Treatment and Prevention
Early detection of breast cancer minimizes the likelihood that the cancer has spread, and increases the chances of making a complete recovery. Treatment depends on individual circumstances, such as the rate of growth, how it responds to treatment, and whether or not it has spread.
When the tumor is confined to the breast, the best choice is surgery, followed by systemic therapy and possibly also radiation. Part or all of the breast is surgically removed soon after the diagnosis to avoid having the cancer spread. Removal of a small part of the breast - only the tumor and some surrounding tissue - is called a lumpectomy, or partial mastectomy if a larger area of the breast is removed. A simple mastectomy involves removing the whole breast, and a radical mastectomy includes the underlying chest muscle and tissue as well. The lymph nodes in the underarms may also be taken out.
Systemic therapy consists of chemotherapy and hormonal therapy. Chemotherapy is often given over six to eight months, and hormonal therapy may continue for five years or longer, if tests on the original cancer find receptors for hormones (receptor-positive cancers). The use of systemic therapy is now very common, and greatly reduces the risk of recurrence of the cancer, often by as much as 50%.
On rare occasions, systemic therapy is used prior to surgery. This is called neoadjuvant therapy. This type of treatment is used to improve chances of recovery, to allow surgery to take place successfully, and to assess the response of the tumor to systemic therapy (which cannot occur if the tumor is already removed).
Radiation therapy is often administered after lumpectomy or partial mastectomy. It is used if the resection margins are very close, or if the tumor was large and involved a lot of lymph nodes. Radiation kills any remaining cancer cells in the breast and sometimes in the armpit and chest wall as well. Side effects of radiation therapy are the result of healthy tissue in the area being destroyed, and go away on their own following the completion of therapy.
While successful surgery and radiation therapy rely on exact knowledge of where the tumor is located, systemic therapy does not. Chemotherapy involves taking one or more medications to destroy secondary tumors or in an attempt to suppress growth of cancer cells that may appear in other locations. Hormone therapy works on cancerous cells that have estrogen receptors, making them susceptible to estrogen-blocking medications. The source of the hormones that stimulate growth - ovaries or the adrenal gland - may also be surgically removed or destroyed using X-rays.
As far as we know, breast cancer can't be prevented. Research is ongoing to confirm that medications known as anti-estrogens can help prevent breast cancer for women at high risk. In the meantime, keep in mind the non-drug steps you can take to reduce your risk of breast cancer:
-
exercise regularly
-
eat a healthy, low-fat diet with lots of fruits and vegetables
-
reduce alcohol intake (one to two drinks per day slightly increases your risk)
In addition, women should perform monthly breast self-examinations - your doctor can show you the correct way to do this. From age 50, women of average risk should also have mammograms and physical examinations every two years. These measures help detect any unusual lumps or abnormalities in breast tissue. Early detection can make a big difference in successful treatment.