The Treatment of Breast Cancer

Today the treatment for breast cancer is more varied than ever, increasing the chances of a favorable prognosis. Keep reading to learn more.
The Treatment of Breast Cancer

Last update: 16 January, 2023

The treatment of breast cancer is determined based on several criteria. The most important, according to evidence, is the subtype to which it belongs; although its stage of development and the availability and preference of patients can also be taken into account.

In any case, the important thing is that those diagnosed with the disease have several treatment options.

Studies have improved methods of dealing with this condition, increasing positive prognosis after diagnosis. Even so, the process is conditioned by how quickly it’s detected in its initial stages, thus the importance of monitoring among those who are part of the risk groups.

Surgery for breast cancer

The treatment of breast cancer includes surgery.
Surgery can be done alone or in combination with other therapies.

Evidence indicates that surgery is one of the most effective breast cancer treatments available to specialists. It’s usually used in stages I and II, so it’s the most viable option when the disease is detected in its early stages of development. There are many types of breast cancer surgeries, among which we’ll highlight the main ones:

  • Lumpectomy: This is also known as breast conservation surgery, as it’s based on the direct removal of the malignant tumor in the company of its surrounding tissue. In all cases, it’s accompanied by radiotherapy to completely eliminate possible residual cancerous tissues.
  • Mastectomy: Unlike the previous surgery, in this case, all of the breast tissue is removed. Today there are alternatives aimed at preserving the shape of the breast, such as skin-sparing mastectomy or nipple-sparing mastectomy. In some cases, a total surgery must be performed, with the removal of the skin, nipple, and areola.

As the American Cancer Society reminds us, the choice of the type of mastectomy depends on the characteristics of each tumor, its size, and its location. These are the most common procedures, although sometimes they can be complemented with the following:

  • Sentinel node biopsy: In principle, this is done to determine if the disease has spread to this area. The National Cancer Institute points out that these are the first to be infected by the spread of the tumor. If healthy tissue is found, it’s unlikely to be present in others, such as those in the armpit.
  • Axillary Lymph Node Dissection: When malignant tissue is found in the sentinel nodes, the doctor usually performs underarm lymph node surgery.

Even if only cancerous tissue has been diagnosed in one breast, a contralateral prophylactic mastectomy can sometimes be performed. That is, the removal of both breasts.

It’s usually done only in patients with high risk factors, such as a family history or a genetic predisposition that was found during a previous biopsy.

Radiation therapy in the treatment of breast cancer

Studies have reported the efficacy of radiation therapy in the treatment of breast cancer, with a wide margin of effectiveness when it develops in the early stages of the disease. Although there are complications derived from its application, in reality, the evidence suggests that the benefits of modern therapies outweigh the risks.

It consists of sessions in which high-frequency X-rays are applied that destroy the affected breast tissues. It can be used no matter how advanced the disease is. There are many types, and the most used in this variant are the following:

  • External radiation therapy: This is the most common of all. It normally develops in sessions of 6 to 7 weeks, although its hypofractionated variant can shorten the time to only 4 weeks. The process is similar, but not identical, to an X-ray. It can be applied to the whole breast or just part of it (called accelerated partial irradiation).
  • Brachytherapy: Also known as internal radiation, this involves placing a device inside the breast that emits radiation. There are two types: Intracavitary (the most common) and interstitial. It’s more frequent after breast conservation surgery, and the size and location determine the results to be obtained.

Rashes, burns, and fatigue are some of the adverse effects of breast cancer treatment with radiation therapy. In rare cases, it causes more serious complications, although the doctor must take into account possible previous diseases before its application (especially in the lungs or the heart).

Chemotherapy treatment for breast cancer

Treatments for breast cancer include chemotherapy.
Despite its effectiveness, chemotherapy is also associated with several adverse effects.

The use of oral or injected drugs to treat the disease is known as chemotherapy. It’s administered in several sessions, in which the characteristics and degree of progression of the malignant tumor are considered.

Because it attacks all rapidly growing cells, the use of this treatment involves several side effects. Among those that occur in the short term, we can highlight the following:

  • Hair loss
  • Fatigue
  • Constipation and diarrhea
  • Loss of appetite
  • Vomiting and nausea
  • Collateral infections (due to the compromised immune system)
  • Damage to nerve networks
  • Sores in the mouth

It’s also known that chemotherapy can cause cognitive problems even when given in standard doses. The most important are difficulties maintaining concentration and memory disturbances. These are complemented by long-term sequelae such as:

  • The development of psychological disorders (such as stress or depression)
  • Heart damage
  • Reduction in bone density (which can lead to osteoporosis)
  • Infertility (in both men and women)

The presence or absence of these elements varies depending on each patient and the characteristics of the disease. It’s important that before starting chemotherapy treatment, you’re aware of them and other sequelae that may arise in the process.

Hormone therapy in the treatment of breast cancer

Some types of cancer, such as estrogen receptor positive cancer or progesterone receptor positive cancer, are particularly sensitive to hormones.

Because of this, the doctor may use hormonal blocking therapy to help stop growth or prevent it from developing again (when the therapy is applied after surgery).

It’s used in a personalized way, depending on whether or not the woman has gone through menopause. Among its side effects, we can highlight night sweats and hot flashes, although vaginal dryness can also occur. The two most used are the following:

  • Selective estrogen receptor modulators (known as SERMs).
  • Aromatase inhibitors (known as AIs ).

Sometimes ovarian suppression therapy can also be used, which is done either surgically or with injections of medications.

Targeted Therapy Against Breast Cancer

This is a newer process that has fewer adverse effects than other breast cancer treatments. Studies associate their use with promising results, although they’re generally applied in conjunction with other therapies.

As their name implies, they’re based on specifically targeting the abnormalities of cancer cells. For example, they’re commonly used to stop human epidermal growth factor 2, a protein that’s abnormally produced by malignant cells. For this, micromolecular drugs or monoclonal antibodies are used.

The National Cancer Institute reminds us that the adverse effects of its application are fatigue, diarrhea, and high blood pressure, among others.

Final advice

Although it’s not part of the treatment of breast cancer, it should be noted that breast reconstruction surgery is an option for those who’ve had to undergo a mastectomy. It can be done in parallel with this intervention or later and uses implants to achieve a better appearance of the breasts.

Because the evidence suggests a relationship between the disease and depression, it’s also a good idea to include psychological monitoring after the diagnosis has been made.

Mental health is often neglected when going through these processes, although the mediation of a professional can improve the quality of life and the assimilation of cancer as a reality.

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Los contenidos de esta publicación se redactan solo con fines informativos. En ningún momento pueden servir para facilitar o sustituir diagnósticos, tratamientos o recomentaciones provenientes de un profesional. Consulta con tu especialista de confianza ante cualquier duda y busca su aprobación antes de iniciar o someterse a cualquier procedimiento.