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Treatment of Breast Cancer
Overview of Treatment Options for Breast Cancer
The side effects of chemotherapy depend on the type of drugs, the amount taken, and the length of treatment. The severity of side effects varies from person to person.
Temporary side effects might include fatigue, nausea and vomiting, loss of appetite, hair loss, and mouth sores, depression and changes in the menstrual cycle. Anemia (low red blood cell count which can cause fatigue), neutropenia (low white blood cell count which can increase risk of infection), and thrombocytopenia (low platelet count which can lead to bruising or bleeding) are the most common side effects due to damage of the blood-producing cells of the bone marrow. Very effective medications are available to help treat or relieve most side effects.
Permanent side effects may include premature menopause and infertility, difficulty in concentration and memory (which may persist for 1-2 years, but then usually resolves).
In rare instances, a life-threatening cancer of the while blood cells called acute myelogenous leukemia may develop 1-2 years after treatment for breast cancer.
Surgery for Breast Cancer
Discussions regarding surgical treatment of breast cancers must take into consideration reproductive issues, psychosocial issues, and body image.
Breast-Conserving Surgery
Breast-conserving surgery approach entails surgery to remove the breast cancer but not the breast itself. Types of breast-conserving surgery include:
- Lumpectomy - removal of the breast lump
- Quadrantectomy - removal of one quarter, or quadrant, of the breast
- Segmental mastectomy - removal of the cancer as well as some of the breast tissue around the tumor and the lining over the chest muscles below the tumor
Mastectomy
Simple Mastectomy - (also known as Total Mastectomy) - The entire breast is removed, but the axillary lymph nodes are left intact. No muscles are removed from beneath the breast. Occasionally, lymph nodes may be removed because they are actually located within the breast tissue taken during surgery. A total mastectomy is appropriate for women with ductal carcinoma in situ or DCIS, and for women seeking prophylactic (preventative) mastectomies to prevent any possibility of breast cancer occurring.
Modified Radical Mastectomy - This is the most common type of mastectomy - The entire breast is removed in addition to some of the axillary lymph nodes in the underarm area (axillary dissection)
Radical Mastectomy - This procedure includes removal of the entire breast, all of the axillary lymph nodes, and the chest wall muscles under the breast. These days, radical mastectomy is usually only performed when cancer has spread to the chest muscles under the breast.
Skin-Sparing Mastectomy - This procedure removes the nipple and areola and most of the breast tissue, but leaves the majority of the skin of the breast intact to accommodate reconstruction
Nipple-Sparing Mastectomy - This is a type of skin-sparing mastectomy that leaves the natural nipples intact (only if they are free of cancer cells).
Ovariectomy
An overiectomy is the surgical removal of the ovaries which produce the estrogen that is needed for breast cancers to grow. Its use has resulted in some improvement in breast cancer survival rates in some premenopausal women whose tumors are hormone receptor-positive. In these women, combining this procedure with tamoxifen may improve results beyond those of standard chemotherapies. Ovariectomy does not benefit women after menopause, and its advantages can be reduced in women who have already received adjuvant chemotherapy. The procedure causes sterility and may not be an optimal choice in younger women.
