The Breast Cancer ProgramTreatment Options Printer Friendly Page

Surgery

Surgery is the most common form of treatment for breast cancer. When possible, the surgeon will perform a breast-sparing surgery, where the tumor and surrounding tissue is removed, but the breast is spared. Sometimes, some lymph nodes under the arm are removed as well. A lumpectomy is a form of breast sparing surgery.

A total (simple) mastectomy refers to a procedure in which the entire breast is removed along with some lymph nodes under the arm.

In a modified radical mastectomy, the entire breast is removed, as are most or all of the lymph nodes under the arm and the lining over the chest muscle. One of the chest muscles may also be removed to provide easier access to all of the lymph nodes.

Breast reconstruction may be performed at the time of the mastectomy or at a later date. See Breast Reconstruction for more information.

Sentinel Node Biopsy is a relatively new approach to determine if cancer cells have spread to the lymph nodes under the arm. The presence of cancer cells in the lymph nodes indicates that the cancer may have spread to other parts of the body, leading to more aggressive treatment approaches. Rather than remove many if not all lymph nodes, only the sentinel node (the node that receives the initial drainage of lymph fluid) is removed as it is thought to have the greatest likelihood of containing cancerous cells. If that node tests negative, removal of other nodes can be avoided. Identification of the sentinel node is complex and this procedure is generally available only in hospitals providing advanced cancer care, such as University Hospital.

Radiation Therapy

Radiation therapy utilizes high energy rays to kill or shrink cancer cells. It usually follows breast-sparing surgery and depending upon the size of the tumor, it may also be utilized following a mastectomy. Sometimes, radiation therapy is used before surgery to help shrink a large tumor, making it easier to remove surgically.

There are two types of radiation therapy: external therapy and brachytherapy. External therapy means the radiation comes from outside of the body and is done as an outpatient procedure over the period of several weeks. Brachytherapy involves the placement of radioactive pellets in a catheter that is placed in the breast, thus increasing the dose of radiation given to the cancerous cells, while protecting the surrounding healthy tissue.

Chemotherapy

Chemotherapy is the use of anti-cancer drugs to kill cancer cells. Depending upon the stage of the disease, women may undergo chemotherapy after surgery to kill any remaining cancer cells that were not removed; before surgery to help shrink a large tumor; or to limit the number of cancer cells when the cancer has spread to other parts of the body.

Hormonal Therapy

In some women, the hormone estrogen promotes the growth of cancer cells. In these cases, a protein known as a hormone receptor appears on the surface of some tumor cells. When estrogen attaches to these receptors, a process begins that results in tumor growth. These tumors are hormone-receptor positive, and can respond to hormonal therapy. Hormonal therapy either blocks the effects of estrogen or limits its production in the body. Tamoxifen is an example of a drug that attaches to the receptor on the cancer cell, preventing estrogen from attaching. Arimidex is a hormonal therapy that limits the production of estrogen so that cancer cells cannot get all of the estrogen that they need.

Biological Therapy

Herceptin is a drug that attaches to a growth-promoting protein that is found in small amounts on the surface of normal breast cells and most breast cancers. Some breast cancers have too much of this protein, which can cause the cancer to grow and spread faster. Herceptin can stop this protein from causing breast cancer cell growth. It may also help the immune system to better attack the cancer.

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