Breast Cancer

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Breast Cancer Treatment

The choice of initial treatment is based upon many factors. For stage I, II, or III cancers, the main considerations are to adequately treat the cancer and prevent a recurrence either at the place of the original tumor (local) or elsewhere in the body (metastatic). For stage IV cancer, the goal is to improve symptoms and prolong survival. However, in most cases, stage IV breast cancer cannot be cured.

• Surgery may consist only of breast lump removal (lumpectomy), or partial, total, or radical mastectomy, usually with the removal of one or more lymph nodes from the axilla (armpit). Special procedures to find the most likely lymph nodes to which cancer may have spread (sentinel nodes) are often used.
• Radiation therapy can be directed at the tumor, the breast, the chest wall, or other tissues known or suspected to have remaining cancer cells.
• Chemotherapy is used to help eliminate cancer cells that may still remain in the breast or that may have already spread to other parts of the body.
• Hormonal therapy with tamoxifen is used to block the effects of estrogen that may otherwise help breast cancer cells to survive and grow. Most women with breast cancers which express estrogen or progesterone on their surface benefit from treatment with tamoxifen. A new class of medicines called aromatase inhibitors, such as Aromasin, have been shown to be as good or possibly even better than tamoxifen in women with stage IV breast cancer.

Most women receive a combination of these treatments. For stage 0 breast cancer, mastectomy or lumpectomy plus radiation is the standard treatment. For stage 1 and 2 disease, lumpectomy (plus radiation) or mastectomy with at least "sentinel node" lymph node removal is standard treatment.

Chemotherapy, hormone therapy, or both may be recommended following surgery. The presence of breast cancer in the axillary lymph nodes is very useful for staging and the appropriate follow-up treatment.

Stage III patients are ususally treated with surgery followed by chemotherapy with or without hormonal therapy. Radiation therapy may also be considered under special circumstances.

Stage IV breast cancer may be treated with surgery, radiation, chemotherapy, hormonal therapy, or a combination of these (depending on the situation).