With constantly improving medical sciences, breast cancer patients now have a high chance of survival and leading a healthy fulfilling life. This is especially true for people who have received an early diagnosis of breast cancer. Scientists are conducting research to improve the existing breast cancer treatment options and find innovative plans for breast cancer care.
Various factors come into play while deciding the best treatment course for you, including the type of cancer and stage. Here, you will find information on different breast cancer treatment methods, side-effects of the treatments, and how to cope with cancer.
- What is breast cancer?
- How is it diagnosed?
- Stages of breast cancer
- Treatment options for breast cancer
- Side effects of treatment
- Managing health and coping with cancer
- Family planning with breast cancer
- Outlook for patients
What is breast cancer?
Breast cancer is the cancer of breasts, it is more common in women but can occur in men as well. Lumps in the breasts, unusual discharge from nipples, breast pain, and changes in the texture of the skin are some common tell-tell signs of breast cancer. Certain risk factors of breast cancer increase the likelihood of you getting the disease including family history of breast cancer.
Essentially breast cancer is the abnormal cell growth in the breast region. Sometimes this cancer is enclosed in a membrane and does not spread to other areas, and other times the cancer spreads to different areas within the breast or to different organs.
How is it diagnosed?
Doctors recommend every woman to go for routine check-ups at their gynaecologists and screen for breast and ovarian cancer for early detection. You can also visit the doctors on noticing any unusual symptoms in your breasts, such as breast pain. The doctor may recommend one or a combination of the following tests to confirm the diagnosis of breast cancer:
- Physical exam
The doctor will manually check your breasts, armpits, and collar bone area to look for any lumps or other abnormalities; you can perform this test by yourself as well.
This is like an X-ray of the breasts, which allows the doctor to have a clear visual of your breasts.
- Breast ultrasound
An ultrasound of the breasts allows the doctor to determine if the lump is a solid mass or a fluid-filled cysts in the breast.
This procedure involves taking a sample of the core tissue of the suspected area to confirm the diagnosis of breast cancer and determine the nature of the diseases.
- Breast magnetic resonance imaging (MRI)
This test can help the doctors attain a detailed imaging of your breast to determine the best treatment plan for you.
Stages of breast cancer
After confirming the diagnosis of breast cancer, your doctor will work on to establish the type and stage (extent) of the cancer. This is extremely helpful in creating a suitable care plan to cure you; some cases are too advanced to cure, and the doctors may work to increase the survival time of the patient in such a scenario. Different tests during the diagnosis can help the doctors collect relevant information, but breast cancer surgery is the only way to completely understand the condition and prevent it from happening again. The following tests may be recommended to determine the stage of your cancer:
- Blood tests including complete blood count
- Mammogram of the other breast
- Breast MRI
- Bone scan
- Positron emission tomography (PET) scan
- Computerised tomography (CT) scan
Doctors note the size of the tumour, affected lymph nodes, and the metastasis (spread of cancer in other areas of the body) while determining the stage. Breast cancer stages range from 0 to IV, where stage 0 breast cancer is least problematic and contained within the membrane, and stage IV of breast cancer indicates the spread of cancer in other areas, such as the liver, bones, and lungs.
Treatment options for breast cancer
The doctor will determine a suitable breast cancer treatment by stage and other factors including the following:
- Type of breast cancer
- Size of the breast tumour
- Sensitivity of the cancer cells to hormones
Irrespective of the case, surgery to remove the affected tissue is usually recommended at every stage from preventing the diseases from progressing further. Stage 0 patients are often treated with surgery and hormone therapy (maybe) and do not require additional treatment, whereas stage I and II patients require surgery and other less toxic treatments. Stage III patients will be exposed to radiation, chemotherapy, and other forms of harsh treatment methods in addition to the breast cancer surgery, which takes a toll on their body. For stage IV patients, the doctors will focus on increasing the life expectancy by recommending a combination of different treatment methods.
Here are the standard treatment options for breast cancer treatment.
- Breast cancer surgery
This process usually involves the removal of the cancerous breast tumour and nearby healthy tissue. Depending on the amount of the tissue removed, breast cancer surgery has been further divided into the following categories:
This is the procedure used for removing smaller tumours and a little bit of the surrounding healthy tissue. A lumpectomy is recommended to people who have small masses, and their breasts can be persevered. Some people who have larger dormant tumours (contained in a membrane and not spreading) are given chemotherapy to shrink the tumour, which is then removed through lumpectomy.
In this procedure, all of the breast tissue, including the lobules, ducts, fatty tissue, nipple, areola, and some skin, of the affected breast, is removed. This is also referred to as simple or total mastectomy. Certain latest breast cancer treatment methods allow doctors to improve the appearance of the breast in selected cases. For example, nipple sparring mastectomy leaves the nipple intact. Sometimes the surgeon may restore the breast shape with the help of silicone implants.
c. Sentinel node biopsy
In some cases, the doctor might recommend the removal of a limited number of lymph nodes to determine the spread of cancer; lymph nodes receive the lymph drainage from the tumour and have cancer markers. The doctor will leave the rest of the lymph nodes intact if no cancer is found in the removed lymph nodes.
d. Axillary lymph node dissection
If the doctors find traces of cancer in the sentinel lymph nodes, they will recommend removing additional lymph nodes from the armpit region.
e. Contralateral prophylactic mastectomy
Women with breast cancer may choose to have both their breasts removed during the surgery to prevent breast cancer from recurring if they have an increased risk of cancer. However, most women with breast cancer do not develop cancer in their remaining breast after the surgery.
2. Radiation therapy
In this breast cancer treatment, high-powered beams of energy, such as protons and/or X-rays, are used to kill cancer cells. The patient is required to lay down on a large machine which uses external beam radiation to treat breast cancer patients. Sometimes a radioactive material can also be placed inside the patient’s body. Doctors often recommend radiotherapy after lumpectomy and after a mastectomy for certain patients to kill the cancer cells that could not be removed during surgery.
Depending on the breast cancer treatment, the radiation therapy can last anywhere form 3 days to 6 weeks. A breast cancer specialist who specialises in radiation therapy—radiation oncologist—determines the right course of treatment for a patient based on the location of the breast tumour, cysts in the breast (if any), and other factors. Radiation therapy is usually performed after a month or so of chemotherapy; each session of radiation therapy lasts for a few minutes.
In this treatment method, drugs are used to destroy the rapidly growing cancer cells; these drugs are either given orally or intravenously. The doctor recommends chemotherapy to patients who have a high chance of recurring cancer or the breast cancer spreading to other parts of the body.
Women who have larger tumours in their breasts are administer chemotherapy before the breast cancer surgery is conducted. Chemotherapy also helps in reducing the symptoms of cancer (such as breast pain) in addition to controlling the cancer.
Many women are recommended chemotherapy after the surgery to kill the remaining cancer cells; however, chemo also destroys healthy cells along with cancer cells and is highly toxic for the body. Although chemotherapy cannot cure stage IV cancer, it can shrink the tumours and increase the life expectancy of the patient.
4. Hormone therapy
This breast cancer treatment is used to treat hormone-sensitive breast cancers. Ovaries in women release oestrogen and progesterone hormones that also contribute to the growth of breasts. Some tumours in the breast are sensitive to these hormones; doctors also refer to these types of cancer as oestrogen receptor positive (ER positive) cancer and progesterone receptor positive (PR positive) cancer.
Hormone therapy is recommended before or after the breast cancer surgery and/or in combination with other treatments to reduce the likelihood of a cancer from recurring. Hormone therapy is also useful in shrinking and controlling already existing cancerous tumours. This treatment method usually involves the following:
i. Medicines that block hormones from attaching to the cancer cells
ii. Medicines that stop oestrogen production in the body before or after the menopause
5. Targeted therapy medication
Some breast cancer cells produce a protein called human epidermal growth factor receptor 2 (HER2) more than normal healthy cells. This protein helps the cancer cells to grow. Targeted therapy drugs work by targeting cancer cells with excess HER2, and the medicine only damages cancer cells without affecting any healthy cells.
Targeted therapy drugs are some of the latest breast cancer treatment options and remain an active area of research. There are different types of such targeted drugs, which focus on abnormalities in the cancer cells.
This treatment method enhances the ability of the immune system to fight the cancer cells. The proteins produced by cancer cells can diminish the disease-fighting ability of the immune system and immunotherapy interferes this process.
People who have triple-negative breast cancer, which means the cancer cells do not have receptors for HER2, oestrogen, or progesterone, may be recommended immunotherapy to treat cancer.
Side effects of treatment
Each breast cancer treatment method comes with few risks, some more severe than others. If you have any doubts, you should consider talking to your doctor to clear your doubts. Many side-effects gradually go away on their own after stopping treatment, but others may be permanent. Here are some of the common side effects of breast cancer treatment:
- Weight loss or gain
- Swelling in arms
- Hair loss
- Changes in skin or nails
- Mouth sores
- Difficulty getting pregnant
- Trouble sleeping and/or thinking clearly
Managing health and coping with cancer
Being diagnosed with breast cancer can leave you feeling bereft and overwhelmed. This can severely impact your mental health, which in turn can cause your physical health to deteriorate. You should learn more about your condition by reading books, watching documentaries, or consulting doctors to make active decisions about your care; make sure you filter out knowledge about the disease if it doesn’t come from a reliable source. Here are some more ways to ensure that you maintain good mental and physical health:
- Talk to people who have been through the same journey—other breast cancer survivors.
- Consult a psychotherapist and/or join a social group so that you can talk to other people about your feelings in a safe setting.
- Spend time with your friends and family and ask them for help if you need someone to run errands or doing chores.
- Ask your doctor about a suitable diet and possibly an exercise plan to help you be more active and lead a healthy life.
Family planning with breast cancer
A woman may get breast cancer before hitting menopause, which can cause complications with conceiving later in life. The treatment for breast cancer is usually quite harsh on your body; for example, chemotherapy damages healthy cells. Some hormone therapy and chemotherapy drugs can cause temporary/permanent infertility or early menopause in some cases. Few cancer treatment methods are also linked with congenital (or birth) defects; thus, women who are undergoing treatment for cancer should take birth control measures to avoid conceiving.
If you are planning to conceive and start a family and are diagnosed with breast cancer, there are certain measures you can take to increase the likelihood of having a family, such as:
- Freezing your eggs or embryos to use in the future
- Freezing the ovarian tissue to be implanted later on to restore ovarian function (this technique is not widely available)
- Getting fertilised egg donation from a donor to be implanted after the treatment is complete
- Putting your reproductive organs in an inactive or dormant state with the help of hormonal suppression to protect germ cells (that develop into eggs) from harmful chemotherapy
Outlook for patients
People with breast cancer may have a hard time coping with the illness both physically and mentally. Since this disease can become potentially life-threatening, it is important to consult a specialist in a breast cancer hospital for the best treatment options and start the care plan early on. Except for the disease, breast cancer treatment can also have harmful side-effects, most of which wear out over time after the treatment stops. Besides, there is a risk that breast tumours might return, and you may need to repeat the treatment.
The doctors usually start a palliative breast cancer care plan during or after the breast cancer treatment stops. It focuses on alleviating breast pain and other symptoms of a serious illness such as breast cancer. The palliative care is helpful in complementing the ongoing breast cancer treatment and may further make it efficient.
What is the best treatment for breast cancer?
Different types of breast cancer treatment are suitable for different people. To determine the best breast cancer care plan for you, your doctor will analyse your condition and recommend a combination of different treatments.
Can breast cancer be cured completely?
es, patients with early-stage breast cancer have a high chance of being cancer free. In some cases, breast cancer surgery coupled with radiation therapy is enough to cure a patient with breast cancer. However, there is a chance that cured patients might get breast cancer again.
What stage of breast cancer is treatable?
Every stage of breast cancer is treatable but not curable. The treatment for last stage breast cancer can largely work on increasing the life of the patient and may not be enough to cure the patient.
What are the four treatments for breast cancer?
The following are the most common treatments for breast cancer:
a) In breast cancer surgery, the breast tumour and a little bit of surrounding healthy tissue are removed.
b) In radiation therapy, high-energy beams are used to kill remaining cancer cells.
c) In chemotherapy, drugs are used to destroy cells growing at a fast pace including healthy cells.
d) Hormone-blocking therapy is useful in treating hormone-sensitive breast cancer.
How much does breast cancer treatment costs?
Breast cancer treatment costs in India usually range from INR 2 lakhs to INR 16.5 lakhs; government hospitals charge less than private hospitals.