Breast cancer treatment

Treatment for breast cancer can be surgery, chemotherapy, radiation therapy or hormone therapy. In some cases, two or more procedures are combined to treat breast cancer. The treatment chosen depends on the type, stage and level of cancer cells.

Tumor surgery
Lumpectomy surgery is performed to remove a tumor that is not too large with a small portion of healthy tissue around it. This procedure is usually followed by radiation therapy to destroy cancer cells that may be left in breast tissue. Patients with large tumors can first undergo chemotherapy to reduce tumor size so that it can be removed with lumpectomy.

Mastectomy Surgery
Mastectomy is another surgical option that consists of operations performed by an oncologist surgeon to remove all tissue from the breast. Mastectomy is performed if the patient cannot be treated with lumpectomy. There are several types of mastectomy operations, namely:

• Simple / Complete Mastectomy - The doctor removes the entire breast, including the nipples, areola and skin envelope, and some lymph nodes.
• Mastectomy leaving skin - Doctors only remove the milk glands, nipples and areola. Tissue from other body parts will be used to rebuild the breast.
• Mastectomy saves nipples - Breast tissue is removed, not including skin and nipples. However, if the cancer is in the tissue under the nipple and areola, the breast nipple will also be removed.
• Modification of Radical Mastectomy - This procedure combines a simple mastectomy and removal of all lymph nodes under the armpit.
• Radical Mastectomy - The doctor removes the entire breast, armpit lymph nodes, and chest muscles (chest).
• Dual mastectomy - This procedure is performed as a preventative measure for women at high risk of developing breast cancer by removing both breasts.

Surgical removal of the lymphatic ganglion

The doctor will do an examination to determine whether the cancer has spread to the armpit lymph nodes. This examination is also used to determine the stage of cancer that is felt by the patient. Removal of lymph nodes can be done in conjunction with surgical removal of a breast tumor or separately. Two types of surgery to remove lymph nodes are:

• Sentinel lymph node biopsy (NBLS). Doctors only remove lymph nodes under the armpits which can develop cancer.
• Axillary node dissection (ALND). The doctor removed more than 20 lymph nodes under the armpit.

Complications associated with breast cancer surgery depend on the procedure performed. In general, surgical procedures can cause bleeding, pain, and swelling of the arm (lymphedema).

radiotherapy

Other treatment options for breast cancer patients are radiotherapy or radiotherapy using high intensity rays, such as X-rays and protons. Radiotherapy can be done by injecting light into the patient's body using a device (external beam radiotherapy) or by placing radioactive material in the patient's body (brachytherapy).

External radiotherapy is usually done after lumpectomy in patients, whereas brachytherapy is done if the risk of breast cancer recurrence is low. The doctor can also advise patients to undergo breast radiotherapy after mastectomy, in the case of larger breast cancer that has spread to the lymph nodes.

Radiotherapy or radiation therapy in breast cancer can last from 3 days to 6 weeks, depending on the type of therapy performed. Radiation therapy can cause complications such as redness in the irradiated area and breasts can also be hard and swollen.

Hormone treatment

In the case of cancers that are affected by the hormones estrogen and progesterone, doctors can advise patients to use estrogen inhibitors, such as tamoxifen. This drug can be given to patients for 5 years. While aromatase inhibitors, such as anastrozole, letrozole and exemestane, are prescribed by doctors to inhibit the production of the hormone estrogen in postmenopausal women.

In women who have not yet reached menopause, gonadotropin-releasing hormones, such as goserelin, can be used to reduce estrogen levels in the uterus. Another option is to remove the ovaries or destroy them with radiotherapy so that hormones are not formed.

Everolimus is another drug used in positive or positive RP cancers, which inhibits the function of the mTOR protein, thereby preventing cancer cells from developing and forming new blood vessels. Side effects of everolimus include diarrhea and vomiting and can even increase cholesterol, triglycerides and blood sugar levels.

chemotherapy

Chemotherapy after surgery (adjuvant chemotherapy) aims to kill cancer cells that may be left behind during surgery, or cancer cells have spread but are not visible even with sweeping tests. The remaining cancer cells can grow and form new tumors in other organs.

Whereas chemotherapy performed before surgery (neoadjuvant chemotherapy) aims to reduce tumor size so that it can be removed surgically. This type of chemotherapy is generally used to treat cancers that are too important to be removed surgically.

The types of drugs commonly used in adjuvant chemotherapy and neoadjuvan chemotherapy are anthracyline (doxorubicin and epirubicin), taxanes (paclitaxel and docetaxel), cyclophosphamide, carboplatin and 5-fluorouracil. In general, doctors associate 2 or 3 of the above drugs.

Chemotherapy can also be used in advanced cancer, especially in women with underarm cancer. The duration of treatment depends on the patient's response. The types of drugs commonly used are vinorelbine, capecitabine and gemcitabine. For advanced cancer, doctors can use a single drug or combine two drugs.

Chemotherapy drugs are usually given intravenously, either by injection or infusion. The patient receives the drug during a cycle followed by a rest period to recover from the effects of the drug. This cycle usually takes place in 2 to 3 weeks, with the administration schedule depending on the type of drug.

Side effects from chemotherapy depend on the drug used, but patients usually experience hair loss, infection, nausea, and vomiting. In some cases, chemotherapy can cause premature menopause, nerve damage, infertility, and heart and liver damage. Although very rare, chemotherapy can also cause blood cancer.

Targeted therapy

Another therapy for breast cancer patients is targeted therapy. This therapy inhibits the growth and spread of cancer cells without damaging healthy cells.

Target treatment is generally applied to HER2-positive cancers. The drug used in targeted therapy aims to inhibit the development of the HER2 protein, which helps cancer cells to develop more aggressively. Trastuzumab, pertuzumab and lapatinib are some of the drugs used in targeted therapy. Some drugs are given orally or injections and can be used to treat cancer in the early or advanced stages.

Possible side effects of HER2-positive cancer targeted therapy may be mild to severe, including heart damage that can progress to heart failure. The risk of heart problems can increase if targeted therapeutic drugs are combined with chemotherapy. Swelling of the feet, shortness of breath and diarrhea can also occur. It is important to remember that this drug is not recommended for treating breast cancer in pregnant women because it can cause miscarriage.

Share this post