Breast Cancer

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Breast cancer is the most common cancer in women, with one in eight women at risk to develop it. (It rarely occurs in men.)

Breast cancer doesn’t discriminate between young women, middle-aged women, or older women – it can occur at at point in a woman’s life, and it’s thought to be driven by the female hormones estrogen and progesterone.

A significant step in your cancer treatment is to understand what type of cancer you have. That, along with other factors we’ll mention below, are what determines the treatment your cancer doctor recommends.

Cancer cells can grow in several different areas of the breast, and the medical community has categorized breast cancer by where the cancerous cells are found:

  • Intraductal — Cancer in the cells lining the milk ducts.
  • Lobular — Cancer in the cells in the glands or lobules.
  • Sarcoma — Cancer in the fatty connective tissue cells of the breast.
  • Lymphoma — Cancer in the lymphoid tissue of the breast

By examining a sample of the cancerous tissue, your oncologist and his team can learn more about your cancer in order to determine the best treatment.

Other important information about your cancer can be discovered by looking for certain biomarkers (biological markers) in the cancerous tissue:

Estrogen receptors (ER) and progesterone receptors (PR)

The oncologist will look for the presence of estrogen and progesterone receptors (ER and PR for short). If these are detected, your cancer is described as “ER and PR positive” and will respond to hormonal treatment (such as Tamoxifen).

HER-2-Neu (C-ERB 2)

Another biomarker that your oncologist checks for is HER-2-Neu (C-ERB 2). Tumors with this marker are responsive to drugs like Herceptin.

Sometimes, but not always, your medical oncologist will recommend genetic testing, which could provide valuable information about your specific cancer and how to treat it. Another reason that genetic testing is helpful is to let other members of your family (daughters, sisters) be aware that the family line has a genetic tendency toward breast cancer, in which case they can seek out their own medical or genetic counseling.

You likely know of someone who has been treated for cancer with radiation, chemotherapy, or surgery – or perhaps all three. You may feel apprehensive and worry about the cancer treatment you’ll receive, but it’s important to know that your cancer treatment may differ greatly from someone else who has cancer.

Your cancer doctor takes other factors into consideration before recommending a course of treatment. Besides the type of cancer you have and the presence (or lack of) certain biomarkers, other significant factors include:

  • Your age
  • Your general health
  • Stage of cancer

In general, the younger you are when cancer is diagnosed, the more aggressive the cancer, which requires an aggressive cancer treatment. When you are diagnosed with cancer later in life, the cancer is slower-growing and there is often time to examine various treatment options.

Your current state of health (for example, physical fitness or the presence of other medical conditions) is important in determining how aggressively your cancer can be treated and what treatments can be used. You should also discuss any past health issues with your oncologist so that he or she can determine if it’s a factor in your cancer treatment.

In order to “stage” your breast cancer, the oncologist will determine the size of the tumor as well as if the cancer cells have spread to anywhere else in your body. Breast cancer can spread to lymph nodes in the armpits, to the skin, or to distant sites like the liver, lungs, bones, or farther.

Staging your cancer is also a very important aspect of determining what treatment you’ll receive:

Stage I Early stage cancer is confined to the breast.

Stage II Cancer cells have spread to the lymph nodes in the armpit.

Stage III Cancer cells have spread into the skin of the breast (also known as inflammatory).

Stage IV Cancer cells have spread to the liver, lungs, etc. (also known as metastatic).

Treatment for breast cancer may include any of the following:

  • Chemotherapy – Anti-cancer drugs taken intravenously or by mouth.
  • Hormonal therapy — Deprives the cancer cells of the hormones needed for their growth.
  • Immunotherapy — Newer types of monoclonal antibodies (and other agents) to prevent cancer cells from growing.
  • Radiation — Radiation is sometimes used in conjunction with surgery, but not always.
  • Surgery — Removes the cancerous area (lumpectomy) or the cancerous breast and nearby lymph nodes (mastectomy).

Your Treatment Team

A medical oncologist, with the assistance of nurses and staff, will treat your cancer in addition to any cancer-related conditions. The medical oncologist has the role of treating your cancer using chemotherapy or other medications, if appropriate.

The oncologist also works with other types of healthcare professionals to treat your cancer:

Breast surgeons
Performs the medical procedures to obtain biopsies or remove tumors from the breast and/or neighboring lymph nodes. This can also include oncoplastic surgeons who perform reconstructive surgery of the breast.

Radiation oncologists
Treats cancer using radiation therapy.

Genetic counselor
Evaluates the results of genetic tests to provide further information about your cancer.

Your oncologist consults extensively with the other doctors to determine what type of treatment will result in the best outcome for you. Although you might receive treatment from any of the doctors on your cancer team, your oncologist is the “quarterback” who coordinates the treatment.

You can read more about your cancer doctor’s background and experience on the About page

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