(Sources: NCI Cancer.gov, BreastCancer.org)

Different types of treatment are available for patients with breast cancer.

Breast Surgery:
Most patients with breast cancer have surgery to remove the cancer from the breast. There are a number of options you should discuss with your breast surgeon. The options range from radical mastectomy to breast conserving surgery, where the surgeon removes only the cancer along with a margin of healthy surrounding tissue from the breast.  When the cancer is invasive, some of the lymph nodes under the arm are usually taken out and looked at under a microscope to see if they contain cancer cells.

Mastectomy: Surgery to remove the whole breast that has cancer. This procedure is also called a simple mastectomy. Some of the lymph nodes under the arm may be removed for biopsy at the same time as the breast surgery or after. This is done through a separate incision.

Modified radical mastectomy: Surgery to remove the whole breast that has cancer, many of the lymph nodes under the arm, the lining over the chest muscles, and sometimes, part of the chest wall muscles.

Radical mastectomy: Surgery to remove the breast that has cancer, chest wall muscles under the breast, and all of the lymph nodes under the arm. This procedure is sometimes called a Halsted radical mastectomy.

Breast Conserving Surgery:
Any form of surgery that removes only part of the breast is considered "breast-conserving" or "breast preservation" surgery.  Breast conserving surgery followed by breast irradiation has replaced modified radical mastectomy as the preferred treatment for early-stage invasive breast cancer. Studies have shown that women diagnosed at early stages of invasive breast cancer have equivalent outcomes when they are treated by lumpectomy and radiation therapy or modified radical mastectomy.³ If however, your cancer is present in several areas of the breast or is in a later stage, breast conserving surgery may not be for you.

Breast conserving surgery includes the following:

Lumpectomy: Surgery to remove a tumor (lump) and a small amount of normal tissue around it. Lumpectomy is the most common form of breast cancer surgery today. The surgeon removes only the part of your breast containing the tumor (the "lump") and some of the normal tissue that surrounds it. All the tissue removed from your breast is examined carefully to see if cancer cells are present in the margins—the normal tissue surrounding the tumor.

If cancer cells are found in the margins, extending out to the edge of the breast tissue that was removed, your surgeon will do additional surgery (called re-excision) to remove the remaining cancer.

Partial mastectomy: Surgery to remove the part of the breast that has cancer and some normal tissue around it. This procedure is also called a segmental mastectomy.

Patients who are treated with breast-conserving surgery may also have some of the lymph nodes under the arm removed for biopsy. This procedure is called lymph node dissection. It may be done at the same time as the breast-conserving surgery or after. Lymph node dissection is done through a separate incision.

Even if the doctor removes all the cancer that can be seen at the time of the surgery, patients may be given radiation therapy, chemotherapy, or hormone therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to increase the chances of a cure, is called adjuvant therapy.

Adjuvant Treatment Options (Post-Surgery Treatments)

After your breast surgery, your physician may recommend adjuvant therapy. This can be radiation therapy, chemotherapy, or hormone therapy to prevent local or systemic recurrence of your cancer.

Radiation Therapy:
Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy.

1. External radiation therapy uses a machine called a linear accelerator to deliver high-energy radiation from outside the body to the affected area.

2. Internal radiation therapy also known as accelerated partial breast irradiation (APBI) delivers radiation from inside the body directly to the lumpectomy site.

Chemotherapy:
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Hormone therapy:
Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances produced by glands in the body and circulated in the bloodstream. Some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy are used to reduce the production of hormones or block them from working.

"About Breast Cancer Brochure"

This information is designed to help people with cancer learn more about the treatment options available. It is not intended to replace advice from a medical professional. If you have any questions about a specific treatment, please ask your radiation oncologist
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Sources:
The National Cancer Institute's Web site (http://www.cancer.gov) provides accurate, up-to-date information about many types of cancer, information about clinical trials, resources for people dealing with cancer, and information for researchers and health professionals
www.breastcancer.org