What is the treatment of breast cancer?
Treatment will be determined by the size of the tumour and its extension to ganglia or other parts of the body. Generally speaking, when a tumour is less than 1cm, surgery is sufficient for removing the cancer, without chemotherapy, although this is not the most frequent case. At present, the most important factor for prognosis is still axillary lymph nodes gangliar affectation: the number of affected ganglia help the gynecologist to decide on subsequent treatment.
High-energy rays such as X-rays are used to destroy or reduce the number of cancerous cells. This is a localized treatment that lasts only a few minutes and is performed after conservative surgery, over a period of 20 to 30 days, without the need for hospitalization. It reduces the size of the tumour so that it can be removed later by surgery or, subsequent to the operation, so that the area where the malign cells are found can be cleaned.
Secondary effects are tiredness or fatigue, inflammation and heaviness of the breast, and redness and dryness of the skin (such as after sunburn), all of which disappear after 6 or 12 weeks.
This consists of the administration of drugs, either orally or intravenously, which destroy the cancerous cells and prevent the appearance of the tumour in other parts of the body. It can be used in addition to surgery (prior to the operation, in order to reduce the size of the tumour, or after, in order to remove any cancerous cells that still remain), or as a single treatment. The length of the treatment varies, but may last from three to six months.
The drugs employed have secondary effects that may cause discomfort, such as nausea and vomiting, loss of appetite, hair loss, mouth ulcers, tiredness, risk of infection due to the reduction in white blood cells, changes in the menstrual cycle and swelling or brusing.
The administration of drugs that block the action of hormones stimulating the growth of cancerous cells, for patients who have positive hormone receptors. New drugs have recently been employed, such as anti-oestrogens or oestrogen response modulators, the lutein-releasing agonists, for the production of oestrogen in pre-menopausal women, aromatase inhibitors, in menopausal patients, or drugs such as progesterone.
The secondary effects of these drugs are similar to menopausal symptoms; that is, breathlessness, nervousness, etc.
Performed once the results of the biopsy are known. The purpose of surgery is the total extirpation of the tumour, and may be more or less complicated depending on the nature of the tumour.
Conservative breast cancer suegery consists in the removal of the tumour while attemtping to keep as much of the mammary tissue as possible intact. According to the size of the tumour, different types of surgery may be performed:
- Lumpectomy: extirpation of the tumur and a margin of normal tissue.
- Partial mastectomy or full-thickness excision: extirpation together with a larger amount of tissue.
- Quadrantectomy: extirpation of one quarter of the breast.
- Total or simple mastectomy: extirpation of all the breast tissue, but leaving the underlying muscle intact and enough skin to cover the wound.
- Modified radical mastectomy: the entire breast is removed, some of the axillary lymph nodes of the arm on the same side as the removed breast, and a small section of pectoral muscle.
- Radical mastectomy: extirpation of the tumour and the breast, the underlying pectoral muscles and the axillary ganglia.
- Sentinel lymph node biopsy
- Lymphedema: occurs in between one and two women out of every ten having the operation; it consists of inflammation, rigidity, pain or loss of mobility in the arm after extirpation of ganglia. The problem can be treated with massages or compresses.
- Breast reconstruction: in general, the patient must have two operations, one for the mastectomy and the other for the implantation of a prosthesis. It is also possible to implant the prosthesis in a single operation.
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