It is one of the most common cancers. If diagnosed early, it is curable in most patients. However, even in advanced stages. It is treatable. Only three to five percent of breast cancers are genetic and inherited from family . The majority of cancers happen randomly.
Diagnosis and screening
Screening means finding cancer before it is found by the women themselves or their doctors by examination of the breast. The best method to find cancer early is a mammogram (x-ray of the breast is called a mammogram).
For early detection of cancer, a mammogram is usually recommended, after age 40, in all women on a yearly or every two-year basis.
The majority of the time In our country women feel the lump themselves and come for further testing.
Diagnosis requires a biopsy which means taking a sample of these tumor cells either by an FNA(fine needle aspiration where a syringe is used to suck few cells out of the cancer in breast or armpit) or a core biopsy (where a large thick needle is used to take a piece out of the cancer mass/lump/tumor).
Then the sample is examined by a pathologist who will determine what kind of cancer it is by various tests including finding out if it is;
– hormone-positive(estrogen and progesterone receptors on cancer cells) or negative,
-her-2-neu positive or negative or
-all negative(triple negative)
Breast cancer treatment depends on the type of breast cancer determined by biopsy and pathology. Every type of cancer has specific treatment protocols that need to be followed for the best outcomes.
Breast cancer also needs to be staged after diagnosis to make sure you know where the cancer is and whether it has spread to any other place including the armpit or it has spread further to other organs like bones, liver, lung, brain, etc. This will help guide your Oncologist to know how best to treat and what medicines to use first to treat it more effectively.
Treatment of breast cancer involves surgery, chemotherapy, and Radiation.
These treatments could be given before surgery or after surgery.
However, there may be some women who will not need any other treatment except surgery, especially If the tumor is very very small.
Some women will require all the treatments including chemotherapy, surgery and radiation therapy, hormonal therapies.
Type of surgery depends on the size of the tumor and the woman’s wishes. Usually removing only the portion of the breast which has the cancer in it is called lumpectomy. Sometimes the whole breast is removed and is called mastectomy. if only the portion which had the tumor in it is removed ,radiation is needed after the operation. It is also very important that your surgeon removes and checks the lymph nodes in the axilla.
That’s the first place where the tumor spreads if it will spread in the future.
Usually only a few lymph nodes need to be removed to check if there is cancer or not. The procedure is called Sentinel lymph node biopsy where the surgeon injects a dye into the cancer in the breast and that dye travels to the lymph nodes in the axilla .The lymph nodes which take up with the dye , are removed and checked to make sure if there is cancer or not.
Chemotherapy Many young women and older women with aggressive cancers will need chemotherapy .chemotherapy helps to stop the cancer from coming back. There are many kinds of chemotherapy treatments.
It’s given after the chemotherapy. It usually lasts for a few days to a few weeks.
The women who have hormone positive cancers, like estrogen positive or progesterone positive cancers will usually require five to ten years of Hormonal therapy.
There are several options. In older women ,for hormonal therapy after the menopause ,drugs like letrozole ,anastrozole ,tamoxifen Etc. are used.
In younger women, tamoxifen is usually used for 5 to 10 years. There are other hormonal therapies, which are also used in some women.
Herceptin is used in women whose cancer is Her-2-Neu positive. In breast cancers about 25 to 30 percent of the women have this type of her-2,nu positive cancer and will benefit from herceptin. This is usually done for six months to a year.
It is an injection form of treatment. It also helps the tumor from coming back.
Treatment of the stage four / metastatic or widespread tumor
It usually involves treatment of the tumor and the tumor related symptoms
If the tumor has spread to the bones, A bone strengthening medicine is also used.
Depending on the type of the breast cancer ,chemotherapy ,hormonal therapy, immunotherapy and biological therapies or other kinds of therapies are utilized to control the cancer from spreading further and helping women to improve their quality of life and live longer.