Breast CancerTreatment, Prognosis, Prevention |
Physician-developed and -monitored. Original Date of Publication: 15 Aug 1999
|
|
Original Source: http://www.oncologychannel.com/breastcancer/treatment.shtml | |
|
Home » Breast Cancer » Treatment, Prognosis, Prevention | 
 |
Treatment
Treatment depends on the stage of the disease and includes the following:
Surgery
Surgery combined with radiation and/or chemotherapy is the most common treatment for breast cancer. The type of surgical procedure recommended to the patient depends on the stage of the disease. Mastectomy is the most commonly performed procedure.
Radiation Therapy
Radiation uses high-energy x-rays to destroy cancer cells. Treatment is delivered by a machine outside the body (called external radiation) or by radioactive "seeds" that are placed directly into the tumor (called brachytherapy). Breast cancer is usually treated using external radiation.
Radiation may be used to shrink the tumor before surgery (called neoadjuvant therapy) or may be used after surgery to destroy cancer cells that remain in the breast, chest wall, or underarm (called adjuvant therapy).
Radiation therapy is performed in a hospital or outpatient center. Each treatment lasts a few minutes and treatment is usually given 5 days per week, for 6 weeks. Side effects include fatigue, reddening of the skin, and swelling.
Anti-estrogen Therapy
Several drugs have been developed to treat breast cancer that is responsive to estrogen. Selective estrogen-receptor modulators (SERMs; e.g., tamoxifen, raloxifene) inhibit the effects of estrogen on breast cancer cells.
Tamoxifen is taken in pill form once or twice per day, usually for 5 years after breast cancer surgery, radiation, and/or chemotherapy to prevent recurrence. Tamoxifen can cause serious side effects, including early stage cancer of the lining of the uterus (this risk increases after 5 years of taking the drug), blood clots, and stroke. Common side effects include the following:
- Bone pain
- Constipation
- Depression
- Dizziness
- Hair loss
- Headache
- Hot flashes
- Nausea
- Pain or reddness at the tumor site
- Weight loss
Studies are being conducted to determine if raloxifene (Evista®) can effectively reduce the risk for breast cancer. Side effects include hot flashes and leg cramps.
Fulvestrant (Faslodex®) destroys estrogen receptors in breast cancer cells. It is used to treat metastatic breast cancer in postmenopausal women who have been treated unsuccessfully with tamoxifen. This treatment is administered once a month by intramuscular injection. Side effects include nausea, hot flashes, and weight gain.
Goserelin (Zolodex®) is a synthetic form of luteinizing hormone-releasing hormone (LHRH) that is prescribed to treat metastatic breast cancer in premenopausal women. This medication signals the body to stop producing estrogen, depriving the tumor of the estrogen it needs to grow. Several weeks of treatment are needed before tumor growth slows. Side effects include hot flashes, sexual dysfunction, increased pain, and rash.
Aromatase inhibitors (e.g., anastozole [Arimidex®], letrozole [Femara®], exemestane [Aromasin®]) inhibit the action of the enzyme aromatase, which is involved in estrogen production in postmenopausal women. These drugs may be prescribed for postmenopausal women with advanced breast cancer that has been unsuccessfully treated with tamoxifen.
Side effects include the following:
- Cough
- Depression
- Diarrhea
- Dizziness
- Fatigue
- Headache
- Hot flashes
- Increased appetite
- Nausea
- Pain
Chemotherapy
Chemotherapy is a systemic treatment (travels throughout the body via the bloodstream) that often uses a combination of drugs to slow tumor growth and destroy cancer cells. Drugs may be administered orally or intravenously (through an IV). Chemotherapy is often used as adjuvant therapy to destroy breast cancer cells that have metastasized to the lymph nodes. It also is used to shrink the tumor prior to surgery (neoadjuvant therapy) and as primary treatment.
The combination most commonly prescribed to treat breast cancer is doxorubicin (Doxil®) and cyclophosphamide (Cytoxin®). Paclitaxel (Taxol®, or the generic form, Paxene®) is often prescribed after this combination treatment, when breast cancer has metastasized to the lymph nodes. It is also prescribed following breast cancer surgery. Other chemotherapy drugs include docetaxel (Taxotere®) and gemcitabine (Gemzar®).
Side effects are often severe and include the following:
- Fatique
- Fever
- Hair loss (alopecia)
- Infection
- Low blood cell count (e.g., anemia, neutropenia, thrombocytopenia)
- Nausea
Ixabepilone (Ixempra®) was approved by the FDA in October 2007 to treat advanced breast cancer that has not responded to other chemotherapy drugs. Ixempra is approved for use alone, or in combination with capecitabine (Xeloda®). It should not be used in patients who have liver damage. Side effects include numbness and tingling in the hands and feet, bone marrow suppression, nausea, fatigue, and bone pain.
Biological Therapy
Biological therapy (also called immunotherapy) involves using trastuzumab (Herceptin®) to inhibit tumor growth and enhance the immune system's ability to fight cancer. It also may be combined with chemotherapy as a first line treatment for metastatic breast cancer and may be used after chemotherapy or anti-estrogen therapy to improve the effectiveness of the treatment.
When used alone or in combination, side effects include the following:
- Cardiac dysfunction (causes severe cough, shortness of breath, difficulty performing physical activities)
- Chills
- Congestive heart failure
- Cough
- Diarrhea
- Fever
- Headache
- Low blood cell count (e.g., anemia, neutropenia)
- Nausea
- Weakness
- Vomiting
In November 2006, the Food and Drug Administration approved Herceptin® for the treatment of HER2 positive breast cancer, following surgery and in combination with standard chemotherapy.
In studies conducted by the National Cancer Institute, patients who received Herceptin had a reduced risk for recurrence as many as 3 years after surgery. Due to the risk for heart damage, patients must be screened for heart function before beginning and during this treatment.
In March 2007, the FDA approved lapatinib (Tykerb®) in combination with capecitabine (Xeloda®) for the treatment of advanced or metastatic HER2 positive breast cancer that has not responded to other treatments.
Side effects include diarrhea, nausea, rash, vomiting, and fatigue. This treatment also carries a risk for heart damage and patients are monitored before beginning and during treatment.
Prognosis
The prognosis for patients with breast cancer depends on the size of the tumor and the stage of the disease at diagnosis.
Prevention
Breast cancer cannot be prevented. Performing monthly breast self-examinations, having regular clinical examinations, and following recommendations regarding mammograms can increase early detection of the disease. Screening may help prevent death from the disease, especially in women over age 50.
Genetic risk for breast cancer can be determined, and patients at high risk may choose preventative measures (e.g., prophylactic mastectomy, prophylactic medication).
Prophylactic mastectomy is the removal of one or both breasts to reduce the risk for breast cancer. This procedure can reduce high risk by 90%.
Studies are being conducted to determine if raloxifene (Evista®) can effectively reduce the risk for breast cancer.
Breast Cancer, Treatment, Prognosis, Prevention reprinted with permission from oncologychannel.com
© 1998-2008 Healthcommunities.com, Inc. All Rights Reserved.
Breast Cancer (continued...)
|
|
Browser Comments
|
Breast Cancer Resources
 | Join Our Breast Cancer Forum
Do you have a question, want to share medical advice, or just need to discuss your situation with someone else having a similar experience? The healthchannels forum is a resource for everyone to share and discuss their health and medical needs with others. |
|
|
 | Living with...Share your story
Do you have a personal health story that you would like to share with others? As a source of free patient education, our goal is to provide our users with trustworthy information and support from others. That's why we've started our "Living with..." sections. | ||
|
Our "Living With..." support pages are a place to share experiences about living with a certain condition, disease, disorder, or illness and for loved ones of those dealing with health-related issues. Many people, especially when newly diagnosed, find comfort in knowing that others are having a similar experience. | |||
 | Stay Updated
Sign up for our newsletter and receive important updates on the medical conditions that are most important to you. | ||
To quickly access health information from your website's browser,
| |||
