The Best Currently Available Breast Cancer Treatment Options
In 2018, more than 266,000 American women will be diagnosed with invasive breast cancer. Over that same period of time, nearly 41,000 women will die from the disease. Other than lung cancer, breast cancer is the most prevalent cancer among U.S. women. In fact, one in eight women will be diagnosed with invasive breast cancer during her lifetime, and they can turn to a variety of options for treatment.
As prevalent as breast cancer is in the U.S., it stands to reason that ongoing research continues to be conducted to find a cure. In the meantime, there are several common treatment options for the disease, and understanding what they are and their pros and cons make it easier to take a proactive approach to the situation. Below, you will find overviews of today’s most common treatment options for breast cancer, including when they are usually used and potential side effects.
The majority of women who get treatment for breast cancer undergo some form of surgery. The type of surgery that is recommended depends on several factors, including the extent of the cancer and whether it has spread to other parts of the body.
Some of the most common scenarios in which surgery is used to treat breast cancer include:
- Breast-conserving surgery: Also known as a lumpectomy or partial mastectomy, breast-conserving surgery involves removing only part of the affected breast and some surrounding tissue. This option is only viable if the cancer has not spread beyond the breast and if it is still fairly contained to a small area.
- Mastectomy: With a mastectomy, the entire breast is removed surgically. Typically, this is because the cancer has spread across most of the breast and may have even infiltrated nearby tissues.
- Lymph node dissection: Either during a partial or full mastectomy or separately, surgery is typically performed to determine whether cancer cells have spread to the lymph nodes. Therefore, this surgery is often used to determine the extent, or stage, of the breast cancer.
- Breast reconstruction: Following a partial or full mastectomy, surgery may be performed to reconstruct the breast.
- Surgery for advanced breast cancer: Finally, surgery may even be performed in cases of advanced breast cancer to provide relief from pain, to address an open wound caused by a tumor, or for other palliative reasons.
The main advantage of surgery for breast cancer is that it can be used to remove the vast majority of the cancer. The primary drawback is that it isn’t very effective for more advanced cases of the disease.
Cancer cells exhibit specific types of changes that allow them to sometimes be targeted through the use of special drugs. Targeted therapy drugs are typically designed to block the spread or growth of cancer cells specifically; unlike options like chemotherapy, they don’t impact healthy cells. In situations where chemotherapy has been tried but wasn’t effective, targeted therapy is sometimes an effective alternative.
A great example of targeted therapy for breast cancer can be found in the way that HER-2-positive breast cancer is treated. One in five women who develop breast cancer develop this type, which involves HER-2 — a growth-promoting hormone — that makes the disease particularly aggressive. Targeted therapy drugs like Herceptin and Perjeta are often used to target this hormone. In turn, they target and attack cancer cells while leaving nearby, healthy cells intact and unharmed.
One of the top benefits of targeted therapy for breast cancer is that it helps to kill cancer cells without killing healthy cells, which causes many unpleasant side effects. However, it is not an option for all types of breast cancer. Side effects are generally mild, but in rare cases, they can include severe diarrhea, heart damage, and other issues.
Certain types of breast cancer are affected by hormones in the blood. Such cancers can sometimes be treated through hormone therapy. The best example of this is found in so-called ER-positive and PR-positive breast cancer cells, which have receptors, or proteins, that attach to the hormone estrogen. The estrogen then helps the cancer to grow.
With hormone therapy, drugs that stop estrogen from attaching to these receptors are prescribed. A form of systemic therapy, the treatment reaches cancer cells virtually anywhere in the body. Sometimes used prior to surgery, it is more commonly used afterward to reduce the chance of recurrence. Common hormone therapy drugs include Tamoxifen and Toremifene.
A major plus of hormone therapy is that it is non-invasive and can be highly effective at slowing the growth and spread of breast cancer. Unfortunately, however, there are drawbacks too. In women who have gone through menopause, for example, it can cause an increased risk of uterine cancer, stroke, and blood clots. In pre-menopausal women, it can also cause thinning of the bones. Headache, bone pain, and hot flashes are other common but not too serious side effects of this type of treatment.
Typically used in conjunction with other treatments, like surgery, radiation involves subjecting cells in the body to high-energy rays that kill them. This treatment does not discern between healthy cells and cancer cells, however, so side effects can be severe. It is most commonly used after breast conserving surgeries and mastectomies, and it is usually administered five days a week for a period of five to six weeks.
When treating breast cancer with radiation, there are two options: external beam radiation and internal beam radiation, which is also known as brachytherapy. External beam, in which radiation is directed at the cancer from outside the body, is by far the most common. Internal beam involves temporarily placing a radioactive source in the body.
One of the pros of radiation is that it is highly effective at killing cancer cells. However, this treatment can cause many unpleasant immediate side effects, including swelling in the breast, fatigue, and skin changes that are akin to sunburn. Long term side effects can also include trouble breastfeeding, weakened ribs, nerve damage in the arms, and smaller, firmer breasts.
Most commonly used in conjunction with surgery, chemotherapy for breast cancer involves introducing anti-cancer drugs, either orally or via IV, that kill cancer cells. However, chemo drugs can also impact healthy cells, which is why it causes so many harsh side effects in so many. It is often used following surgery to eliminate any residual cancer cells or prior to surgery to shrink tumors and make them more manageable for removal.
Dozens of chemotherapy drugs are available, and most patients receive combinations of two or three drugs. Chemo drugs are given in cycles with periods of rest in between. These cycles usually run about two or three weeks, and they continue for a period of three to six months.
A major advantage of chemotherapy for breast cancer is that drugs like Anthracycline and Taxane work very well at killing cancer cells. The major drawback, of course, is that it also affects healthy cells, which can cause very unpleasant side effects. Common side effects of this procedure include nail changes, hair loss, loss of appetite, weight changes, mouth sores, diarrhea, nausea and vomiting, fatigue, an increased risk of infection, and easy bruising or bleeding.