Breast Cancer Treatment Options

How is breast cancer treated?

This information represents the views of the doctors and nurses serving on the
American Cancer Society's Cancer Information Database Editorial Board. These views
are based on their interpretation of studies published in medical journals, as well as
their own professional experience.

The treatment information in this document is not official policy of the Society and is
not intended as medical advice to replace the expertise and judgment of your cancer
care team. It is intended to help you and your family make informed decisions,
together with your doctor.

Your doctor may have reasons for suggesting a treatment plan different from these
general treatment options. Don't hesitate to ask him or her questions about your
treatment options.
 Types of treatments
The main types of treatment for breast cancer are:

Surgery
Radiation therapy
Chemotherapy
Hormone therapy
Targeted therapy
Bone-directed therapy

Treatments can be classified into broad groups, based on how they work and when
they are used.

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 Surgery
Most women with breast cancer have some type of surgery. Surgery is often needed to
remove a breast tumor. Options for this include breast-conserving surgery and
mastectomy. The breast can be reconstructed at the same time as surgery or later on.
Surgery is also used to check the lymph nodes under the arm for cancer spread.
Options for this include a sentinel lymph node biopsy and an axillary (armpit) lymph
node dissection.

Breast-conserving surgery
This type of surgery is sometimes called partial (or segmental) mastectomy. It only
removes a part of the affected breast, but how much is removed depends on the size
and location of the tumor and other factors. If radiation therapy is to be given after
surgery, small metallic clips (which will show up on x-rays) may be placed inside the
breast during surgery to mark the area for the radiation treatments.
 Radiation therapy
Radiation therapy is treatment with high-energy rays or particles that destroy cancer
cells. Radiation to the breast is often given after breast-conserving surgery to help
lower the chance that the cancer will come back in the breast or nearby lymph nodes.
Radiation may also be recommended after mastectomy in patients either with a
cancer larger than 5 cm, or when cancer is found in the lymph nodes.

Radiation is also used to treat cancer that has spread to other areas, for example to
the bones or brain.
 Chemotherapy
Chemotherapy (chemo) is treatment with cancer-killing drugs that may be given
intravenously (injected into a vein) or by mouth. The drugs travel through the
bloodstream to reach cancer cells in most parts of the body. Chemo is given in cycles,
with each period of treatment followed by a recovery period. Treatment usually lasts
for several months.

How is chemotherapy given?

In most cases (especially adjuvant and neoadjuvant treatment), chemo is most
effective when combinations of more than one drug are used. Many combinations are
being used, and it's not clear that any single combination is clearly the best. Clinical
studies continue to compare today's most effective treatments against something that
may be better.
 Hormone therapy
Hormone therapy is another form of systemic therapy. It is most often used as an
adjuvant therapy to help reduce the risk of the cancer coming back after surgery, but it
can be used as neoadjuvant treatment, as well. It is also used to treat cancer that has
come back after treatment or has spread.

A woman's ovaries are the main source of the hormone estrogen until menopause.

After menopause, smaller amounts are still made in the body's fat tissue, where a
hormone made by the adrenal gland is converted into estrogen.

Estrogen promotes the growth of cancers that are hormone receptor-positive. About 2
out of 3 of breast cancers are hormone receptor-positive — they contain receptors for
the hormones estrogen (ER-positive cancers) and/or progesterone (PR-positive
cancers). Most types of hormone therapy for breast cancer either stop estrogen from
acting on breast cancer cells or lower estrogen levels. This kind of treatment is helpful
for hormone receptor-positive breast cancers, but it does not help patients whose
tumors are hormone receptor negative (both ER- and PR-negative).
 Targeted therapy
As researchers have learned more about the gene changes in cells that cause cancer,
they have been able to develop newer drugs that specifically target these changes.
These targeted drugs work differently from standard chemotherapy (chemo) drugs.
They often have different (and less severe) side effects.

Drugs that target the HER2/neu protein

In about 1 in 5 patients with breast cancer, the cancer cells have too much of a growth-
promoting protein known as HER2/neu (or just HER2) on their surface. Breast cancers
with too much of this protein tend to grow and spread more aggressively without
special treatment. A number of drugs have been developed that target this protein.

None of these drugs are safe during pregnancy because they can cause harm or even
death to the fetus.
 Thank you

Source:
http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-treating-general-info