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Breast cancer treatment

By Dr. Waseem Abbas in Breast Cancer , Cancer Care / Oncology

Feb 19 , 2021 | 3 min read

With roughly 1 in 8 women developing breast cancer in their lifetime, the odds are high that nearly every woman is affected by this disease in some way. Whether it’s a personal diagnosis or that of a loved one, finding answers to all the questions and a supportive community of people who understand the experience can make all the difference.

Owing to the advancements in medical treatment for Cancer, 30% of women diagnosed with breast cancer do not need chemotherapy and in coming times this number is going to increase.  

Breast cancer is a curable disease if diagnosed and treated in time. Treatment of breast cancer does not depend only on stage, it also depends on the type of breast cancer. One treatment plan does not fit all. Imaging is very important. Ittells us about the type and extent of breast pathology. Imaging in Breast Cancer includes bilateral mammography and PET CT. 

Clinical examination is significant as well which tells us about the size, involvement of skin, and axillary lymph nodes. After imaging, another important thing to do is a biopsy and there are different ways of doing it. One of the most advanced procedures is Tru-Cut Biopsy which is ultrasound-guided biopsy. It is usually a painless procedure and is done under local anesthesia.

Once the diagnosis of cancer is confirmed, we need to look at Immunohistochemistry markers which include ER, PR, HER2/neu, and Ki 67 index. These markers are important and they tell us the whole story about the aggressiveness of breast cancer. These markers also tell us what therapeutic options can be used depending on the patient. Once the diagnosis and staging are confirmed, treatment should be started immediately without any delay. For locally advanced breast cancer that has spread to lymph nodes, chemotherapy in combination with targeted therapy should be given first and then proceed for surgery.

In the early stage, surgery is the preferred option for most of the patients, but in some patients who are triple-negative or HER2/neu positive, chemotherapy can be given upfront to look for a response. Early-stage hormone receptor-positive breast cancers usually do not require chemotherapy.

After completion of chemotherapy and surgery, radiation therapy to the breast and axillary lymph nodes is advisable depending on the stage of the breast cancer. The tumour which is less than 5 cms does not require radiation.

Once radiation is completed, a patient needs hormonal therapy in the form of a tablet for 5 years, if the hormonal receptor is positive and if it is negative then hormonal therapy will not work for them. Some patients are Her2/Neu positive and require targeted therapy for 1 year. Once the treatment is completed,the patient can live a normal life.

Surgical techniques have also undergone a massive change and in most of the cases, patients’ breast can be preserved. In case there comes a need to remove it, there are umpteen options of getting it reconstructed.

The patient is required to go for a regular mammography (yearly) and clinical examination (every 3 months) as a follow-up.

Bone health remains an issue with hormonal therapy, for which the patient might need bone directed therapy to strengthen their bones. Hence, a multidisciplinary approach to deal with the disease is important.

For a cancer patient, it is very difficult to be strong. However, patient support groups help them regain the confidence, help them empower themselves and start feeling like they have already been cured.

One of my patients, Sarita, was diagnosed with Breast Cancer at the age of 27. As a part of recovery, she gained her strength by getting in touch with women dealing with the same disease, 3 years into remission, she now inspires many young women through wellness, positivity, style, and self-love. Breast cancer support groups help patients to cope up with the disease and get the right treatment.  Long term social, psychological issues are addressed in these support groups.

My advice to all women:

As you turn 45, get in touch with your doctor to discuss and understand the right time to get screened and way forward.

Stay safe and healthy.