Once a patient is diagnosed with breast cancer, she will typically discuss a treatment plan with her physician. An individual's treatment plan for breast cancer depends on multiple factors. The physician will likely consider tumor size, the type of breast cancer, lymph node status and hormone receptor status.
Breast Surgery
The cancerous tumor is often removed surgically. Many breast cancer patients are eligible for a lumpectomy. A lumpectomy does not remove the entire breast; rather the surgeon only removes the breast lump and some surrounding tissue. The goal of a lumpectomy is to obtain clean margins---meaning that the pathologist finds the outer margins of the removed tissue to be free from cancer. Some breast cancer patients need to have a mastectomy, a type of surgery that removes the entire breast. If the tumor is large, or there are multiple tumors spread throughout the breast, then it is likely that a mastectomy will be required to remove the cancer. Some patients who are eligible for a lumpectomy choose to have a mastectomy.
Lymph Node Removal
Typically, the lymph nodes under the arm will be checked to see if the breast cancer has spread to the lymph nodes. The surgeon might then remove all of the lymph nodes. This is called an axillary lymph node dissection. Alternatively, some surgeons are able to perform a sentinel lymph node biopsy, a procedure that usually involves removing one to three lymph nodes. The lymph node surgery may occur at the same time as the breast surgery.
Radiation
Some breast cancer patients are treated with radiation. A lumpectomy is usually followed by radiation, and radiation is usually recommended if cancer was found in the lymph nodes. The most common schedule for radiation treatment is five days a week for six weeks.
Chemotherapy
Chemotherapy drugs might be recommended if the cancer has spread beyond the breast, or it may be recommended for early-stage disease in order to kill cancer cells that have traveled undetected to other areas of the body. Chemotherapy can also be used to shrink a large tumor prior to surgery. Treatment usually occurs in cycles and takes several months to complete.
Other Therapies
A physician may recommend hormone therapy if the pathology report indicates that the tumor is receptive to the hormone estrogen. Hormone therapy is often administered for several years. Some of the newer drugs are called targeted therapies. These drugs target something specific, such as a protein, in order to stop cancer cell growth. The drug Trastuzumab is a type of targeted therapy for breast cancer.
Clinical Trials
Some breast cancer patients qualify to participate in clinical trials. Clinical trials are research studies that offer patient volunteers the opportunity to receive a promising new treatment. Before volunteering for a clinical trial, a breast cancer patient should thoroughly discuss the risks and benefits of the study with her physician.
