Treatment for breast cancer
Surgeon:
This is the most common treatment for breast cancer. A surgeon performs an operation to remove the cancer from your breast and usually some of the lymph nodes under your arm. A number of different operations are used:
Lumpectomy: In this operation (also called a partial mastectomy, or a segmental mastectomy), just the lump is removed from the breast. The surgeon removes a little normal breast tissue all the way around the cancer to be sure that all of the cancer is removed. Lymph nodes are removed from under the arm. This type of operation usually is followed by radiation therapy and sometimes by chemotherapy or hormone therapy.
Advantages of a lumpectomy:
Your breast will not be removed.
Disadvantages of a lumpectomy:
You will need additional treatment with x-ray therapy. You may have arm swelling.
Modified Radical Mastectomy: In this operation, the entire breast is removed, along with some skin and some underarm lymph nodes.
Advantages of a modified radical mastectomy:
You probably will not need radiation therapy.
Disadvantages of a modified radical mastectomy:
Your entire breast and some of your skin will be removed. You may have arm swelling.
Total Mastectomy: In this operation, the entire breast is removed, but usually not the lymph nodes.
Advantages of a total mastectomy:
You probably will not need radiation therapy.
Disadvantages of a total mastectomy:
The surgeon removes a little normal breast tissue all the way around the cancer to be sure that all of the cancer is removed.
Your entire breast and some of your surrounding skin will be removed.
Breast Reconstruction: This is additional surgery done to rebuild (reconstruct) your breast. It may be done either at the same time as your breast is removed or at a later time. You may want to visit a plastic surgeon before making your final decision.
<http://www.onlinebreastcancerinfo.com/surgery.html>
Support for Breast Cancer Patients
earning to live with the changes that are brought about by having breast cancer is easier for you and for those who love you when you have helpful information and support services. Often, a social worker at your hospital or clinic can suggest local and national groups that will help you with rehabilitation, emotional support, financial aid, transportation, or home care.
The American Cancer Society (ACS), for example, has many services for cancer patients and their families. Their "Reach to Recovery" program offers special help for mastectomy patients. Trained volunteers, who have had breast cancer themselves, will visit you at your doctor's request and lend emotional support to you before and after your treatment. They will talk with you and share their own experiences with breast cancer treatment, rehabilitation, and breast reconstruction or fitting of breast forms. Your social worker or nurse can make a formal referral for you to the "Reach to Recovery" program at the time of your surgery.
Another resource for women who have had breast cancer surgery is "ENCORE". Sponsored by the YWCA, this program includes exercise to music, water exercises, and a discussion period. You may join this group after surgery, with your doctor's approval.
Information about other programs and services for breast cancer patients and their families is available through both the Meyer L. Prentis Comprehensive Cancer Center (toll-free: 800-4-CANCER) and the American Cancer Society Cancer Response Service (toll-free: 800-227-2345). Your local American Cancer Society office will have information about local programs and services. Another resource that you may use to find out about breast cancer programs in your community is your local hospital Social Work Department.
<http://www.onlinebreastcancerinfo.com/supportforbreastcancerpatients.ht\
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HOW BREAST CANCER IS DIAGNOSED
t is important to remember that four out of five breast lumps are not cancer. To diagnose breast cancer, a careful physical examination is done, including palpation of your breast, and you are asked about your personal and family history. One or more of these tests may also be done:
Aspiration: In this procedure, your doctor will use a thin needle to remove fluid or a small amount of tissue from your breast lump. This may show whether the lump is a fluid-filled cyst or a solid mass.
Mammography: In this examination, x-rays will be taken of your breast that can give both you and your doctor important information about your breast lump. A mammogram also can show any tumors you may have in your breast that are still too small to be felt. However, mammograms do not show all breast cancers.
Ultrasound: In this test, sometimes called a sonogram, high-frequency sound waves are sent into your breast. The pattern of echoes is shown on a monitor, like a TV screen. Ultrasound examination may be used to distinguish fluid-filled cysts from solid tumors.
Biopsy: A biopsy is surgery to take out part, or all, of a lump or suspicious area. After being removed, the tissue is examined under a microscope by a pathologist. A biopsy is the only sure way to know whether cancer is present. If you are going to have a biopsy, you have an important choice to make.
a. One-step procedure: You can decide that, if cancer is found, you will have surgery to treat your cancer at the same time as the biopsy (a one-step procedure).
b. Two-step procedure: Or, you can decide on only a biopsy and, if it shows cancer, have treatment at a later date. This gives you time to find out about your treatment choices, to get a second opinion, and to prepare for your stay in the hospital, but it does not reduce the chances for successful treatment. Many doctors and patients prefer the two-step procedure, and it is the most common approach.
Hormone receptor tests: If the biopsy shows that cancer is present, laboratory tests called estrogen and progesterone receptor tests are usually done on the tissue removed during the biopsy. These tests can tell whether these hormones help your particular kind of cancer to grow. This information helps your doctor decide whether hormone treatment is likely to be useful in your case.
If your biopsy shows that your lump is cancer, your doctor may order other special laboratory tests to learn more about the cancer. Your doctor may order chest x-rays, blood tests, and/or scans to determine whether or not the cancer has spread from your breast to other parts of your body. These tests help your doctor tell the extent, or stage, of the disease. Doctors use this staging system for breast cancer:
<http://www.onlinebreastcancerinfo.com/howbreastcancerisdiagnosed.html>
Carcinoma in situ
If you have carcinoma in situ (non-invasive breast cancer), you may have a mastectomy or breast-sparing surgery. As with other breast cancers, the type of surgery that is best for you is based upon many factors. Also, depending upon the specific type of breast cancer involved, your doctor may need to remove some of your lymph nodes, and also may advise you to have radiation therapy.
Stage I and Stage II
If your breast cancer is diagnosed as early stage breast cancer (Stage I and H), your treatment choices may include a mastectomy or limited surgery (such as a lumpectomy or partial mastectomy), followed by radiation therapy. Some of the lymph nodes under your an-n also are removed. The type of surgery you will need depends upon the size and location of your tumor, the type of cancer you have, your age, your general health, and the size of your breast.
If you have early stage breast cancer, chemotherapy or hormone therapy may be considered after primary treatment. This additional treatment is called adjuvant therapy. It is used to help prevent the cancer from returning by killing undetectable cells that may remain in your body. The choice between chemotherapy or hormone therapy depends upon your age, your menopausal status, your hormone receptor status, and other factors.
Until recently, women whose underarm lymph nodes were free of cancer usually received no additional treatment because they had a good chance of survival. But, scientists now know that cancer may return in some of these women. Therefore, adjuvant therapy may be recommended in these cases.
Stage III
If you are diagnosed as having Stage IV breast cancer, you probably will have both local and systemic treatment. Your local treatment may be a mastectomy and/or radiation therapy. Your systemic therapy will be chemotherapy and/or hormone therapy.
Stage IV
Most women who have Stage IV breast cancer receive chemotherapy and/or hormone therapy. They also may have limited surgery or radiation therapy to control their breast tumor. If you have Stage IV breast cancer, your doctor also may want to use radiation to treat any cancer that has spread to other parts of your body.
<http://www.onlinebreastcancerinfo.com/extentofdiseaseandtreatment.html>
Radiation Therapy as a "PRIMARY TREATMENT"
This treatment is done by a radiation oncologist who uses high doses of radiation to kill any cancer cells which might remain. 'Me radiation may come from a machine outside your body (external radiation) or it may actually be put into your breast through a small tube (implant radiation). For some women, both ways are used. An extra "boost" of radiation is usually given to the tumor site. The boost may be either external or internal (using an implant).
Advantages of radiation therapy:
Your breast will not have to be removed.
Disadvantages of radiation therapy:
The treatment is usually done 5 days a week for 5 to 8 weeks.
Radiation therapy is usually only available at large hospitals or medical centers, so you may have to travel outside your community for treatment.
There may be a temporary skin reaction similar to sunburn, and daily skin care will be required.
You can have arm swelling.
There may be long-term changes in the appearance and texture of your breast and the skin over your breast.
<http://www.onlinebreastcancerinfo.com/radiation.html>
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