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 Breast Cancer Treatments

 

nce breast cancer has been diagnosed, things happen quickly. This is only right, since most cancer is nothing more than body cells that are growing out of control at a very rapid rate. The longer the cancer cells stay in the body, the greater the possibility of their invading the rest of the body (metastasis).

Generally, cancer cells will continue to grow (and cause problems) if they are allowed to remain in the body. They usually have to be taken out of the body, and that will most likely require surgery. Some trials have been done with breast cancer patients where the patients are given radiation treatments, chemotherapy, or both, before surgery is done, to see if the tumors will shrink, allowing less extensive surgery. Results have been positive.

Somewhere along the line, someone has to get a piece of that new mass that was found in the breast, to find out if it is benign or malignant. A biopsy is the only way to do that, because the only positive method of identifying a malignant growth is with a microscope. Today, most surgeons are not willing to do an invasive biopsy that will upset the tumor, fearing malignant cells will be released to the rest of the body. Excisional biopsies are done today, where they also ake a margin of tissue that surrounds the mass. If they find that the margins have no malignant cells, they may feel that no more surgery is necessary.

When surgery is done, a breast-saving Lumpectomy may be done, where a section of tissue is removed from the breast. It depends on the size of the mass that is removed, but the result of the surgery is often cosmetically similar to a breast lift procedure. If the tumor is large enough and involves enough of the breast, the complete breast may need to be removed with a procedure called a Mastectomy. Each of these surgeries may be done any of several ways, with one being the better option for each patient. Discuss all options with surgeons before decisions are made.

Anyone that has breast cancer runs the risk of "maverick" cells leaving the tumor and circulating through the blood system or the lymphatic system, migrating to other locations in the body. This is called metastasis, and means that cancer is spreading throughout the body. This is not a good sign. To try to stop those maverick cells from living long enough to start somewhere else, chemotherapy is often done.

The purpose of chemotherapy is to kill any maverick cancer cells, which are identified to the chemicals by their rapid reproduction. The drawback is that other cells in the body are also fast-growing cells, and they suffer from the chemicals, too. The lining of the stomach has to replace itself constantly, since the stomach acid constantly assaults it. This means that they are fast growing cells, and the chemotherapy chemicals destroy a lot of them, allowing the stomach acid to attack the deep inner tissues of the stomach wall, which causes nausea and alters the taste of many foods. Medicines are getting better for that problem. Hair is attacked also, since it grows relatively fast. It will come back! A woman's eggs are usually destroyed, and those do not come back. Some women "harvest" eggs before taking chemotherapy, if they want to try to become pregnant after the cancer is gone.

Most people would like to avoid the chemotherapy process, so the doctors do a little extra surgery when they do breast cancer surgery. Whether they end up doing a mastectomy or a lumpectomy, they will remove a group of axillary lymph glands (in the armpit) and biopsy them. If they find any malignant breast tumor cells in the glands, the patient's chart will indicate "nodal involvement", and usually means that chemotherapy will be required. We hope that a relatively new procedure called Sentinel Node Biopsy will continue to be developed, ending the serious violation that occurs to the lymphatic system when the lymphatic node biopsy is performed. Ask for this procedure.

Radiation treatment is usually done to destroy any residual malignant cells. Radiation treatments must be very carefully done, to prevent causing additional damage to the skin and the organs. Be sure to use any creams or medications that the doctor suggests. Our body can only take a specific amount of radiation during our lifetime, and each area of the body has its own limits.

Radiation may be done before surgery, after surgery, concurrent to chemotherapy, after chemotherapy, or whatever. Treatment is individual for each patient, and it depends on variables in the body of the patient. The type of cancer and the type of chemicals used are two major variables taken into advisement. The oncologist will work out an individualized treatment program for each patient.

If the breast is to be removed, or seriously compromised by an extensive lumpectomy, the patient may elect to have the breast (or breasts) reconstructed. Reconstruction can be started during the same surgery in which the cancer was removed, or it may be done after the body has recuperated from the battle with cancer. Depending upon which process the patient or the surgeon wants to use to do the reconstruction, surgeries need to be scheduled, and this varies by what process is chosen. There are several options available, but not all of them are a viable choice for everyone.

Some research and trials are being done to determine the influence that Tamoxifen and other hormones or hormone replacements may have on the prevention of breast cancer returning. Currently, new trials are being proposed every month. New surgical techniques and procedures are being tried, and newer, more accurate and less invasive imaging and surgical equipment is being seen every year. We are so advanced from where we were just five years ago, one cannot help but assume that it can only get better… soon.