After breast cancer is diagnosed, treatment generally follows within a few weeks. The goals of treatment are to remove the cancer and reduce the chance of the cancer returning to your breast or spreading to another location. Although there are typical treatment regimens based on the size, location and other characteristics of tumors, you do have choices. The treatment teams at Mount Carmel understand that no one approach is best for everyone and works closely and carefully with you to determine which approach best meets your needs. A key resource in your cancer treatment at Mount Carmel is your Oncology Nurse Navigator, who, as part of our Cancer Patient Navigation Program, will help you through every step of the process.
Surgical Treatments for Breast Cancer
There are a number of surgeries available to treat breast cancer. Depending on the size, location or stage of the disease, as well as your age and general health, your physician may recommend:
- Lumpectomy (Partial Mastectomy) — This specialized treatment, also called a partial mastectomy, is the standard of care for early stage breast cancer. The tumor and surrounding tissue are removed and sent to the pathology laboratory to identify the type of tumor, whether lymph nodes are involved and if the tumor will respond to hormone therapy. A Sentinel Node Biopsy removes up to three lymph nodes that receive drainage from the breast.
- Mastectomy — A mastectomy removes the entire breast, including the nipple/aerolar complex. A Sentinel Lymph Node Biopsy may also be performed at this time to remove the first lymph nodes that receive drainage from the breast. After breast removal, a drain is placed in the chest area which is removed in 7-10 days post-surgery. This type of breast cancer surgery typically requires and overnight stay in the hospital. Breast reconstruction is often an option immediately following a mastectomy. You should see a plastic surgeon specializing in breast reconstruction before your mastectomy to discuss this additional procedure.
- Sentinel Node Biopsy — A sentinel node biopsy is performed during a lumpectomy or mastectomy to remove the first lymph nodes that drain the affected breast. Sentinel nodes are identified by injecting a radioactive tracer in several areas around the nipple anywhere from 1-3 hours before the surgery, and by injecting blue dye into the breast biopsy area during surgery. Removed nodes are sent to a lab during the remaining surgery for testing. If cancer is identified, additional lymph nodes are removed (Axillary Node Dissection) and a drain is placed in the affected underarm area.
- Axillary Node Dissection — Usually requiring an overnight hospital stay, level 1 and level 2 lymph nodes are removed under the arm and a drain is placed in the affected underarm. It may be performed at the same time as a lumpectomy or a mastectomy, or it may also be scheduled following a positive biopsy. You should be instructed in ways to reduce the risk of developing swelling in that arm (lymphedema) in the future.
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 for breast cancer may be given daily over a period of several days to several weeks.
Chemotherapy is a "systemic" form of treatment that affects all rapidly reproducing cells in your body. This treatment is recommended to reduce the risk of breast cancer recurring and/or spreading to other parts of the body. Chemotherapy may also be used shrink a breast cancer tumor before surgery (neoadjuvant chemotherapy), after surgery (adjuvant chemotherapy) or when there is disease spread to other areas of the body (metastatic breast cancer). Your chemotherapy can last several months or more. It is given in treatment cycles, once every one, two or three weeks. Most often chemotherapy is injected into a vein through an IV, although sometimes it may be taken by mouth.
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. That’s what hormone therapy is used to achieve.
- Tamoxifen — This hormone has been found to reduce the chance of breast cancer recurrence. Tamoxifen is the only anti-hormonal medication that is used in pre-menopausal women. The most common side effects are hot flashes, vaginal dryness and sometimes mood swings. Rare but mroe serious side effects include cancer of the lining of the uterus and blood clots. Most women tolerate this medication well.
- Aromatase Inhibitors — These medications (Arimidex, Femara, Aromasin) are used in women who have gone through menopause and reduce the risk of breast cancer recurrence. Some of the more common side effects of these medications are joint discomfort and hot flashes.
Find an Outpatient Cancer Treatment location near you. For more information about breast cancer treatment at Mount Carmel, please read our Breast Cancer Care Book, or call 614-546-HOPE.