The treatment for breast cancer depends on many factors, including, your age, general health, the stage of the disease, the size of the tumour, what the cancer cells look like, and of course your personal preference.
Five main types of treatment are available:
Surgery is performed on the breast and, often, on the lymph nodes in the armpit. The type of surgery depends upon the size and type of the breast cancer, and its position within the breast.
Surgery can be performed in two ways:
- Lumpectomy – the lump and some of the surrounding tissue is removed and most of the breast is kept. Removing more of the breast is called a partial mastectomy. Some of the lymph nodes in the armpit may be removed at the same time. During the surgery, the doctor may conduct breast reconstruction to help you maintain a healthy, natural look. Adjustment may also be done on another breast with your consent.
- Mastectomy – the whole breast, including the skin and the nipple are removed. Usually the lymph nodes in the armpit are also removed during this operation. This is called auxiliary clearance or dissection.
- Removing lymph nodes from under the armWe have around 30 to 40 lymph nodes in each of our underarm. Sometimes breast cancer may spread to the lymph nodes in the underarm area which can then spread to the whole body via the lymphatic system.
During surgery, doctors will often remove part of the lymph nodes in the underarm nearest to the infected breast. If case cancer cells are found in these lymph nodes, a surgery may be needed to remove the remaining lymph tissues. Alternatively, radiotherapy may be applied to clear the cancer cells.
Lymph node removal in the underarm area may damage some of the nearby nerve cells, resulting in a feeling of numbness, stabbing pain and/or inflexibility of the upper arm. These side effects may last for a period of time however, physiotherapy can help relieve the discomfort.
Chemotherapy uses drugs to kill or slow the growth of cancer cells that may have travelled to other parts of the body. These drugs are called cytotoxic. The drugs are sometimes given orally or, more usually, intravenously (injected into a vein) and given in cycles so your body has time to recover before the next treatment. Usually, you have a short period of treatment followed by a rest period, and then another period of treatment, and so on. Treatment can be once a week or even once a month, depending on the type of breast cancer, and it lasts about six months.
Chemotherapy can cause temporary side effects, including:
- Feeling sick
- Tiredness and vomiting
- Mouth ulcers
- Thinning or loss of hair from your body or head
Radiotherapy uses X-rays to kill cancer cells. It may be used post-operation to kill any remaining cancer cells. The X-rays are carefully aimed to avoid damaging healthy cells surrounding cancerous cells. The treatment is usually given five days a week over about a six-week period. It doesn't hurt and each session only takes a few minutes. Following radiotherapy a woman's breasts may feel slightly firmer and may change a little in size or shape.
There are two types of radiotherapy; internal radiotherapy and external radiotherapy. External radiotherapy is more commonly used due to limited capacity at the breast site to insert radioactive substances for internal radiotherapy.
Radiotherapy can cause temporary side effects, including:
- Tiredness and nausea
- Mild headaches
- Skin around the treatment area may become red and sore
Hormone Treatment is only suitable for breast cancer clients who are hormone receptor-positive. Some breast cancers require the female hormone oestrogen to grow. Reducing the amount of oestrogen in your body can help slow the growth of the cancer or even shrink it. Some drugs can stop your body producing oestrogen while others drugs, such as Tamoxifen, stop the cancer cells from using oestrogen.
Contraceptive pills are not effective when undergoing hormone treatment. Doctors can provide alternate contraceptive methods = such as condoms, or fitting patients with a cervical cap.
Targeted therapy is a cancer treatment that uses drugs to kill cancer cells. It is different from chemotherapy because it targets specific genes or proteins to stop cancer from growing and spreading. It has fewer side effects than chemotherapy and has a much smaller impact on the immune system and hematopoietic stem cells.
Targeted therapy works only on a certain types of tumors. It is more expensive than traditional cancer treatments and cancer clients should consult professional advice on their individual suitability. In most cases, targeted therapy is used in combination with surgery, chemotherapy and radiotherapy; it is seldom used alone.