Doubts About Breast Cancer Treatment You Should Clarify

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Some people with Stage 2 or Stage 3 cancer may receive chemotherapy first, which is known as “pre-operative “ or “neoadjuvant*” chemotherapy. The goal is to shrink the tumor. By making it smaller first, you may have the option of a breast-conserving surgery or lumpectomy instead of a mastectomy.

*The term adjuvant means “helper” or “enhancer.” Neo means “new” or “at the onset.” So a neoadjuvant therapy is a helper therapy delivered at the beginning of treatment.

How Will I Know What Kind Of Surgery Is Right For Me?

Either your doctor or a breast surgical oncologist (a breast surgeon specializing in breast cancer surgeries) will advise you regarding the surgery options to consider based on specific information about your breast cancer. You can discuss and compare the benefits and risks of each option and describe how well each possible choice can achieve the goal of ridding your body of the primary breast cancer.

Standard Treatment & Clinical Trials

Before selecting your treatment plan, you should first understand the difference between standard treatment and clinical trials.

Breast cancer standard treatments are methods that experts agree are appropriate, accepted, and widely used. These standard procedures have proven useful in fighting breast cancer in the past.
A breast cancer clinical trial, on the other hand, is an approved research study that some doctors believe has a strong potential to improve standard treatments. When clinical trials demonstrate better results than the standard, that new treatment becomes the standard. Remember, all our current standards were clinical trials at one time.

If a breast cancer clinical trial is an option for you, your doctor will explain the possible trade-offs with the trial treatment versus standard treatment. Together with your medical team, you will need to decide what treatment method is the best for you and your health.

Breast Cancer Standard Treatments By Stage

Your treatment options depend on the stage of your disease and these factors:

The size of the tumor in relation to the size of your breast
The results of specific pathology tests (hormone receptors, HER2 receptors, grade of the cells, proliferation rate of the cells)
Whether you have gone through menopause
Your general health
Your age
Your family history or other risk factors associated with a predisposition for developing breast or ovarian cancer
Below are brief descriptions of common treatments for each stage. Other treatments may be appropriate for some women. Research studies (clinical trials) can be an option at all stages of breast cancer.

What Are The Goals Of Breast Cancer Surgery?

The first step and most common form of treatment for breast cancer is surgery. Surgery involves removing the tumor and nearby margins. The margin is the surrounding tissue that might be cancerous. The goal of surgery is to remove not only the tumor, but also enough of the margin to be able to test for the spread of the cancer. Once the removed tissue is checked, your post-operative report should tell you if you had “clear margins,” (meaning the tissue farthest away from the breast was free of any cancer cells.)

Some people with Stage 2 or Stage 3 cancer may receive chemotherapy first, which is known as “pre-operative “ or “neoadjuvant*” chemotherapy. The goal is to shrink the tumor. By making it smaller first, you may have the option of a breast-conserving surgery or lumpectomy instead of a mastectomy.

*The term adjuvant means “helper” or “enhancer.” Neo means “new” or “at the onset.” So a neoadjuvant therapy is a helper therapy delivered at the beginning of treatment.

How Will I Know What Kind Of Surgery Is Right For Me?

Either your doctor or a breast surgical oncologist (a breast surgeon specializing in breast cancer surgeries) will advise you regarding the surgery options to consider based on specific information about your breast cancer. You can discuss and compare the benefits and risks of each option and describe how well each possible choice can achieve the goal of ridding your body of the primary breast cancer.

What Is Chemotherapy?

Chemotherapy is a treatment method that uses a combination of drugs to either destroy cancer cells or slow down the growth of cancer cells.

Cytotoxic drugs (meaning “toxic to cells”) are usually given orally or through a vein (intravenously or “through the bloodstream”).
Chemotherapy is a systemic therapy, meaning that the drugs travel in the bloodstream throughout the entire body.

Who Needs Breast Cancer Chemotherapy?

Chemotherapy is offered to most patients based on several factors including:

Type of receptors and status
Number of lymph nodes involved and degree of involvement
The risk for cancer to spread elsewhere in the body
Your medical team will work to select the right blend of chemotherapy drugs to suppress each stage of the cancer cells’ growth.

How Is Breast Cancer Chemotherapy Administered?

Chemotherapy is commonly prescribed along with other treatment methods such as hormonal and targeted therapies. It can also be used to shrink a tumor before surgery for easier and safer removal.

If you receive chemotherapy, your doctor will administer it in short courses with several weeks in between to allow your normal cells to recover. This treatment period can be a challenging time emotionally and physically. It is important for you to develop a support team of family or friends that can help comfort and encourage you in this time.

What Is Radiation Therapy And How Does It Work?

Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. It affects cells only in the part of the body that is treated with the radiation. Breast cancer radiation therapy may be used to destroy any remaining mutated cells that remain in the breast or armpit area after surgery.

Note: There are special situations in which radiation is used for women with metastatic breast cancer experiencing painful bone metastasis. This section however focused on the use of radiation for adjuvant therapy (treatment given after the main treatment to lower the chance of breast cancer returning).

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