Understanding Treatment Options for
Breast Cancers

Once diagnosed, breast cancer can be treated in various ways. Whether you have been newly diagnosed, or have been undergoing treatment for a while, it is normal to be confused and have a lot of questions. An important first step is to understand your disease better. Read more

Next, it can be helpful to understand your diagnosis and the stage of your cancer. This information is critical, as it helps determine the treatment options that are available to you. Refer to this section to understand your cancer diagnosis and for more information about how breast cancer is staged. Read more

Treatments for Breast Cancer

Once you have met with your primary physician and clinical care team, it can help to learn more about each of the treatment options they have prescribed for you. There are a variety of methods used to treat breast cancer. Some (such as surgery, radiation therapy and chemotherapy) are currently being used for treatment, and some (such as clinical trials) are experimental in nature. Treatments for breast cancer can be either:

  • Localized (targeting cancerous cells in one area of the body), or
  • Systemic (targeting cancerous cells throughout the body)
Type of Treatment Nature of Treatment Nature of Treatment
Localized
Invasive
Generally performed once
Localized
Can be invasive or non-invasive
Typically administered over many sessions
Systemic
Can be invasive or non-invasive
Typically administered over many cycles
Systemic
Can be invasive or non-invasive
    Typically prescribed as:
  • oral tablets to be taken daily for a certain duration, or
  • a series of injections over many cycles, or
  • a specific surgical procedure
Systemic
Non-invasive
Typically administered over many cycles
Systemic
Non-invasive
Typically administered over many cycles
Depends on the trial
Depends on the trial
Depends on the trial
Localized Treatment Options
Surgery

What to expect

Surgery is the most common form of treatment for breast cancer. Prior to surgery, your doctor will perform a biopsy to confirm the presence of cancerous cells. Once confirmed, the cells are removed through certain surgical procedures, as detailed below. It is advisable to have an in-depth discussion with your primary physician and cancer care team to find the course of treatment that is best suited for you. 

  • During a Partial Mastectomy or breast-conserving surgery, the surgeon will remove the cancer and some normal tissue around it (as is the norm), but not the breast itself. Depending on the placement of the tumour, some part of the chest wall lining may also be removed. This type of surgery is also called a lumpectomy, segmental mastectomy or breast-sparing surgery.
  • During a Total Mastectomy, the surgeon will remove the whole breast affected by a malignant tumour. This procedure is also called a simple mastectomy. Depending on the spread of the cancer, the surgeon might make another incision to remove and check some of the lymph nodes under the arm for cancer.
  • During a Modified radical mastectomy, the surgeon will remove the whole breast that has cancer, many of the lymph nodes under the arm, the lining over the chest muscles, and sometimes, part of the chest wall muscles.

The surgeries may be combined with other forms of treatment to improve the odds of survival: 

  • Pre-operative therapy: Also called neoadjuvant therapy, this refers to treatments administered before surgery. For instance, chemotherapy may be suggested prior to the surgery to shrink the tumour and reduce the amount of tissue that needs to be removed during surgery. 
  • Post-operative therapy: Any treatment given post the surgery to lower the risk of cancer coming back is called post-operative or adjuvant therapy. These could include radiation therapy, chemotherapy, targeted therapy or hormone therapy, to kill any remaining cancer cells. Additionally, survivors might consider having a breast reconstruction surgery after undergoing a mastectomy. The doctor might suggest the surgery at the time of the mastectomy or at some time after.
Radiation Therapy

What to expect

Radiation therapy uses high-energy x-rays or other types of radiation to remove cancer cells and keep them from growing further. There are two types of radiation therapy:

  • In external radiation therapy, the radiation isadministered from outside the body using a specially designed machine, and is non-invasive.
  • In internal radiation therapy, a radioactive substance is placed directly into or near the cancer through needles, seeds, wires, or catheters. This is an invasive procedure.
Systemic Treatment Options
Chemotherapy

What to expect

Chemotherapy is a drug-based cancer treatment that deploys medication to stop the cancer from growing further, either by killing cancerous cells or by stopping them from dividing. There are two kinds of chemotherapy, depending on the way they are administered:

  • In systemic chemotherapy, the drug is administered either orally or intravenously. The drug enters the bloodstream and targets cancer cells throughout the body. This is the most commonly used type of chemotherapy for cancers.
  • In regional chemotherapy, the drug is administered directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, to ensure the drugs target the cancer cells in those areas more efficiently.

The type of chemotherapy being administered depends on the type and stage of the cancer that is being treated. It is advisable to have an in-depth discussion with your primary physician and cancer care team to find the course of treatment that is best suited for you.

Chemotherapy

What to expect

Certain types of breast cancer have hormone receptors, which mean that some hormones can aid the growth of cancerous cells. If you have been diagnosed with a type of breast cancer with hormone receptors, your doctor may prescribe hormone therapy. Hormone therapy is a treatment that removes or blocks hormones and stops the cancer from growing. Hormones are produced by glands present in our body and stimulate certain functions of our body. Your doctor may suggest either drugs, surgery, or radiation therapy to reduce the production of hormones or block them from working.

Targeted therapy

What to expect

Targeted therapy uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Some of the targeted therapies are:

  • Monoclonal antibodies: This form of targeted therapy uses antibodies made from a single type of immune system cells to identify and attack either cancerous cells themselves, or substances that may them grow.
  • Tyrosine kinase inhibitors are drugs that block signals needed for tumours to grow and may be used with other anticancer drugs as adjuvant therapy
  • Cyclin-dependent kinase inhibitors are drugs that block proteins called cyclin-dependent kinases, which help cancer cells grow
  • Mammalian target of rapamycin (mTOR) inhibitors block a protein called mTOR, which can help cancer cells grow
  • PARP inhibitors block DNA repair and may cause cancer cells to die
Immunotherapy

What to expect

Immunotherapy readies and trains your immune system to fight cancer using substances made by the body or made in a laboratory to boost, direct, or restore the body’s natural defences against cancer. This type of treatment is also called biotherapy or biologic therapy.

Clinical Trials

What to expect

Clinical trials are medical research studies and are used to find out if new cancer treatments are safe, effective or better than the standard treatment protocol. Trials can also look at improving diagnosis or symptom management. Results from clinical trials can improve cancer treatments and help people live longer. For some people, a clinical trial may be the best treatment option. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients can enter clinical trials before, during, or after starting their cancer treatment.

Alternative Medicine

What to expect

After you have been diagnosed with cancer, you may hear about different forms of alternative medicine through your research orfrom your family, friends or colleagues. Many different areas make up the practice of alternative medicine, and some of these therapies have been practiced for centuries in many parts of the world. Some types of alternative medicine are:

  • Ayurveda
  • Homeopathy
  • Naturopathy
  • Chinese medicine
  • Acupuncture
  • Reiki
  • Hypnosis

While no alternative medicines have been found to cure cancer, they can help cope with side effects of treatment.

It is critical to inform your doctor if you intend to take any of these medicines, or are currently taking them. Sometimes, combining these remedies with the allopathic treatment prescribed by your doctor can be very dangerous. In some cases, the chemicals present in each form of treatment can interact. This can cause reduced efficacy of both types of treatments, or other harmful side effects. It is best to have an open discussion with your doctor about these therapies, and which regimens can be safely combined with your doctor’s care.

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