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Treating and preventing breast cancer
Treatment
Early detection of breast cancer minimizes the likelihood
that the cancer has spread, and increases the chances of
making a complete recovery. Treatment depends on individual
circumstances, such as the rate of growth, how it responds to
treatment, and whether or not it has spread.
When the tumour is confined to the breast, the best choice is
surgery, followed by systemic therapy and possibly also
radiation. Part or all of the breast is surgically removed
soon after the diagnosis to avoid having the cancer spread.
Removal of a small part of the breast - only the tumour and some
surrounding tissue - is called a lumpectomy, or partial
mastectomy if a larger area of the breast is removed.
A simple mastectomy involves removing the whole breast,
and a radical mastectomy includes the underlying chest
muscle and tissue as well. The lymph nodes in the underarms may
also be taken out.
Systemic therapy consists of chemotherapy and hormonal
therapy. Chemotherapy is often given over six to eight
months, and hormonal therapy may continue for five years or
longer, if tests on the original cancer find receptors for
hormones (receptor-positive cancers). The use of systemic therapy
is now very common, and greatly reduces the risk of recurrence
of the cancer, often by as much as 50%.
On rare occasions, systemic therapy is used prior to surgery.
This is called neoadjuvant therapy. This type of treatment
is used to improve chances of recovery, to allow surgery to take
place successfully, and to assess the response of the tumour to
systemic therapy (which cannot occur if the tumour is already removed).
Radiation therapy is often administered after lumpectomy or
partial mastectomy. It is used if the resection margins are
very close, or if the tumour was large and involved a lot of lymph
nodes. Radiation kills any remaining cancer cells in the breast
and sometimes in the armpit and chest wall as well. Side effects
of radiation therapy are the result of healthy tissue in the area
being destroyed; they go away on their own following the completion of therapy.
While successful surgery and radiation therapy rely on exact
knowledge of where the tumour is located, systemic therapy does not.
Chemotherapy involves taking one or more medications to destroy
secondary tumours or to attempt to suppress growth of cancer cells
that may appear in other locations. Hormone therapy works on cancerous
cells that have estrogen receptors, making them susceptible to
estrogen-blocking medications. The source of the hormones that
stimulate growth - ovaries or the adrenal glands - may also be
surgically removed or destroyed using X-rays.
Prevention
As far as we know, breast cancer can't be prevented. Research
is ongoing to confirm whether medications known as
anti-estrogens can help prevent breast cancer
for women at high risk. In the meantime, keep in mind
the non-drug steps you can take to reduce your risk of
breast cancer:
- exercise regularly
- eat a healthy, low-fat diet with lots of fruits and vegetables
- reduce alcohol intake (one to two drinks per day slightly increases your risk)
In addition, women should get to know their breasts.
One way to do that is to perform monthly breast
self-examinations - your doctor can show you the
correct way to do this. From age 50, women of average
risk should also have mammograms and physical examinations
every two years. These measures help detect any unusual
lumps or abnormalities in breast tissue. Early detection
can make a big difference in successful treatment.
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