Thoracic tumor

The main treatment for breast cancer is surgery, often combined with chemotherapy, radiation, or both. It may also include other treatment options such as targeted therapy, proton therapy, and angiogenesis inhibition.

Surgical operation

Many patients undergo some form of surgery as part of their breast cancer treatment.

Some receive chemotherapy or targeted therapy before surgery. The goal of these treatments is to shrink the tumor and affected lymph nodes, making surgery and recovery easier for the patient. This also allows the treatment team to assess how the cancer is responding to treatment, which is important for some breast cancer subtypes.

There are two broad categories of breast cancer surgery:

Lumpectomy: In a typical tumor removal surgery, the tumor and a small amount of surrounding normal tissue are removed. This procedure may be appropriate in the case of early breast cancer when the tumor is still small. Lumpectomy is generally an outpatient procedure with a short recovery time. These steps are usually followed by radiation therapy.

Mastectomy: In a typical mastectomy, the tumor and the entire breast are removed. There are several different types of mastectomy, including surgery to avoid breast skin and nipples/areola. More often than not, a mastectomy and breast reconstruction can be done in the same procedure.

In some cases, both breasts will be removed (double mastectomy). This can help prevent the development of new breast cancers. It is commonly used in patients who are at a higher risk of developing breast cancer due to family history or their own genetic profile, such as BRCA mutations.

In both lumpectomy and mastectomy, the surgeon may also remove nearby lymph nodes. Breast cancer can spread through nearby lymph nodes. Doctors will study the removed lymph nodes to determine if there are cancer cells inside them. This information can help determine the risk of the disease spreading to distant organs and whether chemotherapy and radiation therapy are needed.

chemotherapy

Chemotherapy uses powerful drugs to directly kill cancer cells, control their growth or reduce pain. It is often given to patients before surgery to shrink tumors and simplify the procedure. Breast cancer patients may receive oral or intravenous chemotherapy.

radiotherapy

Radiation therapy uses powerful, carefully designed beams of energy to kill breast cancer cells.

For breast cancer patients, radiation therapy can be used before surgery to shrink large tumors and make surgery easier for the patient. Radiation therapy can also be used after surgery to kill any remaining breast cancer cells that cannot be seen with the naked eye. After tumor removal, patients typically receive three to four weeks of daily radiation therapy. In some cases, one to two weeks may be appropriate. When lymph nodes are involved or a mastectomy is necessary, patients usually need six weeks of daily radiation therapy.

In cases of metastatic breast cancer, radiation therapy can also be used as a palliative care to reduce symptoms caused by cancer spreading to other parts of the body and improve the patient's quality of life.

There are different techniques used for radiation therapy. Your doctor and radiation oncologist will work together to ensure that you receive the most effective and precise dose of treatment. Radiation therapy for breast cancer patients includes:

Three-dimensional conformal radiation therapy: This technique uses a beam of radiation that forms the size of the tumor.

Intensity modulated radiation therapy: Intensity modulated radiation therapy uses multiple beams of radiation of different intensifies to deliver precise, high doses of radiation to the tumor.

Volumetric arc therapy: In this particular type of intensive-modulated radiation therapy, in VMAT therapy, a beam of radiation emitted by a part of the machine rotates around the patient in an arc. This allows for more precise irradiation of the tumor and shorter surgical time.

Accelerated partial breast irradiation: A close-range, APBI uses radioactive particles or seeds to kill cancer cells that may remain after tumor removal.

Stereotactic body radiation therapy: Stereotactic radiation therapy uses high doses of radiation, using beams of different strengths aimed at different angles to pinpoint the tumor.

Stereotactic radiosurgery: Stereotactic radiotherapy is the most commonly used treatment for breast cancer that has spread to the brain. Stereotactic radiosurgery uses dozens of tiny beams of radiation to target tumors with precise, high-dose radiation.

In most hospitals, the radiation oncologists who develop these treatments are effective for several different types of cancer.

Proton therapy

Proton therapy is similar to the above radiation therapy, but it uses a different type of energy and is more accurate in targeting tumors. It delivers high doses of radiation directly into the tumor, thereby protecting nearby healthy tissues and vital organs. For many patients, this leads to better cancer control and fewer side effects.

Targeted therapy

Cancer cells rely on specific molecules (usually in the form of proteins) to survive, multiply, and spread. Targeted therapies stop or slow the growth of cancer by interfering with or targeting these molecules or the genes that produce them.

In recent years, targeted therapy has become a major weapon in the fight against breast cancer. Subtypes of breast cancer that once had a poor prognosis are now highly treatable.

One type of targeted therapy is endocrine therapy (also known as hormone therapy), which is given to patients with hormone receptor-positive breast cancer. This can shrink the tumor before surgery. It is also taken for 5 to 10 years after surgery to prevent recurrence. Patients with metastatic forms of this disease are also given endocrine therapy to prevent disease progression.

Patients with HER 2-positive breast cancer also receive targeted therapy. These patients may receive different targeted therapy drugs before and after surgery. Because about half of patients with HER 2-positive breast cancer also have hormone receptor-positive tumors, endocrine therapy is also given.

While there are currently no targeted therapies for triple-negative breast cancer, researchers are conducting research into the disease to identify possible drug targets.

Angiogenesis inhibitor

Angiogenesis is the process of producing new blood vessels. Vascular endothelial growth factor (VEGF) is one of the main molecules controlling this process. Some cancerous tumors are very efficient at using these molecules to create new blood vessels, which increases the blood supply to the tumor, making it grow rapidly.

Researchers have developed a class of drugs called angiogenesis inhibitors or anti-angiogenesis therapies to disrupt the growth process. These drugs seek out and bind to their own VEGF molecules, or receptor proteins, preventing them from activating angiogenesis.