In recent years, there's been an explosion of life-saving treatment advances against breast cancer, bringing new hope and excitement. Instead of only one or two options, today there's an overwhelming menu of treatment choices that fight the complex mix of cells in each individual cancer. The decisions — surgery, then perhaps radiation, hormonal (anti - estrogen) therapy, and/or chemotherapy — can feel overwhelming.
1. Surgery
Surgery is usually the first line of attack against breast cancer. This section explains the different types of breast cancer surgery.
Decisions about surgery depend on many factors. You and your doctor will determine the kind of surgery that’s most appropriate for you based on the stage of the cancer, the "personality" of the cancer, and what is acceptable to you in terms of your long-term peace of mind.
Is Lumpectomy plus radiation right for you ?
Lumpectomy plus radiation may NOT be right for you under the following circumstances :
- You have already had radiation to the same breast for an earlier breast cancer. Radiation cannot be given twice to the same area.
- You have extensive cancer in the breast or have two or more separate areas of cancer in the same breast. If cancer is extensive or in multiple areas, a mastectomy may be required.
- You have a small breast and a large tumor and removing the tumor would be extremely disfiguring.
- Your surgeon has already made multiple attempts to remove the tumor with lumpectomy, but has not been able to completely remove the cancer and obtain clear margins.
- You have a connective tissue disease, such as lupus or vasculitis, which would make you sensitive to the side effects of radiation.
- You are pregnant. If you're pregnant, it's not save to have radiation therapy.
- You are not willing to commit to the daily schedule of radiation therapy, or distance makes it impossible.
- You believe you would have greater peace of mind with a mastectomy.
- Taking pain medication: You may be given pain medication in the recovery room, and your surgeon will probably give you a prescription to take with you when you leave the hospital. You might want to get it filled on your way home or have a friend or family member get it filled for you as soon as you are home. You may not need the medication, but it’s good to have it on hand in case you do.
- Caring for the bandage (dressing) over your incision: Ask your surgeon how to take care of the lumpectomy bandage. Sometimes, the surgeon will ask that you wait until your first follow-up visit so that he or she can remove the bandage.
- Caring for a surgical drain: If you have a drain in your breast area or armpit, the drain might be removed before you leave the hospital. Sometimes, however, a drain stays inserted until the first follow-up visit with the doctor, usually 1-2 weeks after surgery. If you’re going home with a drain inserted, you’ll need to empty the fluid from the detachable drain bulb a few times a day. Make sure your surgeon gives you instructions on caring for the drain before you leave the hospital.
- Stitches and staples: Most surgeons use sutures (stitches) that dissolve over time, so there's no longer any need to have them removed. But occasionally, you'll see the end of the suture poking out of the incision like a whisker. If this happens, your surgeon can easily remove it. Surgical staples — another way of closing the incision — are removed during the first office visit after surgery.
- Exercising your arm: Your surgeon may show you an exercise routine you can do after surgery to prevent arm and shoulder stiffness on the side where you had the lumpectomy. Usually, you will start the exercises the morning after surgery. Some exercises should be avoided until drains are removed. Ask your surgeon any questions you may have to make sure the exercise routine is right for you. Your surgeon should also give you written, illustrated instructions on how to do the exercises.
- Recognizing signs of infection: Your surgeon should explain how to tell if you have an infection in your incision and when to call the office.
You’ll recuperate at home for a few days after lumpectomy surgery. Here are some guidelines to follow:
- Rest. When you get home from the hospital, you might be fatigued from the experience. Allow yourself to get enough rest so that you can return to your normal routine in a few days. There are a number of ways to manage fatigue.
- Take pain medication as needed. You might feel a mixture of numbness and pain around the surgery area in the breast (and the armpit incision, if you had lymph nodes removed). If you feel the need, take pain medication according to your doctor’s instructions. Learn more about managing pain and armpit discomfort.
- Take sponge baths until your doctor has removed your drains and/or sutures. You can take your first shower when your drains and any staples or sutures have been removed. A sponge bath can refresh you until showers or baths are approved by your doctor.
- Wear a good sports or support bra. You’ll want a supportive bra to wear both day and night for a while to minimize any movement that could cause pain. If you have larger breasts, you may find it more comfortable to sleep on the side that has not been operated on, with your healing breast supported by a pillow in front of you.
- Begin doing arm exercises. The morning after surgery, begin doing arm exercises if your surgeon has advised you to do so.
Weeks and months after lumpectomy
Like all surgeries, lumpectomy carries certain risks:
- Loss of sensation : There is usually some numbness and loss of sensation in part of the breast after lumpectomy, depending on the size of the lump removed. Some or most of this ability to feel can return.
- Breasts that don’t match exactly : Your breasts may not match precisely in size and shape after surgery. This is because removing breast tissue during surgery usually makes the affected breast appear smaller. You may not know this right away, because swelling in response to surgery may make your breast appear temporarily larger.
MASTECTOMY SURGERY
Is Mastectomy right for you ?
Mastectomy may be the right choice for you if the following is true for you :
- If the tumor is larger than 5 centimeters, you will probably need a mastectomy. Depending on stage and other factors, some tumors smaller than 5 centimeters may still require mastectomy, although others may be addressed by lumpectomy.
- If your breast is small and a lumpectomy would leave you with very little breast tissue, your doctor may advise you to have a mastectomy.
- If your surgeon has already made multiple attempts to remove the tumor with lumpectomy, but has not been able to completely remove the cancer and obtain clear margins, you may need a mastectomy.
- If lumpectomy plus radiation is not an option for your small tumor (for example, under 4 centimeters) because you have had prior radiation to the same breast, you have a connective tissue disease (lupus, rheumatoid arthritis), you are pregnant, or you do not want to commit to daily radiation treatment, you may need to have a mastectomy.
- If you believe mastectomy would give you greater peace of mind than lumpectomy, you might decide to have a mastectomy.
Simple or total mastectomy concentrates on the breast tissue itself :
- The surgeon removes the entire breast.
- The surgeon does not perform axillary lymph node dissection (removal of lymph nodes in the underarm area). Sometimes, however, lymph nodes are occasionally removed because they happen to be located within the breast tissue taken during surgery.
- No muscles are removed from beneath the breast.
A simple or total mastectomy is appropriate for women with multiple or large areas of ductal carcinoma in situ (DCIS) and for women seeking prophylactic mastectomies — that is, breast removal in order to prevent any possibility of breast cancer occurring.
Modified Radical Mastectomy
Modified radical mastectomy involves the removal of both breast tissue and lymph nodes :
- The surgeon removes the entire breast.
- Axillary lymph node dissection is performed, during which levels I and II of underarm lymph nodes are removed (B and C in illustration).
- No muscles are removed from beneath the breast.
Most people with invasive breast cancer who decide to have mastectomies will receive modified radical mastectomies so that the lymph nodes can be examined. Examining the lymph nodes helps to identify whether cancer cells may have spread beyond the breast.
Radical Mastectomy
Radical mastectomy is the most extensive type of mastectomy:
- The surgeon removes the entire breast.
- Levels I, II, and III of the underarm lymph nodes are removed (B, C, and D in illustration).
- The surgeon also removes the chest wall muscles under the breast.
Who usually gets a radical mastectomy ?
Today, radical mastectomy is recommended only when the breast cancer has spread to the chest muscles under the breast. Although common in the past, radical mastectomy is now rarely performed because in most cases, modified radical mastectomy has proven to be just as effective and less disfiguring.
Partial Mastectomy
Partial mastectomy is the removal of the cancerous part of the breast tissue and some normal tissue around it. While lumpectomy is technically a form of partial mastectomy, more tissue is removed in partial mastectomy than in lumpectomy.
Subcutaneous (nipple sparing) Mastectomy
During subcutaneous ("nipple-sparing") mastectomy, all of the breast tissue is removed, but the nipple is left alone. Subcutaneous mastectomy is performed less often than simple or total mastectomy because more breast tissue is left behind afterwards that could later develop cancer. Some physicians have also reported that breast reconstruction after subcutaneous mastectomy can result in distortion and possibly numbness of the nipple. Because subcutaneous mastectomy is still an area of controversy among some physicians, your doctor may recommend simple or total mastectomy instead.
After Mastectomy surgery
You’ll be moved to the recovery room after mastectomy surgery, where staff will monitor your heart rate, body temperature, and blood pressure. If you are in pain or feel nauseous from the anesthesia, let someone know so that you can be given medication.
You’ll then be admitted to a hospital room. Hospital stays for mastectomy average 3 days or less. If you have a mastectomy and reconstruction at the same time, you may be in the hospital a little longer.
The morning after your surgery, your surgeon or nurse will show you an exercise routine you can do to prevent arm and shoulder stiffness on the side where you had the mastectomy and to help prevent the formation of significant scar tissue. Some exercises should be avoided until drains are removed. Ask your surgeon any questions you may have to make sure the exercise routine is right for you. Your surgeon should also give you written, illustrated instructions on how to do the exercises.
Before you leave the hospital, your surgeon or nurse will give you information about recovering at home:
- Taking pain medication: Your surgeon will probably give you a prescription to take with you when you leave the hospital. You might want to get it filled on your way home or have a friend or family member get it filled for you as soon as you are home so that you have it available.
- Caring for the bandage (dressing) over your incision: Ask your surgeon or nurse how to take care of the mastectomy bandage. The surgeon may ask that you not try to remove the bandage, and instead wait until your first follow-up visit so that he or she can remove the bandage.
- Caring for a surgical drain: If you have a drain in your breast area or armpit, the drain might be removed before you leave the hospital. Sometimes, however, a drain stays inserted until the first follow-up visit with the doctor, usually 1-2 weeks after surgery. If you’re going home with a drain inserted, you’ll need to empty the fluid from the detachable drain bulb a few times a day. Make sure your surgeon gives you instructions on caring for the drain before you leave the hospital.
- Stitches and staples: Most surgeons use sutures (stitches) that dissolve over time, so there's no longer any need to have them removed. But occasionally, you'll see the end of the suture poking out of the incision like a whisker. If this happens, your surgeon can easily remove it. Surgical staples — another way of closing the incision — are removed during the first office visit after surgery.
- Recognizing signs of infection: Your surgeon should explain how to tell if you have an infection in your incision and when to call the office.
- Exercising your arm: Your surgeon or nurse may show you an exercise routine you can do to prevent arm and shoulder stiffness on the side where you had surgery. Usually, you will start the exercises the morning after surgery. Some exercises should be avoided until drains are removed. Ask your surgeon any questions you may have to make sure the exercise routine is right for you. Your surgeon should also give you written, illustrated instructions on how to do the exercises.
- Recognizing signs of lymphedema: If you have had axillary dissection, you will be given information on taking care of your arm and being alert to signs of lymphedema.
- When you can start wearing a prosthesis or resume wearing a bra: The site of mastectomy surgery, and especially mastectomy with reconstruction, needs time to heal before you can wear a prosthesis or bra. Your doctor will tell you how long you may need to wait.
At-Home Recovery from Mastectomy
It can take a few weeks to recover from mastectomy surgery, and longer if you have had reconstruction. It’s important to take the time you need to heal.
In addition to your surgeon’s instructions, here are some general guidelines to follow at home:
- Rest. When you get home from the hospital, you will probably be fatigued from the experience. Allow yourself to get extra rest in the first few weeks after surgery. Read more about managing fatigue.
- Take pain medication as needed. You will probably feel a mixture of numbness and pain around the breast incision and the chest wall (and the armpit incision, if you had axillary dissection). If you feel the need, take pain medication according to your doctor’s instructions. Learn more about managing chest pain, armpit discomfort, and general pain.
- Take sponge baths until your doctor has removed your drains and/or sutures. You can take your first shower when your drains and any staples or sutures have been removed. A sponge bath can refresh you until showers or baths are approved by your doctor.
- Continue doing arm exercises each day. It’s important to continue doing arm exercises on a regular basis to prevent stiffness and to keep your arm flexible.
- Have friends and family pitch in around the house. Recovery from mastectomy can take time. Ask friends and family to help with meals, laundry, shopping, and childcare. As your body heals, don’t feel you should take on more than you can handle.
In the months after Mastectomy
Your body will continue to adjust to the effects of the surgery over a period of months. Here are some things to keep in mind:
- You may have “phantom sensations” or “phantom pain” in the months after mastectomy : As nerves regrow, you may feel a weird crawly sensation, you may itch, you may be very sensitive to touch, and you may feel pressure. Your discomfort may go away by itself, or it may persist but you adapt to it. Analgesics and NSAIDs (pronounced EN-seds) such as acetaminophen and ibuprofen usually can address the pain related to this type of nerve injury. Opioids (pronounced OH-pee-oydz) also can be used to treat this type of pain. Read more about managing phantom pain.
- Continue doing regular arm exercises : Stay with your arm exercise routine to keep your arm limber.
- You may experience fatigue from time to time in the early months after surgery : If you’re having trouble with fatigue, ask your doctor about things you can do.
Like all surgeries, mastectomy has some risks:
- Numbness of the skin along the incision site and mild to moderate tenderness of the adjacent area: Numbness and tenderness can happen because the nerves were cut during surgery. Find out more about numbness.
- Extra sensitivity to touch within the area of surgery: Touch sensitivity is also due to irritated nerve endings. The sensation usually improves as the nerves grow back. Read more about managing breast area sensitivity.
- Fluid collecting under the scar: Fluid collection under the scar may be the result of hematoma — an accumulation of blood in the wound — or seroma, an accumulation of clear fluid in the wound. Both usually resolve on their own or after being drained with a needle by your doctor. Learn more about hematoma and seroma.
- Delayed wound healing: During mastectomy, the blood vessels that supply your breast tissue are cut. Occasionally that can present problems when your body tries to heal the incision site. If there isn't enough blood flow to the flaps of your incision, small areas of skin may wither and scab or need to be trimmed by your surgeon. This is uncommon and is usually not a serious complication. Read more about managing delayed healing.
- Increased risk of infection in the surgical area: If infection happens, it can usually be discovered early and responds well to treatment. Talk to your doctor about the warning signs of infection.
- Scar tissue formation: With mastectomy alone and mastectomy plus reconstruction, there is a risk for scar tissue to form and build up over time. Sometimes the scar tissue can be lumpy or painful. Your surgeon can tell you about ways to manage any discomfort. Find out more about managing scar tissue formation.
If you have invasive breast cancer, your surgeon will probably remove some of the lymph nodes under your arm during your lumpectomy or mastectomy. Examining your lymph nodes helps your doctors figure out the extent of cancer involvement. Cancer in lymph nodes is associated with an increased risk of having cancer cells in other parts of your body.
Your lymph nodes act as filters for your body's lymphatic drainage system. That's why the lymph nodes are likely to "catch" or filter out cancer cells that might be floating in the fluid that drains away from the cancerous area of the breast. Doctors look at the different kinds of nodes that are involved with your breast :
- The nodes around your collarbone and neck (supraclavicular, infraclavicular, and cervical nodes) are examined manually (by hand). Your doctor will feel this area for signs of enlarged nodes.
- The nodes under your arm (axillary lymph nodes) are also examined manually and are relatively easy to get to during surgery. Surgery to remove some or all of the lymph nodes under your arm is called axillary lymph node dissection.
You can learn more about possible side effects of lymph node removal in our section on Arm Lymphedema.
Chemotherapy is a systemic therapy; this means it affects the whole body by going through the bloodstream. The purpose of chemotherapy and other systemic treatments is to get rid of any cancer cells that may have spread from where the cancer started to another part of the body.
Chemotherapy is effective against cancer cells because the drugs love to interfere with rapidly dividing cells. The side effects of chemotherapy come about because cancer cells aren't the only rapidly dividing cells in your body. The cells in your blood, mouth, intestinal tract, nose, nails, vagina, and hair are also undergoing constant, rapid division. This means that the chemotherapy is going to affect them, too.
Still, chemotherapy is much easier to tolerate today than even a few years ago. And for many women it's an important "insurance policy" against cancer recurrence. It's also important to remember that organs in which the cells do not divide rapidly, such as the liver and kidneys, are rarely affected by chemotherapy. And doctors and nurses will keep close track of side effects and can treat most of them to improve the way you feel.
You'll also read about the different chemotherapy regimens and about deciding together with your medical oncologist which regimen would be best suited to you.
It's important to remember that every woman's ideal treatment plan is different. Be aware that your "chemo" regimen may be different from someone else's, based on very individual—and sometimes subtle—breast cancer factors. These include: lymph node involvement, tumor size, hormone receptor status, grade, and oncogene expression. Be prepared for your doctor to recommend a combination of chemotherapies—together or in a series.
3. Radiation Therapy
Radiation therapy — also called radiotherapy — is a highly targeted, highly effective way to destroy cancer cells in the breast that may stick around after surgery. Radiation can reduce the risk of breast cancer recurrence by about 70%. Despite what many people fear, radiation therapy is relatively easy to tolerate and its side effects are limited to the treated area.
Your radiation treatments will be overseen by a radiation oncologist, a cancer doctor who specializes in radiation therapy.
Ten Key Points about Radiation Therapy
2. The actual delivery of radiation treatment is painless. But the radiation itself may cause some discomfort over time.
3. External radiation treatment, the most common kind of radiation therapy, does not make you radioactive.
4. Treatment is usually given 5 days a week for up to 7 weeks. Sometimes radiation may be given twice a day for 1 week.
5. Since the daily appointments usually take about 30 minutes, you'll most likely be able to follow most of your normal routine during treatment.
6. Radiation will not make you lose your hair, unless radiation is given to your head.
7. In the area where you are receiving radiation, your skin can turn pink, red, or tan, and may be sensitive and irritated. Creams and other medicines can soothe these symptoms.
8. During your treatment course, you may feel tired. This feeling can last for a few weeks–even months–after treatment ends.
9. Most radiation side effects are temporary.
10. Radiation therapy can significantly decrease the risk of cancer returning after surgery.
4. Hormonal therapy
Hormonal therapy is a very effective treatment against breast cancer that is hormone-receptor-positive. Find out if you should be tested to see if you need other therapies, as well. Sometimes called "anti-estrogen therapy," hormonal therapy blocks the ability of the hormone estrogen to turn on and stimulate the growth of breast cancer cells.
For years, tamoxifen was the hormonal medicine of choice for all women with hormone-receptor-positive breast cancer. But in 2005, the results of several major worldwide clinical trials showed that aromatase inhibitors (Arimidex [chemical name: anastrozole], Aromasin [chemical name: exemestane], and Femara [chemical name: letrozole]) worked better than tamoxifen in post-menopausal women with hormone-receptive-positive breast cancer.
Aromatase inhibitors are now considered the standard of care for post-menopausal women with hormone-receptor-positive breast cancer. Tamoxifen remains the hormonal treatment of choice for pre-menopausal women.
Hormonal therapy is an important option for anyone with hormone-receptor-positive breast cancer. That includes women of all ages, with any stage of disease, and together with or separate from other forms of treatment. Some types of hormonal therapy can also help women who've never had breast cancer but who are at increased risk for developing the disease.
You might benefit from hormonal therapy if you have:
- non-invasive disease, such as DCIS (ductal carcinoma in situ). Hormonal therapy lowers the risk of the non-invasive cancer coming back. More importantly, it also lowers the risk of developing a more serious INVASIVE cancer in either breast.
- early-stage invasive disease. Hormonal therapy can reduce the risk of the cancer coming back as well as the risk of developing a new breast cancer in either breast.
- a large cancer in the breast. Hormonal therapy can help shrink the size of the cancer before surgery to help you keep your breast and avoid mastectomy.
- a recurrence of a prior cancer. If the cancer that comes back is hormone-receptor-positive, then hormonal therapy can help. Hormonal therapy is used differently depending on whether the recurrence is:
- local (involves just the breast)
- regional (involves the lymph nodes next to the breast), or
- metastatic (involves other parts of the body).
- advanced (metastatic) disease. Hormonal therapy can help get metastatic disease under control, shrink it, and limit further spread.
- a high risk of breast cancer but no prior personal history of the disease. Hormonal therapy can help reduce the risk of ever getting breast cancer for women with:
- a strong family history of breast cancer
- a known breast cancer gene abnormality or
- a prior breast biopsy showing abnormal cell growth
Women who have breast cancers that are hormone - receptor - negative will want to consider other options for treatment. Without estrogen and progesterone receptors for hormonal therapies to work on, hormonal therapy offers hardly any benefit. And it's not worth dealing with side effects if there are no real benefits.
Hormonal therapy can produce remarkable results with relatively few side effects in many women. But it's not perfect. There are factors you must sort out, and pros and cons you must weigh, before you start hormonal therapy. You and your doctor will go over the issues, balancing the potential benefits and side effect for your unique situation. You'll also want to discuss how these benefits and side effects may be influenced by your other health concerns.
Together with your doctor, first think about your cancer-related concerns. Learn as much as you can about the various types of hormonal therapy. Figure out which kind, or kinds, might help you. Next, look at the hormonal therapy's side effects. Then see how the hormonal therapy might influence your other medical conditions.
Step 1 : Find out wheter hormonal therapy is right for you
Here are the cancer-related concerns to help you and your doctor decide :
- The cancer's hormone - receptor status — Does the cancer have hormone receptors for estrogen or progesterone (is it hormone - receptor - positive or hormone - receptor - negative) ?
- Other treatments you've had — Have you already had chemotherapy and/or radiation? Have you had other forms of hormonal therapy before ?
- Your risk of recurrence — Do any factors put you at high risk for breast cancer recurrence or a new breast cancer, and what can you do to lower your risk ?
If the answers to the above questions indicate that hormonal therapy will help you, the next step is for you and your doctor to choose the treatment plan that's the best one for you. You will need to consider all the factors below :
Menopausal status
- Are you pre-menopausal (still getting your period every month), peri-menopausal (having irregular periods), or post-menopausal (no longer having periods)? (In addition to a change in menses, menopause brings with it a variety of other changes in the body, including bone loss.)
- Tamoxifen is standard of care for pre-menopausal women.
- Ovarian shutdown or removal is another option for pre-menopausal women, sometimes combined with another form of hormonal therapy.
- Aromatase inhibitors are only for post-menopausal women.
- Faslodex (chemical name: fulvestrant) is another option for post-menopausal women with advanced disease.
Stage of breast cancer
- Tamoxifen is the only hormonal therapy approved to reduce risk for women at high risk (with no personal history of breast cancer) and for women with non-invasive breast cancer. It is standard of care for pre-menopausal women with any stage of disease.
- Studies of aromatase inhibitors for risk reduction for women with no personal history of breast cancer are under way.
- Aromatase inhibitors are the first choice of hormonal treatment for post-menopausal women with any stage of hormone-receptor-positive invasive breast cancer.
- Other hormonal therapies may also be used, depending on the cancer's stage and your personal situation.
Nature of the cancer
- There is early evidence that HER2-positive breast cancer in post-menopausal women may respond better to an aromatase inhibitor than tamoxifen. A study suggested choosing hormonal therapy in part based on the cancer's combined estrogen and progesterone receptor-status (ER+/PR+ or ER+/PR-).
You may have other health concerns, unrelated to breast cancer, that might require extra management while you are taking hormonal therapy. These health concerns usually will not be the deciding factor in which hormonal therapy you should use. Rather, these health issues together with possible side effects of hormonal therapy may require extra attention and management during your course of therapy.
- A personal history of blood clots
If you have had blood clots, your doctor will probably want you to avoid tamoxifen. But if you are pre-menopausal, your history of blood clots was not serious, and tamoxifen is an important part of your care, your doctor may recommend taking a blood thinner (such as baby aspirin) along with tamoxifen. - Serious osteoporosis
Some doctors will want to do bone tests before starting you on hormonal medication, because many of these medicines have been shown to affect bone health. If you have had a test to measure your bone density (a DEXA scan), your doctor will have told you whether you have osteoporosis (bone loss). If you do, you may be put on a bone-building medicine. If you don't respond to the medicine, and you've had broken bones already, then your doctor may recommend tamoxifen over an aromatase inhibitor. But if your doctor thinks that it's critical for you to be on an aromatase inhibitor, then a more effective bone-building plan may be recommended along with the aromatase inhibitor. - Arthritis
Arthritis is common in women with or without a diagnosis of breast cancer. Aromatase inhibitors can cause joint and muscle pain. This might be a new symptom for you, or hormonal therapy may make existing aches and pains worse. - No hysterectomy (you still have a uterus)
If you have NOT had a hysterectomy and still have your uterus, your doctor may suggest that you avoid tamoxifen, which is associated with a higher incidence of uterine cancer.
So the answer to the question, "who is hormonal therapy for?" includes a pretty wide range of people. All along the way, you and your doctor will re-evaluate the balance of benefits and side effects.
Learning all about the different hormonal treatments will help you to have a more informed conversation with your doctor.
You might think of hormonal therapy as a critical insurance policy to back up your other treatments. Hormonal therapy gives many benefits. It can :
- reduce your risk of cancer coming back or spreading
- reduce your risk of a new cancer starting in the other breast
- shrink a medium-to-large breast cancer before surgery, making it possible for you to have lumpectomy and radiation instead of mastectomy
Also, if you have never had breast cancer but areat increased risk for getting the disease, hormonal therapy can reduce that risk.
Most of the different hormonal treatments have similar benefits. You and your doctor will choose the treatment that is right for you by looking at your medical history, your menopausal status, and your personal preferences. Your doctor's recommendation will be based on clinical guidelines as well as experience with many patients taking hormonal therapies over the years. Once you select a hormonal therapy, you have to take the medicine as prescribed in order to get the benefits.
In addition to considering the benefits, the two of you will need to look at the various side effects of the treatments. Weighing one against the other will allow you to select the best hormonal therapy for YOU.
5. Targeted Cancer Therapies
Targeted cancer therapies are treatments that target specific characteristics of cancer cells, such as a protein that allows the cancer cells to grow in a rapid or abnormal way. Targeted therapies are generally less likely than chemotherapy to harm normal, healthy cells. Some targeted therapies are antibodies that work like the antibodies made naturally by our immune systems. These types of targeted therapies are sometimes called immune targeted therapies.
There are currently 3 targeted therapies doctors use to treat breast cancer :
Herceptin
Herceptin (chemical name: trastuzumab) works against HER2-positive breast cancers by blocking the ability of the cancer cells to receive chemical signals that tell the cells to grow.
Tykerb
- Tykerb (chemical name: lapatinib) works against HER2-positive breast cancers by blocking certain proteins that can cause uncontrolled cell growth.
Avastin (chemical name: bevacizumab) works by blocking the growth of new blood vessels that cancer cells depend on to grow and function.
