Treatment for Breast Cancer

There are many different types of treatment for breast cancer - find out all about them today.
Treatment for Breast Cancer

Last update: 06 June, 2021

Treatment for breast cancer is determined by considering several criteria. The most important, according to the evidence, is the subtype to which it belongs. However, its stage of development and the availability and preferences of patients can also be taken into account.

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

Studies have improved methods of dealing with this condition, a positive result in increasing prognosis after diagnosis. Even so, the process is conditioned by the speed with which it is detected in its initial stages. Therefore, it’s very important to monitor those who are part of the risk groups.

Surgery for breast cancer

Treatment for breast cancer includes surgery
The 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 is the most viable option when the disease is detected in its early stages of development. There are many types of breast cancer surgeries; among the main ones we highlight the following:

  • 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 is accompanied by radiotherapy to completely eliminate possible residual cancerous tissues.
  • Mastectomy: Unlike the previous surgery, in these cases, 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 complete surgical procedure must be carried out, 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, and its size and location. These are the most common procedures, although sometimes they can be complemented with the following:

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

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.

This is usually done only in patients with high-risk factors, such as a family history or a genetic predisposition being found during a previous biopsy.

Radiation therapy treatment for 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 where 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, 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 is 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 pathologies 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.

Treatment of oral or injected drugs to treat the disease is known as chemotherapy. It is administered over 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 carries several side effects. Among those that occur in the short term, we highlight the following:

It is also known that chemotherapy can cause cognitive problems even when given in standard doses. The most important ones are inconveniences to maintain concentration and memory disturbances. These are complemented by long-term sequelae such as:

  • 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 in each patient and the characteristics of the disease. It is important that before starting chemotherapy treatment you are aware of them and other sequelae that may arise in the process.

Hormone therapy for 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 hormone-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 had the 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 abnormalities of cancer cells. For example, they’re commonly used to stop human epidermal growth factor 2, a protein that is 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 isn’t part of the treatment for breast cancer, it should be noted that breast reconstruction surgery is an option for those who have had to undergo a mastectomy. It can be done in parallel with this intervention or later on, 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 reality.

  • Ahles, T. A., & Saykin, A. Cognitive effects of standard-dose chemotherapy in patients with cancer. Cancer investigation. 2001; 19(8): 812-820.
  • Den Hollander, P., Savage, M. I., & Brown, P. H. Targeted therapy for breast cancer prevention. Frontiers in oncology. 2013; 3, 250.
  • Maughan, K. L., Lutterbie, M. A., & Ham, P. Treatment of breast cancer. American family physician. 2010; 81(11): 1339-1346.
  • Moulder, S., & Hortobagyi, G. N. Advances in the treatment of breast cancer. Clinical Pharmacology & Therapeutics. 2008; 83(1): 26-36.
  • Sánchez, C., Bustos, M., Camus, M., Álvarez, M., Goñi, I., & León, A. ¿Es curable el cáncer de mama en etapa precoz?: Resultados del tratamiento combinado con cirugía, radioterapia y quimioterapia. Revista médica de Chile. 2007; 135(4): 427-435.
  • Senkus-Konefka, E., & Jassem, J. Complications of breast-cancer radiotherapy. Clinical Oncology. 2006; 18(3): 229-235.
  • Somerset, W., Stout, S. C., Miller, A. H., & Musselman, D. Breast cancer and depression. Oncology (Williston Park, NY). 2004; 18(8): 1021-34.
  • Schrader, M., Heicappell, R., Müller, M., Straub, B., & Miller, K. Impact of chemotherapy on male fertility. Oncology Research and Treatment. 2001; 24(4): 326-330.
  • Taylor, C., Correa, C., Duane, F. K., Aznar, M. C., Anderson, S. J., Bergh, J., … & Early Breast Cancer Trialists’ Collaborative Group. Estimating the risks of breast cancer radiotherapy: evidence from modern radiation doses to the lungs and heart and from previous randomized trials. Journal of Clinical Oncology. 2017; 35(15): 1641.
  • Waks, A. G., & Winer, E. P. Breast cancer treatment: a review. Jama. 2019; 321(3): 288-300.

Este texto se ofrece únicamente con propósitos informativos y no reemplaza la consulta con un profesional. Ante dudas, consulta a tu especialista.