Surgical Treatments

A number of surgical procedures are used to treat breast cancer depending on the size, location or stage of the disease as well as the patient's age and general health.

• Lumpectomy – The standard of care for early stage breast cancer is a lumpectomy followed by five to eight weeks of standard radiation therapy or 5 days of treatment through an implanted catheter. A lumpectomy is performed on an outpatient basis under local or general anesthesia and takes one to two hours. The tumor and surrounding tissue are removed and sent to the pathology laboratory to identify the type of tumor, whether nymph nodes are involved and if the tumor will respond to hormone therapy. The surgeon will remove any enlarged lymph nodes or may conduct a sentinel node biopsy to identify and remove up to three nodes deemed most likely to contain cancer.
• Mastectomy – In a partial mastectomy the tumor and a large portion of surrounding tissue are removed. Usually, lymph nodes will also be removed. Mastectomies are performed on an outpatient basis under general anesthesia and take two to three hours (although if a patient is having reconstructive surgery immediately following, they will be admitted to the hospital for several days).
• Sentinel Node Biopsy – A sentinel node biopsy is performed during a lumpectomy or mastectomy to remove lymph nodes which are most likely to contain cancer (sentinel nodes). Sentinel nodes are identified by injecting a radioactive tracer near the tumor. The tracer follows the same path to the lymph nodes that cancer cells will take, making it possible to determine the nodes are most likely to be cancerous. Removed nodes are sent to a lab for testing.
• Axillary Node Dissection – If the sentinel nodes are determined to be cancerous, then remaining nodes will be removed in a follow up outpatient surgical procedure. A complication of axillary node dissection is lymphedema (swelling of the arm) or nerve damage.

Radiation Therapy

Radiation therapy is usually given after a lumpectomy. Treatments generally start several weeks after the surgery so the area has some time to heal. Sometimes, a physician will recommend chemotherapy to be administered before radiation. Radiation treatments may be given daily over a period of several days to several weeks.

Chemotherapy

Chemotherapy is a "systemic" from of breast cancer treatment used when lymph nodes test positive and indicate cancer has spread beyond the breast. Chemotherapy may also be used to shrink large tumors before surgery or radiation therapy. Chemotherapy is given in cycles of treatment followed by a recovery period. Chemotherapy may also be given as the main treatment for women whose cancer has spread to other parts of the body outside of the breast and lymph nodes. This spread is known as metastatic breast cancer and occurs in a small number of women at the time of diagnosis, or when the cancer recurs some time after initial treatment for localized (non-metastatic) breast cancer. The entire chemotherapy treatment generally lasts several months to one year depending on the type of drugs given.

Hormone Therapy

About two thirds of breast cancer tumors depend on the female hormone estrogen. Growth of these tumors can be slowed by drugs that block the body's naturally occurring estrogen.

• Tamoxifen – This hormone has been found to reduce the chance of breast cancer recurrence and new breast cancers in women when taken for five years. However, Tamoxifen increases the risk of uterine cancer, so women should have regular pelvic exams and tell their doctor about any abnormal uterine bleeding. Other risks include deep-vein thrombosis, blood clots in the lungs and benign ovarian cysts. Minor side effects include hot flashes, mood swings and cataracts.
• Aromatase Inhibitors – According to new studies, aromatase inhibitors which prevent estrogen production appear to be more effective than tamoxifen in women who are past menopause. Three aromotase inhibitors are: Arimidex, Femara and Aromasin.