary breast cancer can not cure the disease. This treatment will only serve to alleviate symptoms and raise mortality rates because breast cancer has already spread outside of the breast and lymph nodes<a href="#accordion">[1]</a>.

&nbsp;

<ol start="4">
	<li>
	<h5>Hormone Therapy</h5>
	</li>
</ol>

Hormone therapy is used for breast cancers that are hormone receptor-positive. This means the cancer cells have receptors for estrogen and/or progesterone, both of which are naturally-occurring hormones in the body. The method slows the growth of cancer by blocking the effects of hormones on cancer cells or by lowering hormone levels in the body.

Hormone therapy may be the only option for treating breast cancer in some cases when the patient&#39;s general health precludes chemotherapy, surgery, or radiotherapy.

However, hormone therapy is typically administered after surgical intervention and must be taken for at least five years<a href="#accordion">[1]</a>.

Hormone therapy includes<a href="#accordion">[1]</a>:

<ul>
	<li>Tamoxifen</li>
	<li>Aromatase inhibitors (for menopausal women)</li>
	<li>Ovarian ablation or suppression</li>
</ul>

Targeted therapy medications can be taken orally or intravenously.

Note: This will not affect the tumor cells if the type of breast cancer you have is not sensitive to hormones.

&nbsp;

<ol start="5">
	<li>
	<h5>Targeted Therapy</h5>
	</li>
</ol>

Targeted therapies are drugs that specifically target certain proteins or genes involved in cancer growth. They cannot treat all types of breast cancer. They are frequently used for HER2-positive breast cancers, in which the cancer cells have an excess of the HER2 protein.

The following drugs are used in targeted therapy<a href="#accordion">[2]</a>:

<ul>
	<li>Antibody-drug conjugates</li>
	<li>Monoclonal antibodies</li>
	<li>CDK4/6 inhibitors</li>
	<li>Kinase inhibitors</li>
	<li>PI3K inhibitor</li>
	<li>mTOR inhibitor</li>
	<li>PARP inhibitor</li>
</ul>

Targeted therapy is often used along with hormone therapy, like fulvestrant, to treat some types of breast cancer.

&nbsp;

<ol start="6">
	<li>
	<h5>Immunotherapy</h5>
	</li>
</ol>

Immunotherapy is a type of treatment that strengthens the immune system of the body so that it can identify and combat cancer cells. Although it is less frequently used than other breast cancer treatments, ongoing research is looking into its potential in some circumstances.

Breast cancer is usually treated with a combination of chemotherapy, surgery, and radiotherapy. Chemotherapy or radiation therapy are administered after surgery. In some cases, though, it may be followed by targeted or hormone treatments<a href="#accordion">[1]</a>.

That said, treatment plans are highly individualized. A multidisciplinary team of <a href="https://merisehat.pk/article/accessing-quality-healthcare-online-doctors-in-pakistan">healthcare</a> professionals, including surgeons, medical oncologists, radiation oncologists, and other specialists, will work together to determine the most appropriate treatment approach for each person diagnosed with breast cancer.

&nbsp;

<ol start="7">
	<li>
	<h5>Reconstruction</h5>
	</li>
</ol>

The new breast(s) can be reconstructed using tissue from another part of the patient&#39;s body or by inserting a breast implant. It can also be divided into two categories: immediate reconstruction and delayed reconstruction.

&nbsp;

<ol start="8">
	<li>
	<h5>Complementary Therapy</h5>
	</li>
</ol>

These are intended to improve the patient&#39;s mental and physical health. These treatments are not meant to be administered in isolation; rather, they should be given alongside more traditional forms of care.

They include:

<ul>
	<li>Massage</li>
	<li>Breathing exercises</li>
	<li><a href="https://merisehat.pk/article/is-acupuncture-the-right-choice-for-you">Acupuncture</a></li>
	<li>Aromatherapy</li>
</ul>

Note: It&rsquo;s important to ask your doctor before starting or stopping these therapies.

&nbsp;

<ol start="9">
	<li>
	<h5>Clinical Trials</h5>
	</li>
</ol>

Clinical trials test new treatments or combinations of treatments to determine their safety and effectiveness. Participation in clinical trials may be an option for some people, particularly those with advanced or difficult-to-treat breast cancer.

Remember that you can refuse or withdraw from a clinical trial without affecting your primary treatment.

&nbsp;

<ol start="10">
	<li>
	<h5>Psychological Support</h5>
	</li>
</ol>

From practical difficulties to emotional challenges, cancer can be exhausting not only for the patient but also for those close to them. There is no set time to seek the services of a trained therapist or counselor. You can seek assistance at any stage of the illness. 
&nbsp;

Breast cancer can recur despite doctors&#39; best efforts and the use of new treatments. If this occurs, the treatment will be determined by where the cancer returns, what treatments the patient has previously received, and how well those treatments worked for them. 
&nbsp;

key points

<ul>
	<li>There are various treatments available to treat breast cancer, including surgery, medications, radiation, and complementary therapies. Doctors may recommend one based on the patient&#39;s specific circumstances.</li>
	<li>Primary treatment aims to kill all cancer cells. Surgery is the primary treatment for most types of cancer. In some cases, chemotherapy or radiation therapy may be used.</li>
	<li>After primary treatment, adjuvant therapy aims to eradicate any remaining cancer cells. Common adjuvant therapies include chemotherapy, hormone therapy, and radiation therapy. However, this can be achieved with any cancer treatment.</li>
	<li>Palliative treatment aims to relieve symptoms or side effects of cancer treatments. Surgery, chemotherapy, radiation, medication, and hormone therapy can all be used in this case.</li>
	<li>The two main types of surgery to remove breast cancer are lumpectomy and mastectomy. Surgery is preferred when there&rsquo;s a high risk of breast cancer, it&rsquo;s early-stage breast cancer, noninvasive breast cancer, large breast cancer, recurrent breast cancer, or locally advanced breast cancer<a href="#accordion">[3]</a>.</li>
	<li>Chemotherapy for breast cancer can be divided into neoadjuvant (or primary systemic) and adjuvant breast cancer chemotherapy.</li>
	<li>The majority of breast cancers are hormone receptor-positive and can be treated with hormone therapy. The two most common types of hormone therapy are aromatase inhibitors and selective estrogen receptor modulators.</li>
	<li>Radiation therapy uses high-energy beams to damage cancer cells&#39; DNA and destroy or slow their growth. It is usually considered after breast cancer surgery to destroy any remaining cancer cells.</li>
	<li>Biological response drugs are used in targeted therapy to treat HER2-positive breast cancer, triple-negative breast cancer, breast cancer caused by BRCA mutations, and hormone receptor-positive breast cancer.</li>
	<li>Immunotherapy helps deal with patients who have inoperable, metastatic types of breast cancer with either mismatch repair deficiency or microsatellite instability-high<a href="#accordion">[2]</a>.</li>
</ul>