Breast Cancer remains one of the most common and emotionally painful diagnoses for millions of women or Assigned Females at Birth (AFAB) around the world. While the word “Cancer” might be frightening, improvements in early detection and treatment have turned Breast Cancer from a once-fatal illness to one that is frequently very manageable, particularly when detected early.
Treatment is no longer one-size-fits-all; instead, it is highly customized, focusing on the unique features of each tumor to enhance results and reduce adverse effects. From surgery and radiation to chemotherapy, the path to Breast Cancer care is driven by knowledge, strategy, and support.
In this article, we’ll discuss the top 7 most commonly employed Breast Cancer treatments—what they involve and what patients may expect on their journey to recovery.
7 Breast Cancer treatment options
Treatment for Breast Cancer is a multidimensional and highly customized approach based on the disease’s stage, molecular subtype, and patient preferences. The primary goals are to eliminate or kill Cancer cells, reduce recurrence, and preserve quality of life.
Treatment options often combine local and systemic treatments, which are generally managed by a team of specialists. These frequently include surgery, radiation therapy, hormone therapy, chemotherapy, targeted therapy, immunotherapy, and palliative care.
Now, let’s discuss these treatment options in detail.
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1. Surgery
Surgery is the initial stage of treatment for Breast Cancer, attempting to remove the tumor from the breast and, in many cases, determine whether the illness has spread to nearby lymph nodes. The suggested form of surgery is determined by the tumor’s size, location, stage, and the patient’s preferences and overall health.
Commonly employed surgical methods are:
Breast-conserving surgery (Lumpectomy)
This treatment, also known as a Partial Mastectomy, Quadrantectomy, or Segmental Mastectomy, removes the cancerous cells with a margin of surrounding healthy tissue, leaving the majority of the breast intact. Radiation treatment is commonly used after a Lumpectomy to reduce the chance of recurrence.
The tumor’s size and location determine the quantity of tissue removed. This treatment is appropriate for many early-stage Cancers and delivers survival rates equivalent to Mastectomy when paired with radiotherapy.
Mastectomy
This procedure includes removing the entire breast and is advised for larger tumors, multiple Cancer locations in the breast, or when breast-conserving surgery is not an option. There are three types of Mastectomy: complete (simple), skin-sparing, and nipple-sparing mastectomy, with the latter conserving the nipple and areola for superior cosmetic results.
In certain situations, both breasts are removed (Double Mastectomy), especially if there is a high genetic risk.
Lymph node surgery
It is of the following two types:
- Sentinel Lymph Node Biopsy (SLNB): The sentinel nodes are the first lymph nodes where cancer tends to grow. SLNB involves eliminating these nodes to search for Cancer cells. Further lymph node removal is unnecessary if no tumor is identified, lowering the chance of consequences like Lymphedema.
- Axillary Lymph Node Dissection (ALND): If the tumor is found in the sentinel nodes, extra lymph nodes may be removed from the armpit area using ALND. This is less common now due to the effectiveness and lower risk profile of SLNB.
2. Radiation therapy
Radiation treatment for Breast Cancer uses high-energy radiation (such as X-rays or protons) to destroy Cancer cells. It is generally used after surgery to remove any remaining Cancer cells inside the breast, chest wall, or lymph nodes.
It can also be used as a primary treatment for people who are unable to undergo surgery or to relieve the symptoms of Breast Cancer. Radiation treatment is classified into several types, including:
- External beam radiation therapy: Radiation is administered from a machine located outside the body.
- Internal radiation therapy (Brachytherapy): It involves inserting radioactive material directly into the breast tissue for a brief period.
- Intraoperative Radiation Therapy (IORT): It involves giving a high dosage of radiation directly to the tumor bed throughout surgery after the tumor has been taken out.
3. Hormone therapy
Hormone treatment for Breast Cancer is used to treat hormone receptor-positive breast tumors (ER+/PR+). These therapies inhibit or reduce Estrogen levels in the body, preventing them from stimulating the growth of Cancer cells, and generally include:
- Selective Estrogen Receptor Modulators (SERMs), including Tamoxifen, prevent Estrogen from binding to Estrogen receptors in Cancer cells.
- Aromatase Inhibitors (AIs) like Letrozole, Anastrozole, and Exemestane are used to suppress Estrogen production in postmenopausal women.
- Ovarian suppression for preventing the ovaries from generating Estrogen in premenopausal women, including medication (e.g., LHRH agonists), surgery (Oophorectomy), and radiation.
- Estrogen Receptor Degraders (ERDs) like Fulvestrant bind to and destroy Estrogen receptors.
4. Chemotherapy
Chemotherapy is a medicine-based treatment that kills Cancer cells throughout the body. It often includes medicines, such as Taxanes (like Paclitaxel and Docetaxel) and anthracyclines (like Doxorubicin and Epirubicin). Chemotherapy can also use other agents like Capecitabine, Gemcitabine, and Carboplatin.
According to a review published by the Oncologist journal in 2004, Carboplatin is one of the promising and effective treatment approaches for Metastatic Breast Cancer. However, more research is required.
These medicines can be administered orally or intravenously before surgery (neoadjuvant chemotherapy) to shrink big tumors and make them simpler to remove or after surgery (adjuvant chemotherapy) to destroy any leftover Cancer cells and lower the chance of recurrence. Chemotherapy is the primary Metastatic Breast Cancer treatment.
5. Targeted therapy
Targeted treatment for Breast Cancer uses medications that target particular abnormalities in Cancer cells, such as the HER2 protein. These medicines can help to slow the growth and spread of Cancer while limiting harm to healthy cells. Examples include:
- Therapies that target the HER2 protein in HER2-positive breast tumors, like Trastuzumab, Pertuzumab, and Ado-trastuzumab Emtansine (T-DM1). An article published by the Core Evidence journal in 2019 suggests that Pertuzumab provides satisfactory outcomes for patients with early Breast Cancer.
- CDK4/6 inhibitors, like Palbociclib, Ribociclib, and Abemaciclib, are used in conjunction with hormone treatment to treat hormone receptor-positive, HER2-negative advanced Breast Cancer.
- PI3K inhibitors, such as Alpelisib, are used with hormone treatment to treat certain hormone receptor-positive, HER2-negative advanced breast tumors that have a PIK3CA mutation.
- PARP inhibitors, like Olaparib and Talazoparib, are used to treat advanced Breast Cancer in individuals with inherited BRCA1 or BRCA2 mutations.
6. Immunotherapy
Immunotherapy medications help the immune system detect and fight Cancer cells. While not as widely used as other Breast Cancer treatments, immunotherapy medications such as Pembrolizumab and Atezolizumab are approved for specific types of advanced or Metastatic Breast Cancer, particularly for Triple-negative Breast Cancer treatment, in which the Cancer cells lack receptors for Estrogen, Progesterone, or HER2.
7. Palliative care
Palliative care for Breast Cancer aims to improve quality of life by treating the disease’s physical, emotional, and psychological symptoms, particularly in the advanced or metastatic phases. It is not confined to end-of-life care, but can be used at any time along with ongoing treatment.
This supportive approach can assist with pain, exhaustion, nausea, shortness of breath, and other uncomfortable symptoms caused by Cancer or its treatment. Palliative care also includes emotional support, assistance with challenging medical decisions, and advice to both patients and families.
For patients at the advanced stage of Breast Cancer, it is essential to preserve self-worth, comfort, and a sense of control while eradicating unnecessary hospital visits and procedures. The objective is to help people live completely and pleasantly, regardless of their prognosis.
Conclusion
Breast Cancer treatment has emerged as a highly customized and multidimensional approach, providing patients with several practical therapies based on their individual diagnosis and requirements. Surgery, chemotherapy, radiation, hormone therapy, and targeted and immunotherapies are all necessary treatments for disease management and survival.
Early identification and prompt management remain essential for effective outcomes, while current research improves treatment options and reduces side effects. Importantly, the journey through Breast Cancer is not only medical but also emotional and psychological, so palliative care and informed decision-making are vital components of recovery.
Individuals diagnosed with Breast Cancer can manage therapy with better confidence and hope for a healthy future if they have the correct medical advice, access to resources, and a strong support network.
Frequently Asked Questions
How long is chemotherapy treatment for Breast Cancer?
Chemotherapy for Breast Cancer typically lasts 3 to 6 months, depending on the Cancer stage, type of medicines used, and treatment goals. It is usually given in cycles, with rest periods between sessions to allow the body to recover.
When to stop treatment for Metastatic Breast Cancer?
Treatment for Metastatic Breast Cancer may be stopped when it no longer controls the disease, causes severe side effects, or the patient chooses to prioritize quality of life and comfort through palliative care. However, discontinuation should be done under strict medical supervision.
What not to do during radiation treatment for Breast Cancer?
During radiation treatment for Breast Cancer, avoid applying lotions or perfumes on the treated area, exposing skin to direct sunlight, wearing tight clothing, and scratching or rubbing the skin, as these can worsen irritation and delay healing.
Does Breast Cancer cause hair loss before treatment?
No. Breast Cancer itself does not cause hair loss. Hair loss typically occurs as a side effect of chemotherapy or other Cancer treatments, not from the Cancer itself. Some medicines, mainly used for chemotherapy, can cause temporary or permanent hair thinning.
How long are radiation treatments for Breast Cancer?
Radiation treatments for Breast Cancer typically last 3 to 6 weeks, with sessions given 5 days a week. Depending on the case, some patients may opt for shorter courses, such as hypofractionated radiation, lasting 1 to 3 weeks.
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