The Different Kinds of Breast Cancer Treatment
The three major treatments for breast cancer are surgery, radiation and drug therapy. There is not one specific treatment that fits the needs of every patient and usually, a combination of treatments is required. The choice is determined by many factors, including a patient’s age, menopausal status, the type of breast cancer (i.e. invasive lobular or ductal carcinoma, ductal carcinoma in situ, etc.), its stage and whether or not the tumor contains hormone receptors.
Surgery is considered primary treatment for early-stage breast cancer; many patients require surgery alone. The goals of breast cancer surgery include complete resection of the primary tumor with negative margins to reduce the risk of local recurrences and pathologic staging of the tumor and axillary lymph nodes to provide necessary prognostic information.
Adjuvant treatment of breast cancer: includes radiation therapy and systemic therapy, which includes a variety of chemotherapeutic, hormonal and biologic agents. This treatment is designed to treat microsmatic disease – meaning breast cancer cells that have escaped the breast and regional lymph nodes, but have not yet had an established identifiable metastasis.
Breast cancer treatments are defined as local or systemic:
Surgery and radiation are considered local therapies because they directly treat the tumor, breast, lymph nodes or other specific regions, surgery is usually the standard initial treatment.
Drug treatment is called systemic therapy because it affects the whole body. Drugs may include either chemotherapy or hormone therapy. Drug therapy may be used as primary therapy for patients for whom surgery or radiation therapy is not appropriate, neoadjuvant therapy (before surgery or radiation) to shrink tumors to a size that can be treated with local therapy or adjuvant therapy (following surgery or radiation) to reduce the risk of cancer recurrence. For metastatic cancer, drugs are used to help improve the quality of life and may help prolong survival.
Any or all of these therapies may be used separately or, most often, in different combinations. For example, radiation alone or with chemotherapy or hormone therapy may be beneficial before surgery if the tumor is large or late stage.
Most women with breast cancer will have some form of surgery to eradicate the tumor. However, the earlier breast cancer is detected the less invasive the treatment will have to be and the increased chance of survival. This demonstrates the importance of detecting breast cancer early; however, breast imaging has limitations that often halt this. For example, women with dense breasts are at a higher risk of a missed diagnosis because breast density appears white on a mammogram, which is the same color as a tumor would appear. This can delay a woman’s diagnosis, leading to the requirement of more invasive treatment.
This leads to the question, how can we improve breast cancer detection to ensure all cancer is caught as early as possible?
If we were to combine a blood-based approach with the current standard-of-care we would be able to improve early breast cancer detection, as this test would be based on anatomy, not physiology alone. This would allow for the earlier detection of breast cancer, especially in women with difficult-to-interpret findings and thus, improve survival rates of the disease.