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Following diagnosis, you may be treated with surgery to remove the tumor. You also may get chemotherapy before surgery to reduce the size of the tumor. After surgery, you may be treated with chemotherapy, hormone therapy, radiation therapy or a combination.
Treatment for Breast Cancer Before Surgery
You may get chemotherapy or hormone therapy before surgery to reduce the size of the tumor, lower the stage of your cancer and improve the overall outcome. This is called "neo-adjuvant therapy." This therapy can reduce the size of the tumor so that the woman needs only a lumpectomy instead of a complete mastectomy. How the cancer responds to this treatment can help doctors decide on the best treatment after surgery, too.
Surgery for Breast Cancer
Your doctor may recommend lumpectomy, where only the lump is removed and the area is radiated. Or, your doctor may recommend a mastectomy, where the entire breast is removed. As part of the surgery, our doctors always test the "sentinel" lymph node, where fluid from breast cancer drains first. If it has cancer cells, doctors also will remove nearby lymph nodes.
Breast Reconstruction Options
Many women want to have some kind of breast reconstruction as part of their treatment. Reconstruction can be done during the initial breast cancer surgery, or it may be delayed. The timing and type of reconstruction depend on issues such as:
- Ability to adapt to effects of the surgery
- Healing time
- Need for follow-up treatment
- Overall body size
- General health status
- Personal preferences
Via Christi Cancer Care offers several types of breast reconstruction. One group of options uses your own tissue. Another uses implants.
After removing the breast, the doctor may place an implant under the skin to create a breast shape. This is sometimes done during the initial surgery. Most often, it requires a two-step process. The doctor may place a tissue expander - like a balloon - under the chest muscle. Over several months, the doctor will slowly add saline solution to the expander to make room for a breast implant. Then, you will have surgery again to remove the expander and add the implant. Implants usually are filled with salt water or silicone gel.
Tissue Flap Reconstruction
You also may have the option of using your own body tissue to re-build your breast. The doctor may be able to take muscle from your tummy, shoulder blade or thigh and move it into the chest area. This procedure also can happen during the first surgery, or it may be delayed until after you've finished all treatment for your breast cancer.
Via Christi Cancer Care is one of only a few centers offering this method. Instead of using muscle, it uses skin and fat from the tummy area. It allows the doctor to re-shape this area and also avoids removal of any muscle tissue. DIEP stands for deep inferior epigastric perforator.
Chemotherapy uses medications to destroy cancer cells. You may receive it by injection, through your veins or by mouth.
Targeted Biological Therapy
Targeted therapies are substances that target the biological process involved in your particular kind of cancer. For example, one of them blocks the HER-2/neu protein involved in a specific kind of breast cancer. Targeted therapies often are combined with chemotherapy and can increase your survival rate. They can be given by mouth or through the veins.
About 70% of all breast cancers are receptive to the hormone estrogen. Hormones are chemicals the body produces naturally, but they can sometimes cause cancer to grow. Hormone therapy can block these chemicals and cause the cancer to shrink or reduce the chance of the cancer spreading or returning. Hormone therapy can be given by mouth or by injection. Generally, hormone therapy lasts about five years. It's usually combined with other treatments.
Radiation therapy uses high-dose X-rays to kill cancer cells and shrink tumors. It can be internal or external. You may receive radiation, like an X-ray, from outside the body. Or, the doctor may place radioactive material inside your body, near the cancer site. This is called high-dose brachytherapy. External radiation therapy is normally done Monday through Friday - typically for six to seven weeks.
Often people with breast cancer take part in clinical trials. Clinical trials are research projects to test medicines and treatments.