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Understanding Breast Cancer -- Diagnosis & Treatment

Breast Self-Exams and Mammograms continued...

An MRI of the breast is performed before surgery to look for other hidden tumors and to decide on the proper surgical technique. Other imaging tests like CT scans, PET scans, bone scans, or X-rays are not recommended to be done routinely in operable breast cancers unless clinical signs or symptoms of possible metastasis are present.

Cancer cells are analyzed for the presence or absence of endocrine (estrogen and progesterone) receptors to find out if the cancer is likely to respond well to hormone therapy. Other tests, such as the her-2-neu oncogene test, can help predict the likelihood of metastasis and the potential for recurrence after treatment as well as help decide on treatment programs.


What Are the Treatments for Breast Cancer?

If you have breast cancer, the earlier you can get treatment, the better. But before making treatment decisions, research your options. Ask questions of your doctor, other specialists, and people who have had breast cancer. Find a doctor you trust, and don't rush your decision. A brief delay between diagnosis and treatment will not compromise the effectiveness of treatment.

Surgery for Breast Cancer

The treatment options for breast cancer depend on how advanced the cancer is, how old the woman is, and how healthy she is otherwise. If possible, breast cancer is treated surgically, followed usually by some combination of radiation therapy, chemotherapy, or hormone therapy.

Modified Radical Masectomy

The standard surgery for breast cancer was once modified radical mastectomy -- removal of the entire breast and lymph nodes in the breast and under the arm. For many women whose breast cancer is detected early and is still localized, lumpectomy -- removal of the cancerous lump and testing key lymph nodes -- is now the preferred treatment. Followed by appropriate radiation therapy, chemotherapy, and hormone therapy, lumpectomy has proven as effective as mastectomy for early breast cancer and is much less disfiguring.

For breast cancer that has metastasized and for breast cancer that has come back, radiation therapy and chemotherapy are the main treatments. Hormone therapy may also be beneficial for cancers that are hormone-responsive. In addition, biologic modifiers such as trastuzumab (Herceptin) may be useful in helping patients whose cancer has an excess of a particular protein called HER2 that causes the cells to divide and grow more agressively. Surgery may still be an option depending upon the site of recurrence and the extent of other sites of disease.

Chemotherapy for Breast Cancer

When breast cancer is limited to the breast or lymph nodes, adjuvant chemotherapy may be given after a lumpectomy or mastectomy. This is done to help reduce the chance of breast cancer coming back.

If the breast tumor is large, chemotherapy or endocrine therapy may be given before surgery to shrink the tumor so it can be removed more easily, or a lumpectomy can be performed instead of a mastectomy.

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