Breast cancer treatment is highly personalized and depends on several factors, including the type and stage of the cancer, its genetic profile, and the patient's overall health.
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Here's a detailed overview of the primary treatment options for breast cancer:
1. Surgery
Surgery is often the first line of treatment for breast cancer. The type of surgery depends on the size and location of the tumor, and whether it has spread to the lymph nodes.
Breast-Conserving Surgery (Lumpectomy): This procedure removes the tumor and a small amount of surrounding healthy tissue, leaving most of the breast intact.
It is typically followed by radiation therapy to kill any remaining cancer cells. Mastectomy: This is the surgical removal of the entire breast.
In a modified radical mastectomy, the entire breast and the axillary lymph nodes (in the armpit) are removed. Many people who undergo a mastectomy choose to have breast reconstruction, which can be done at the same time as the mastectomy or at a later date.
2. Radiation Therapy
Radiation therapy uses high-energy rays to kill cancer cells.
External Beam Radiation: This is the most common type, where a machine outside the body directs radiation to the affected breast or chest wall.
Internal Radiation (Brachytherapy): A radiation-delivery device is temporarily placed inside the breast in the area where the tumor was removed, delivering a high dose of radiation over a shorter period.
3. Chemotherapy
Chemotherapy uses drugs to destroy fast-growing cancer cells throughout the body.
Neoadjuvant Chemotherapy: Given before surgery to shrink a large tumor, making it easier to remove and potentially allowing for a lumpectomy instead of a mastectomy.
Adjuvant Chemotherapy: Given after surgery to kill any remaining cancer cells and reduce the risk of the cancer recurring.
4. Hormone Therapy (Endocrine Therapy)
Hormone therapy is a treatment for breast cancers that are hormone receptor-positive (meaning they are fueled by hormones like estrogen or progesterone).
Selective Estrogen Receptor Modulators (SERMs): Drugs like tamoxifen block estrogen from binding to cancer cells.
Aromatase Inhibitors: These drugs, such as anastrozole (Arimidex) and letrozole (Femara), are used in postmenopausal women to stop the body from producing estrogen.
5. Targeted Therapy
Targeted therapy uses drugs to attack specific proteins or genes that help cancer cells grow and survive.
HER2-Targeted Therapy: For HER2-positive breast cancers, drugs like trastuzumab (Herceptin) and pertuzumab (Perjeta) block the HER2 protein, which is overexpressed in these cancers.
CDK4/6 Inhibitors: These drugs (e.g., palbociclib, abemaciclib) block proteins that help cancer cells divide, and are often used for hormone receptor-positive, HER2-negative breast cancers.
Antibody-Drug Conjugates (ADCs): These are a new class of drugs that combine a targeted antibody with a powerful chemotherapy drug.
The antibody finds the cancer cell, and the drug is delivered directly to it. An example is sacituzumab govitecan (Trodelvy).
6. Immunotherapy
Immunotherapy is a newer treatment that uses the body's own immune system to fight cancer.
Immune Checkpoint Inhibitors: These drugs, such as pembrolizumab (Keytruda), block proteins that prevent the immune system from attacking cancer cells, essentially "releasing the brakes" on the immune response.
Emerging Treatments and Clinical Trials
The field of breast cancer treatment is constantly evolving. Researchers are developing new drugs, refining existing treatments, and exploring personalized medicine approaches.
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