Breast Cancer Treatment a Time for Decisions
By Darla Gullikson, RN, OCN
Avera Sacred Heart Cancer Center Director
A diagnosis of breast cancer can bring about many emotions in a woman – fear, anger and depression to name a few. One emotion that must remain stable, however, is that of hope.
The diagnosis itself will be made from the results of a biopsy and then staged from 0-IV. A biopsy is a small sample of tissue taken from the breast for laboratory analysis. This is the only definitive test to detect whether or not a malignancy is present. This procedure, which can be performed a number of different ways, can also determine whether or not surgery is necessary and what type of surgery should be performed.
Once the results from the biopsy have been returned and it has been determined that cancer is present, staging tests will determine how far the disease has advanced. This will, in turn, help determine the course of treatment. Cancer is determined to be at Stage 0 if it is non-invasive. Stage 0 cancers have a high success rate for curability. Stage I to IV cancers are invasive tumors that have the ability to invade other parts of the breast tissue and body. A Stage I cancer is small and localized and has a high cure rate. The higher the stage number, however, the lower the chances for a cure. By Stage IV, the cancer has spread beyond the breast to other organs. This is why it’s so important to screen regularly – these things can progress rapidly.
Treatment for breast cancer can vary greatly depending on the stage. It’s imperative to speak with your health care team and learn as much as you can about your options. Treatments exist for every type and stage of breast cancer. Typically, most women have surgery and an additional treatment option such as radiation, chemotherapy or hormone therapy.
Surgical options for breast cancer include:
- Lumpectomy – This procedure removes the lump plus a part of the surrounding tissue. This option saves as much of the breast as possible. Lumpectomies – usually with radiation treatment - are often chosen over radical mastectomy. In most cases survival rates for both prodedures are similar. Circumstances that may rule out lumpectomy include a tumor that is very large and deep within the breast tissue; having already had radiation treatment; have two or more areas of cancer within the same breast; have inflammatory breast cancer; or have a connective tissue disease that makes you sensitive to radiation.
- Mastectomy (Partial, Simple, Modified Radical) – The removal of the breast tissue, and in some instances (simple and modified radical) the removal of the entire breast, lobules, ducts, fatty tissue and lymph nodes (modified radical). Most women having this procedure will also undergo radiation or chemo or hormone therapies or a combination of the three.
- Sentinel Lymph Node Biopsy – The first place breast cancer spreads is the lymph nodes under the arms. With this procedure, the surgeon focuses on finding the sentinel nodes – the first nodes that receive drainage from the tumor(s) and the first place the cancer cells will travel. This can spare the unnecessary removal of some lymph nodes and reduce the chance of complications in the future.
Other common treatments for breast cancer include:
- Radiation Therapy – The use of high energy X-rays to kill cancer cells and shrink tumors
- Chemotherapy – The use of drugs to destroy cancer cells – treatment often involves using a combination of drugs to fight the cancer cells.
- Hormone Therapy – Some forms of cancer are sensitive to estrogen and progesterone and this therapy, with the use of hormone blocking agents, can help shrink the tumor and control spreading of the disease by eliminating or blocking the source of hormones.
Coping With Breast Cancer
As I’ve stated earlier, a diagnosis of breast cancer can be overwhelming and will most likely bring about a flood of emotions.
Most people who have been diagnosed with breast cancer (and most other forms of cancer) find that communication is the key component to coping with the disease. Of course you will spend much time with your medical team, but it’s also important to build a strong support system. This obviously starts with your family, but could also include support groups – many of which are offered right here in Yankton. Most survivors find it comforting to have a group of people who have gone through the same issues. Fellow survivors are oftentimes the best resources a new cancer survivor can lean on.
Use these resources and keep a positive attitude.
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