Breast Cancer Treatment Options
If cancer is present, treatment will depend on where the cancer is and whether it is invasive or has spread to nearby tissue. One of the most important considerations in treatment is if the cancer has spread.
There are two basic types of treatment for breast cancer - local and systemic. Local treatments are used to remove or destroy breast cancer in a specific area. Surgery is the main local therapy for breast cancer.
A mastectomy is an operation to remove the breast or as much of the breast tissue as possible. In a total (simple) mastectomy, the surgeon removes the whole breast. Some lymph nodes under the arm may also be removed.
In modified radical mastectomy, the surgeon removes the whole breast, and most or all of the lymph nodes under the arm. Often, the lining over the chest muscles is removed.
A woman may choose to have breast reconstruction if she has a mastectomy. This is plastic surgery to rebuild the shape of the breast. It may be done at the same time as a mastectomy or later. If you are considering reconstruction, you may wish to talk with a plastic surgeon before having a mastectomy.
This type of surgery includes lumpectomy, partial mastectomy, segmental mastectomy, quadrantectomy.
Breast-conserving surgeries remove the cancer but leave most of the breast intact. In a lumpectomy, the surgeon removes the cancer and some normal breast tissue surrounding the lump in order to obtain "margins" around the tumor that are free of cancer.
The other types of breast-conserving surgery remove a somewhat larger area of the healthy breast. The appearance of the breast will depend on the size of the breast compared to the size of the cancer and the amount of healthy breast tissue that is removed. The appearance of the scar depends on the type of surgery and the location of the cancer.
During surgery, some of the lymph nodes may also be removed. This will be done to determine if the cancer has spread.
Your physician may recommend radiation as well, especially after breast-conserving surgery, to destroy any breast cancer cells that may remain in the area. Radiation therapy is treatment with high-energy rays or particles that destroy cancer cells. This radiation can be focused from a source outside the body on the area affected by the cancer, including the breast, chest wall, and/or underarm area.
Internal radiation, or brachytherapy, is another way to deliver radiation therapy. In this therapy, radioactive seeds or pellets are placed directly into the breast tissue next to the cancer.
Systemic treatments affect cells throughout the body. Systemic treatments can be used to shrink a tumor before local therapy, they can be used after other treatments to prevent reoccurrence or they can be used to treat cancer that has spread.
Examples of systemic therapy include chemotherapy, hormonal therapy and biological therapy.