Treatment of Breast Cancer

Surgery – Lumpectomy vs Mastectomy

Lumpectomy and mastectomy are two possible surgical methods for treating breast cancer. Both methods are discussed in this Breast Cancer Section, and the decision about which one to use is determined by the affected person with her or his physician (Although breast cancer almost always occurs in women, about 1% of men also get breast cancer). Click here for our discussion of lumpectomy and mastectomy.

Chemotherapy

is treatment with anticancer drugs. They may be given by vein (intravenously) or by mouth. The drugs travel through the blood to reach cancer cells in the body. When chemotherapy is taken after the lumpectomy or mastectomy, it reduces the risk of the breast cancer returning. The chemotherapy is given in cycles with a recovery period after each treatment. The usual full period of treatment is 6 months.

Chemotherapy can also be used to treat cancer that has already spread beyond the breast and underarm area. This kind of spread is called metastasis. The length of treatment varies from woman to woman, and depends on how much the cancer shrinks. Chemotherapy is also sometimes used to shrink a large breast cancer before surgery. For example, it may shrink it enough to permit lumpectomy instead of mastectomy.

The side effects of chemotherapy vary depending on the type of drugs, the dose, and the length of treatment. Temporary side effects may include fatigue or tiredness, nausea and vomiting, loss of appetite, hair loss, and mouth sores. Anemia or a low blood cell level may also develop because of damage to blood-producing cells of the bone marrow. Damage to the white blood cells can also increase a person’s chance of infection, and due to a shortage of blood platelets, there may be bleeding or bruising after minor cuts or injuries. Changes in the menstrual cycle may be temporary or permanent.

There are effective treatments for many of the temporary side effects, like nausea and vomiting. A group of drugs called growth factors can help the patient’s bone marrow recover after chemotherapy and can treat problems caused by low blood counts.

Premature menopause (not having menstrual periods) and infertility (not being able to become pregnant) are potential permanent complications of chemotherapy. The older a woman is when she receives chemotherapy, the more likely it is that she will develop infertility or become menopausal. The premature menopause may also lead to bone loss from osteoporosis.

Radiation Therapy or Radiotherapy

A treatment process that uses high-energy rays to stop cancer cells from growing and dividing. It is often used to destroy any remaining cancer cells in the breast, on the chest wall, or under the arm in the affected side. In the case of breast cancer, at least 7 weeks of radiotherapy is usually given to women after they have had a lumpectomy and the tissue has had time to heal. Radiation therapy is also sometimes given before surgery to shrink the size of the tumor.

Temporary fatigue or extreme tiredness is the most common side effect of radiotherapy. Other temporary side effects are:

Loss of appetite
a sharp decrease in the number of white blood cells
swelling or tenderness of the breast
feeling of heaviness of the breast
sun-burn-like appearance of the breast

These signs usually gradually disappear after completion of the radiotherapy. Generally, pregnant women are not given radiotherapy in order to avoid damage to the fetus.

Other key resources for breast cancer information are:

American Cancer Society:  Tel. 800-227-2346
National Cancer Institute:  800-4-Cancer (800-422-6237
The websites of both organizations can be visited directly from our Resource Directory.