How is breast cancer treated?
There are many different forms of breast cancer, each one requiring a different type of treatment or a number of treatments in combination. Your choice of treatment also depends on whether the cancer has spread beyond the breast, how far it has spread, and what stage the cancer is at.
Ductal Carcinoma in situ (DCIS)
This form of breast cancer occurs when there are cancerous cells contained within the ducts of the breast that have not spread to any lymph nodes. Generally considered to be an early stage form of breast cancer, DCIS has the potential to spread to other parts of the body and therefore needs to be treated effectively. DCIS can be classified into either high grade, which means it could spread quickly into the lymph nodes, or low grade, where the cancerous cells grow slowly and are less likely to spread.
Even if a ductal carcinoma in situ case is classified as low grade it still requires treatment. A case that is left untreated will spread slowly into the surrounding breast tissue and potentially to other parts of the body.
The primary treatment for DCIS is the surgical removal of the affected cancerous area, otherwise known a lumpectomy or local excision If the affected area is particularly large, however, it may be necessary for a mastectomy to take place, which involves the removal of the whole breast. A mastectomy might also be needed if the DCIS is located in a number of areas in the breast, or if you have small breasts which wouldn’t be able to compensate for tissue removed by a local excision. Many patients also choose to have a mastectomy as it reassures them that the cancer has been fully removed.
Surgical removal for DCIS can sometimes be followed by chemotherapy or radiotherapy if there is a suspicion that some cancer cells might be left in the ducts, or if the DCIS wasn’t diagnosed early.
Invasive breast cancer
As the cancer has spread into the breast tissue, a mastectomy is usually required for invasive breast cancer, but it is also possible to have a lumpectomy if the cancerous area is small. If the cancerous area is large then chemotherapy may be given before surgery in order to sufficiently shrink the size of the tumour and reduce the amount of tissue which needs to be surgically removed. On the other hand, chemotherapy is sometimes given in combination with radiotherapy after a mastectomy to reduce the likelihood of the cancer returning.
Hormone therapy is also used in the treatment of invasive breast cancer. This treatment aims to lower your levels of estrogen, a hormone which can accelerate and feed the growth of cancerous cells. Hormone therapy help can slow rate of cancer growth before surgery or shrink a cancerous growth which has returned.
Inflammatory breast cancer
Occurring in around 4 out of every 100 breast cancer cases, inflammatory breast cancer is a rare form of disease which requires different treatment methods. It develops when the cancer cells prevent the lymph nodes from draining away waste fluids and toxins, causing the breast tissue to swell and become inflamed. It is often mistaken for an infection of the breast, or mastitis, as it shares a number of symptoms such as a thickening of the skin, nipple discharge and an inverted nipple.
The treatment process for inflammatory breast cancer usually involves chemotherapy followed by surgery and radiotherapy. Surgery in the case of inflammatory breast is usually a mastectomy. This could also be combined with a long-term course of hormone therapy.
What is breast cancer?
Many people notice lumps or growths in their breasts at some point in their lifetime. When cells in the breast begin to divide rapidly they can cluster into hard lumps of tissue which are noticeably different from the rest of the breast tissue. Around 90% of breast lumps are benign (non-cancerous), and are usually cysts or collections of glandular tissues.
Although the majority of them are benign, if you discover a lump in the breasts you should have it checked out as soon as possible. It could be the first sign of breast cancer.
Besides a lump or growth, the main signs of breast cancer to look out for include:
- Changes in the size or shape of the breast
- Discharge from the nipple, usually containing blood
- Lumps or swelling around the armpit area
- Changes in the shape or size of the nipple
- A dimpled appearance around the nipple
- Itchy rash around the nipple
- Dull ache or pain in the breast combined with inflammation
The symptoms could all be caused by other medical conditions, but they could also be an early sign of cancer. Early diagnosis is essential in the successful treatment of breast cancer. No matter how insignificant it may seem, if you notice any symptoms you should have a breast examination as soon as you can. If the lump is found to be benign you might choose to have it removed to avoid any worry about it turning cancerous.
The cancer tends to form in the ducts which transport milk to the nipple, but it can also appear in the milk glands themselves. The breasts are connected to the body’s lymphatic system, which carries fluid and toxins from the body and is made up of cell-like structures called nodes. Cancerous cells that form in the breast can enter into the lymphatic system and the lymph nodes surrounding the breast, which subsequently results in a high chance of the cancer being spread via the lymph vessels to other parts of the body.
How is breast cancer diagnosed?
Once a lump has been discovered and you have been assessed by a doctor, you will most likely be sent for some tests to see whether the lump is cancerous. This could involve either a mammogram (x-ray of the breasts) or an ultrasound, or both. These tests can detect whether the lump is filled with fluid or is a solid lump of tissue.
If it is filled with fluid then the lump is most likely a cyst, which can be drained there and then by a nurse. On the other hand, if the lump is found to be solid then a biopsy is required to test for cancerous cells. A small sample of tissue is taken and sent for further analysis at laboratory, where a pathologist can see whether cancer cells are present.
What causes breast cancer?
There is no definitive cause of breast cancer, but there are a range of risk factors which increase the likelihood of it developing.
Incidences of breast cancer are highest in women over 50 and a woman’s chances of getting breast cancer increase with age. Almost all cases of breast cancer occur in women over the age of 40.
Genes and family history
Studies suggest that certain inherited genes can slightly increase the chances of breast cancer developing, and that women with close family members who have had breast cancer are also more at risk.
Women who had cancer in past are at a higher risk of contracting breast cancer, regardless of whether their previous cancer was in the breasts or elsewhere in the body.
Hormone replacement therapy
Around 3 in every 100 breast cancer cases can be linked to hormone replacement therapy, which aims to lessen the symptoms of the menopause.
There are a number of lifestyle factors which influence your chances of getting breast cancer. Both alcohol and tobacco have been shown to increase risk.
Poor physical condition can increase the chances of breast cancer developing, particularly if you are overweight, consume a lot of fatty foods or have diabetes.
Women who have children at a young age are less likely to encounter breast cancer in later life, while women who do not have any children at all have an increased breast cancer risk.
Life after breast cancer treatment
Many women who undergo a full mastectomy choose to have breast reconstruction surgery once their cancer treatment is completed. This replaces the removed tissue as well as the nipple and surrounding skin. While some women choose to have breast reconstruction for aesthetic reasons, others need reconstruction to restore the natural balance of the breasts. The feeling of having a natural pair of breasts again can also have an impact on your self-confidence and mental wellbeing after cancer treatment.
You will need to have regular checkups for a minimum of 5 years after breast cancer treatment, and ideally return for annual assessments for up to 10 years. It is important to closely monitor yourself for any changes in the breast for some time after treatment and should report anything suspicious to your care team straight away.
Mammograms are also conducted regularly after treatment for breast cancer. You should undergo a mammogram on an annual basis for at least 5 years after your initial treatment is completed.
Although modern treatments for breast cancer are highly-specialized and effective, as with any form of cancer there is always a chance it will return.
How much does breast cancer treatment cost?
It can be tough to find an accurate quote for breast cancer treatment. The final estimate is based the stage of the cancer, whether it has spread, and factors such as age, health, lifestyle, family history and any previous cancer. Consulting an experienced care team is the best way to get a good idea of how much your treatment will cost.
Breast cancer facts
- Breast cancer is the second most common cause of cancer deaths in women
- 1 in 8 women will develop invasive breast cancer at some point in their life
- 30% of all female cancer diagnoses are for breast cancer
- Only 5% of women diagnosed with breast cancer are under the age of 40
- 80% of breast cancer cases are found in women over 50
- 5% of breast cancers can be attributed to gene defects