Breast cancer surgery - Medical specialists

Modern day breast cancer treatments continue to evolve, and there are many more options available to combat the disease than could have been envisaged even a decade ago. With such a range of choices, it’s important to learn as much as possible about each treatment in order to gain an understanding about which are likely to be of most help.

Whichever option you finally choose, each recommended treatment will have two primary aims:

• to remove as much of your breast cancer as is possible
  
• to stop the disease from returning

Who offers breast cancer treatment?

Breast cancer treatment is often provided by specialist private health clinics, which are in some cases managed by universities, insurers, mutual societies or religious institutions. In addition, there are state-run hospitals (such as the UK’s NHS), which also employ skilled oncologists and surgeons who specialise in breast cancer treatments.

Breast cancer surgery

What does breast cancer treatment help with?

Some breast cancer treatments are designed to remove or eradicate cancerous cells within the breast and in other tissues close by, such as lymph nodes. These options include:

• surgical procedures such as a mastectomy, which removes the entire breast, or a lumpectomy, which is a breast-sparing procedure, designed to remove only the cancer tumour and its surrounding tissues. There are various specific kinds of mastectomies and lumpectomies.
  
• radiation therapy, which employs powerful waves, such as X-rays, to destroy cancerous cells.

Other treatments that have been devised with the aim of destroying or controlling cancerous cells throughout the body include:

• chemotherapy, which employs powerful medicinal drugs to destroy cancer cells. While they are often an effective means of fighting cancer in the body, some drugs can also trigger side effects.
  
• hormone therapy is used to suppress some of the body’s hormones (especially oestrogen), which are known to fuel the development of breast cancer cells. Some drug medications are prescribed for women before and after the menopause (e.g. tamoxifen), while others are prescribed only for post-menopausal women (e.g. anastrozole, exemestane and letrozole). A common strategy is to prevent the ovaries from producing hormones, and once again, these drug treatments can cause side effects.
  
• targeted therapy uses medication to induce your body’s immune system to destroy cancerous cells. Common drugs, such as lapatinib, pertuzumab and trastuzumab, seek out breast cancer cells with excessive levels of a protein known as HER2, while the drug palbociclib seeks to suppress a molecule known to boost cancer growth.

Treatments such as chemotherapy, hormone therapy and targeted therapy can also be used alongside breast cancer surgery or radiation to eradicate any remaining cancer cells not destroyed by the other treatments.

When is breast cancer treatment used?

The type of breast cancer treatment offered by your doctor will depend on your general health and personal preferences, plus a number of other factors, such as:

• the specific kind of breast cancer you have
  
• the ‘stage’ of your cancer, which will be determined by the size and location of your tumour, and by the extent to which the cancer has spread in your body
  
• whether your tumour has been identified as having ‘receptors’ for oestrogen, progesterone and HER2 protein

Naturally, your age and whether you have experienced the menopause will also play a part in the final choice of treatment.

What are the risks of breast cancer treatment?

Breast cancer surgery is usually considered a safe option, but as with any other type of surgery, there are certain risks attached. These may include:

• wound infection
  
• haematoma (an accumulation of blood beneath your skin)
  
• seroma (an accumulation of fluid beneath your skin)
  
• lymphedema (a swelling that can occur in your arm)
  
• an adverse reaction to anaesthesia

Once their cancer is removed, it’s common for many women to undergo a breast reconstruction. There can also be occasional issues with such procedures, including:

• wound infections
  
• slow healing
  
• breast implants that rupture or leak
  
• residual scar tissue

As well as destroying cancerous cells, chemotherapy and radiation can also have an impact upon healthy tissues. As a result, you may experience:

• a loss of appetite
  
• nausea and sickness
  
• some weakness and tiredness
  
• mouth sores
  
• hair loss
  
• some weight gain
  
• an early menopause
  
• a greater risk of infections
  
• bleeding
  
• diarrhoea

The use of medications and other therapies can help to ease many of these problems.

Are there alternatives to breast cancer treatment?

In addition to the ‘standard’ care described above, there are complementary treatments, which may reduce some of the side effects of standard treatments, as well as alternative treatments designed to replace the options developed by Western medical science.

Though these holistic medical approaches have often been used since ancient times in some parts of the world, such methods have not been subject to rigorous testing.