Breast cancer is one of the most frightening diseases a woman can face, but there is hope. The truth is, women who get breast cancer have an excellent chance of beating it, even without radical surgery, especially if it is diagnosed while it is small and localized. For those whose cancer is detected at a later stage, new advances in treatment hold increasing hope for a positive outcome.
With breast cancer, early detection is key. Cancers are “staged”, classified, according to how much they have spread. Women with stage 0 or stage 1 cancer have a 100% probability of being alive five years after their cancer is diagnosed. Women who are not diagnosed until they are stage IV, the most advanced stage, have only a 20% chance of surviving five years after diagnosis.
Of course, these are only statistics, and the many variations in types of cancer and response to treatment make each case unique. However, it is easy to see that the best cancer is the one found early.
Therefore, it is important for a woman to do a breast self-exam every month. Many women do theirs the day after their period, and then switch to the first of the month after menopause. They put their health first. Any medical professional can provide instruction in breast self-exam.
Women over forty should have a mammogram every year or two, and women over fifty should have one yearly. Mammography takes an x-ray picture of breast tissue that shows its structure and density. This completely non-invasive procedure provides valuable information to a woman and her doctor.
MRI, Magnetic Resonance Imaging, can better identify anything examination or mammography finds. Ultrasound can indicate the composition of a lump, for example whether it is solid or filled with fluid. Scans can show if a cancer has spread. Blood tests may indicate the presence of cancer.
If cancer is found, it will generally be tested for proteins and hormone receptors. The outcomes of these tests help doctors determine which chemotherapy will best fight the disease. Tests also help with staging. Staging guides treatment, and gives the patient an idea of what to expect.
Current treatment options
The course of treatment for breast cancer varies with the stage of the disease, its location, and specific characteristics of the patient’s cancer cells. Different cancer cells have characteristics that make them susceptible to particular treatments including chemotherapy, estrogen-blocking therapy, and biologic therapy.
Most breast cancer treatment starts with surgery. This may be a lumpectomy, which removes a small cancer and some surrounding tissue, or it may be a mastectomy, which can remove part of a breast, all of a breast, or sometimes one or both breasts and certain surrounding tissues.
After recovering from the surgery, women often have radiation treatment. It can lower the risk of recurrence by more than 50%. Radiation therapy destroys cancerous tissue. It attacks cells when they are dividing; since cancer cells divide rapidly they are especially susceptible to radiation. This therapy may kill cancer the surgeon was unable to remove. Women who choose to have lumpectomy commonly have radiation as well.
Chemotherapy takes various forms, depending upon the nature of a particular cancer. It affects the whole body. Some of the drugs used are Taxol, Adriamycin, Taxotere, and Abraxane. There are many others. These drugs work singly or in combination to kill cancer cells. Chemotherapy is often given by infusion. Patients will generally be given medications to help with side effects, and some non-traditional techniques may help as well.
Estrogen fuels the growth of some cancer cells. For that reason, estrogen sensitive breast cancer is treated with hormone therapy that reduces and blocks estrogen, like tamoxifen. A newer class of medicines, aromatase inhibitors, work as well as or better than, tamoxifen in post-menopausal women. One aromatase inhibitor is exemestane (Aromasin). Hormone therapy is often used in conjunction with chemo.
Biologic or targeted therapy affects cells that show certain changes that may lead to cancer. These changes show up in the HER2 test. In women with HER2/neu positive breast cancer, trastuzumab (Herceptin), a monoclonal antibody, works with chemotherapy to improve results. In those with early stage cancer, Herceptin and chemotherapy cut the rate of recurrence in half. Other targeted treatments include Avastin, which starves cancer cells of blood, and Tykerb, which blocks proteins that encourage cancer growth.
Whatever forms of treatment they and their doctors choose, women who have had breast cancer often continue to take tamoxifen or a similar drug for a long time after treatment is complete. Women will also continue to see their doctors frequently, for blood tests, mammograms, and other aftercare.
Research is finding ways to deal with cancers once considered untreatable. Testing is always going on, and it is possible for patients to be included in studies, if they fit the profile that researchers are seeking. Test subjects usually get free treatment.
A new technique for delivering chemotherapy is dose-dense chemo. It steps up the frequency of chemotherapy, to increase its power. Doctors seem to be getting good results with it.
Another innovation is RAD001. This drug is being tested in patients whose cancers are resistant to Herceptin. When combined with Herceptin, RAD001 seems to make treatment more effective.
Many drugs are in testing that appear to slow cancer’s growth. It is quite likely that someday breast cancer will be defeated, either by eliminating it or by turning it into a chronic condition. Even now, although one in eight American women is diagnosed with breast cancer, only one in thirty-five dies of the disease.
Breast cancer is very treatable, especially if discovered early. Effective therapies exist, and more are discovered all the time. Growing numbers of women around the world have fought breast cancer and survived.