Treatment

Breast cancer is treated by several different methods: surgery, radiation treatment, chemotherapy, and hormone treatment. The treatment choice, using just one treatment or a combination of them, depends upon:

  • the actual breast cancer: its type, grade, size, and whether or not it has spread (stage of the cancer)
  • the individual woman: her age, general health and personal choice.

Surgery

The first treatment for breast cancer is usually surgery. This includes surgery on the breast and, for most women, on the glands in the armpit (the axillary lymph nodes). Examination of the cancer and the lymph glands by the pathologist will indicate whether further treatment should be considered after the surgery.

Tipieseina o le susu atoa

Taotoga e aveeseina ai le kanesa ae tumau foliga o le susu (pe a vave ona maua le kanesa)


Sentinel node biopsy

A sentinel node biopsy locates the first lymph node(s) that drains from the area where the breast cancer developed. When cancer cells are found in the sentinel node more surgery will be needed.

Image: A women being prepared for radiation treatment.

Radiation treatment

This is the use of radiation (rays of energy called photons or little particles called electrons) to destroy cancer cells, usually using a machine called a Linear Accelerator. You will see a radiation oncologist who will discuss this treatment with you.

Treatment is carefully planned to reduce any effect on normal cells. This usually requires a visit for a simulation or planning CT scan to work out the position you will lie in for treatment, and to plan your treatment on a computer.

Treatment is given four to five days a week over about four to five weeks. It is painless and only takes a few minutes for each treatment.

Radiation may also be used for the treatment of recurrence or cancers that cannot be removed, either in the area of the breast or in other parts of the breast. The aim is to try and control the disease or reduce symptoms. This usually requires fewer visits.

A person having chemotherapy treatment

Chemotherapy

This is the treatment of cancer by drugs. The aim is to destroy cancer cells while having the least possible effect on normal cells. The drugs are usually given intravenously via a drip and, therefore, circulate around the body. Chemotherapy is a systemic treatment (treating the whole body) compared with surgery and radiation treatment, which are local treatments to a specific area in the body (breast, chestwall, axilla etc).There are different regimens or combinations of drugs used in breast cancer. Most will contain an anthracycline drug, for example doxorubicin (Adriamycin), and if there is a greater risk of spread and, therefore, greater benefit from chemotherapy, taxanes, for example paclitaxel (Taxol) may be used. Treatment is often in cycles at three-weekly intervals, and will last for several months. A medical oncologist will discuss all aspects of the treatment with you.

Side effects of chemotherapy

Chemotherapy side effects vary according to the particular drugs used.

When adjuvant chemotherapy is given to women with breast cancer, side effects may include:

  • Risks of infections–the drugs can lower your ability to fight infections.

If you are feverish (your temperature is 38 degrees C or more), or if you feel unwell in any way–don’t wait to see what happens–take action immediately. Contact your cancer doctor or nurse, and follow the advice given.

  • Temporary hair loss. If you have temporary hair loss you are entitled to a benefit to buy a wig.
  • Sore mouth.
  • Tiredness.

Your periods may become irregular or stop. Avoid pregnancy during treatment. You should use a reliable contraceptive, such as a diaphragm or condom, during treatment.

Hormone treatments

Many breast cancers appear to be influenced by the female hormones, oestrogen and progesterone. Pre-menopausal women may be offered tamoxifen, a hormone treatment taken as a tablet. They may also have menopause induced to stop their own production of hormones. This can be done by four-weekly injections with goserelin (Zoladex) or by surgical removal (laparoscopic oophorectomy) of the ovaries. Once you stop taking goserelin your periods will usually return. Post-menopausal women may be offered oral hormone treatments–either tamoxifen or aromatase inhibitors, such as anastrozole (Arimidex), letrozole (Femara) or exemestane (Aromasin), which reduce the production of hormones in the body (other than from the ovaries).

Making decisions about treatment

Sometimes it is difficult to make decisions about what is the right treatment for you. You may feel that everything is happening so fast that you do not have time to think things through. However, it is important not to be rushed into a decision. It must be the right one for you.