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Deciding On a Treatment Plan That Is Best For You

Once a breast cancer diagnosis has been confirmed, a treatment plan can be determined. Several factors will be considered when determining a treatment plan, including the age of the patient, stage of the cancer, menopausal status, overall health of the patient and patient preferences.1 Having a general idea of what treatment options exist will help when you discuss them with your doctor.

The goal in the treatment of breast cancer is to use the least invasive methods possible that will effectively treat the cancer in attempt to cure. The earlier the cancer is diagnosed, more treatment options exist. The general categories of treatment options are as follows:

  • Surgery
  • Chemotherapy
  • Targeted therapy/Immunotherapy
  • Radiation Therapy
  • Hormone therapy

Some of these treatment options can be used alone or in combination for a comprehensive treatment plan that is based on several factors related to the patient and the patient’s cancer.

Surgical Treatments

Surgery is the most common treatment option for breast cancer, and can be used alone to treat breast cancer. However, it is used more often in conjunction with other types of treatment modalities for breast cancer. There are different surgical procedures that can be performed according to treat breast cancer. A lumpectomy removes the part of the breast involved with cancer as well as some surrounding normal tissue to ensure that all of the cancer is gone. In contrast, a mastectomy removes the entire breast including the breast tissue that extends into the armpit area. A modified radical mastectomy includes removing all breast tissue and the lymph nodes that are in the armpit area. Research has shown that long-term survival for women that elect to have a lumpectomy (breast conserving therapy) versus mastectomy are 41.7 and 41.2 percent, respectively.2 This means that survival is essentially the same despite what type of surgery you choose. For this reason, more women are choosing to have breast conserving therapy.

Chemotherapy

Chemotherapy describes the use of drugs to stop cancer cells from continuing to divide and ultimately kills cancer cells throughout the entire body. There are over 51 different chemotherapy drugs that have been approved by the FDA for treatment of breast cancer. There are also many other drugs and drug regimens that are currently being tested in clinical trials for their efficacy in treating breast cancer. 3 With more and more patients deciding to have breast conserving surgery as opposed to a mastectomy, chemotherapy is often used to treat any breast cancer cells that may have already spread throughout the body.

Hormone Therapy

Estrogen and progesterone are naturally occurring hormones in the body that have been found to encourage growth of breast cancer cells, especially in post-menopausal women. When cancer cells are found to have receptors for these hormones, certain drugs can be used to target the receptors on these cells to treat the cancer.

Targeted Therapy

This type of therapy works by targeting specific receptors or proteins in cancer cells that prevent them from continuing to divide. They do this by mimicking portions of the normal immune system and boosting the patient’s own immune system to fight cancer. Targeted therapy is rarely used alone and is most often used in conjunction with surgery with or without chemotherapy.

Radiation Therapy

Radiation therapy has long been used to treat many conditions, including different kinds of cancer. It is a valuable treatment tool and is used most often as a part of breast conserving therapy after a lumpectomy, or partial mastectomy has been performed. The goal with radiation therapy is to kill breast cancer cells within the breast and armpit area to prevent recurrence of the cancer. Occasionally, radiation therapy can be used to palliate, or relieve pain for cancers that are inoperable and no other options exist.

References

1 Treatment Option Overview. (n.d.). Retrieved from National Cancer Institute: www.cancer.gov/cancertopics/pdq/treatment/breast/Patient/page5

2 Veronesi, U., Cascinelli, N., Mariani, L., et al. (2002). Twenty-Year Follow-up of a Randomized Study Comparing Breast-Conserving Surgery with Radical Mastectomy for Early Breast Cancer. The New England Journal of Medicine , 1227-1232.

3 Drugs Approved for Breast Cancer. (2011, August 5). Retrieved from National Cancer Institute: www.cancer.gov/cancertopics/druginfo/breastcancer

4 Fisher, B., Bryant, J., Wolmark, N., et al. (1998). Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. Journal of Clinical Oncology , 2672-2685.

5 van Leeuwen, F. E., van den Belt-Dusebout, A. W., Benraadt, J., et al. (1994). Risk of endometrial cancer after tamoxifen treatment of breast cancer . The Lancet, 448-452.

This article was originally published on July 27,2012 and last revision and update of it was 9/2/2015.