Brast Cancer Treatment

Most patients with breast cancer have surgery to remove the cancer from the breast. Some of the lymph nodes under the arm are usually taken out and looked at under a microscope to see if they contain cancer cells.

Surgery for breast cancer can take the form of breast-conserving surgery, an operation to remove the cancer but not the whole breast. Breast-conserving surgery often requires that radiation be used to help prevent breast cancer recurrence in the remainder of the preserved breast.

The other way to treat breast cancer is to remove the entire breast, an operation known as a mastectomy. Traditional mastectomy techniques involve the sacrifice of the nipple and areola in addition to the skin overlying the breast. Using very careful surgical technique, it is possible to perform a mastectomy while preserving the nipple and areola and all of the skin overlying the breast. The incision is hidden under the breast. This enables a much better cosmetic result than standard mastectomy which sacrifices much of the skin and nipple and areola overlying the breast. Mastectomy can be performed with reconstruction of the breast at the time of mastectomy.

Patients who are treated for breast cancer may also have some of the lymph nodes under the arm removed for biopsy. Sentinel lymph node biopsy is the removal of the sentinel lymph node during surgery. The sentinel lymph node is the first lymph node to receive lymphatic drainage from a tumor. It is the first lymph node the cancer is likely to spread to from the tumor. A radioactive substance and/or blue dye is injected near the tumor. The substance or dye flows through the lymph ducts to the lymph nodes. The first lymph node to receive the substance or dye is removed. A pathologist views the tissue under a microscope to look for cancer cells. If the lymph nodes have tumor in them, a procedure known as an axillary lymph node dissection, may be required. An axillary lymph node dissection involves removal of all of the lymph glands in the armpit.

The decision about which form of breast cancer treatment is best needs to be made on an individual basis following consultation with a breast cancer specialist.

Traditional radiation treatment requires women with breast cancer who undergo a lumpectomy to have 6 1/2 weeks of radiation to the entire affected breast after surgery.  The result is a long treatment course which results in numerous damaging effects to the breast. Whole breast radiation results in damage to the skin over the breast and damage to the entire breast. Skin changes from radiation include redness, dark discoloration and skin thickening. The entire breast can become unnaturally thickened and some women experience an extreme shrinkage of the entire breast.

A newer way to provide radiation therapy is called intraoperative radiation therapy (IORT).  The IORT treatment is provided during the lumpectomy surgery in about 10-15 minutes. The area of the breast receiving the radiation dose is reduced from the entire breast in standard whole breast radiation to the area of the breast immediately around the lumpectomy site with IORT.

 

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