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BREAST CANCER: TREATMENT FOR EACH STAGE

Dr. P. Raghu Ram, Friday, November 8, 2019

WHAT IS BREAST CANCER

The term “breast cancer” refers to a malignant tumour that has developed from cells in the breast. Usually breast cancer either begins in the cells of the lobules, which are the milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple.


WHAT IS THE TREATMENT ADVOCATED IN STAGE 0 OF BREAST CANCER?

If precancerous cells are found within the milk ducts, it’s called non-invasive breast cancer or ductal carcinoma in situ (DCIS). Stage 0 breast cancer can spread beyond the ducts. Lumpectomy plus radiation therapy are sufficient in many cases.

In a lumpectomy, the surgeon removes the cancerous cells and spares the rest of the breast. A “simple mastectomy” is the surgical removal of the breast. Surgery to reconstruct the breast can begin at the time of the mastectomy or at a later date.

Radiation is a type of targeted therapy. It’s usually recommended following lumpectomy for stage 0 breast cancers. High-energy X-rays are used to destroy cancer cells, prevent them from spreading, and lower risk of recurrence.

Your doctor will probably recommend a hormone treatment if you’ve had a lumpectomy for oestrogen receptor-positive (ER+) or progesterone receptor-positive (PR+) breast cancer. Oral hormone treatments are generally prescribed to lower your risk of developing invasive breast cancer.

Hormone treatment isn’t always prescribed for women who have had a mastectomy for stage 0 breast cancer.


 WHAT IS THE TREATMENT ADVOCATED IN STAGE 1 OF BREAST CANCER?

Stage 1A breast cancer means the primary tumour is 2 centimetres or less and the lymph nodes are not affected. In stage 1B, there is no tumour in the breast, or it’s smaller than 2 centimetres and cancer is found in axillary lymph nodes. Surgery and one or more adjuvant therapies may be recommended.

Lumpectomy and mastectomy are both options for stage 1 breast cancer. For mastectomy, reconstruction of the breast can begin at the same time or after additional treatment is completed. Radiation therapy is often recommended after surgery for stage 1 breast cancer. It may not be necessary for women over 70 years old, especially if hormone therapy is possible.

Hormone therapy may be recommended for hormone receptor-positive breast cancers, regardless of tumour size.

Chemotherapy isn’t always needed for early-stage breast cancers, especially if they can be treated with hormone therapy.


WHAT IS THE TREATMENT ADVOCATED IN STAGE 2 OF BREAST CANCER?

In stage 2A, the tumour is smaller than 2 centimetres and has spread to nearby lymph nodes. Or it’s between 2 and 5 centimetres and hasn’t spread to lymph nodes. Stage 2B means the tumour is between 2 and 5 centimetres and has spread to nearby lymph nodes. Or it’s larger than 5 centimetres and hasn’t spread beyond the breast. You’ll probably need a combination of surgery, radiation, chemotherapy, and/or hormone treatment.

Lumpectomy and mastectomy may both be options depending on the size and location of the tumour. A modified radical mastectomy is a removal of the breast including chest muscles. Radiation therapy targets any remaining cancer cells in the chest and/or lymph nodes.

In Chemotherapy, powerful drugs are delivered intravenously over the course of many weeks or months.

After all other treatment is complete, you may benefit from continued treatment for ER+, PR+, and HER2+ breast cancers. Oral medications are generally prescribed for five years.


WHAT IS THE TREATMENT ADVOCATED IN STAGE 3 OF BREAST CANCER?

Stage 3A breast cancer means that cancer has spread to four to nine axillary (armpit) lymph nodes, or has enlarged the internal mammary lymph nodes. The primary tumour may be any size.

It can also mean the tumour is bigger than 5 centimetres, and small groups of cancer cells are found in the lymph nodes. Finally, stage 3A can also include tumours greater than 5 centimetres in size with involvement of one to three axillary lymph nodes or any breastbone nodes.

Stage 3B means a breast tumour has invaded the chest wall or skin and may or may not have invaded up to nine lymph nodes. Stage 3C means cancer is found in 10 or more axillary lymph nodes, lymph nodes near the collarbone, or internal mammary nodes.

Treatment for stage 3 breast cancers is similar to that of stage 2.


WHAT IS THE TREATMENT ADVOCATED IN STAGE 4 OF BREAST CANCER?

Stage 4 indicates that breast cancer has spread to a distant part of the body. Breast cancer most often spreads to the lungs, brain, liver, or bones. Aggressive systemic therapy is the main treatment. Depending on your type of breast cancer, you’ll probably have chemotherapy and one or more targeted therapies. The number and location of tumours determine your surgical options.


WHY KIMS?

KIMS, one of the best breast surgery hospitals in Hyderabad, India, has the finest breast cancer doctors in Hyderabad, including Dr. P. Raghu Ram, who specializes in breast cancer surgery. We provide comprehensive treatment for all stages of breast cancer and support for cancer survivors.

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