Understanding Breast Cancer -- Diagnosis & Treatment
What Are the Treatments for Breast Cancer? continued...
Reconstructive Breast Surgery
Reconstructive plastic surgery for breast cancer is performed to replace skin, breast tissue, and the nipple removed during mastectomy. The amount of missing tissue varies with each mastectomy. Factors contributing to the amount of tissue removed include the width, size, and location of the original tumor, and its proximity to the armpit (called the axilla), where the lymph glands are removed.
The ultimate goal for reconstruction is to restore symmetry between the two breasts. Reconstructive breast surgery can usually be done at the time of the original surgery for the cancer or after the completion of adjuvant therapy (chemotherapy or radiotherapy).
Endocrine Therapy for Breast Cancer
If lab tests show that your tumor depended on your natural hormones to grow, it will be called estrogen-receptor-positive or progesterone-receptor-positive breast cancer. Such tumors are often sensitive to treatments, called endocrine therapy.
Endocrine (or hormone) therapy is used to prevent the growth, spread, or recurrence of breast cancer by blocking your body's natural hormones from reaching any remaining cancer cells.
Endocrine therapy is the use of medicines that block the effects of estrogen, or having surgery to remove the ovaries or medication or radiation to make the ovaries unable to produce hormones.
The estrogen-blocking drug tamoxifen is one of the most common hormonal therapy drugs. It has been shown to decrease the chance of recurrence in some early-stage cancers and to prevent the development of cancer in the opposite breast. Tamoxifen works by blocking estrogen from attaching to estrogen receptors on cancer cells. It is believed that blocking the estrogen receptors will halt the growth of the cancer cells.
Tamoxifen is effective in pre- and post-menopausal women.
Other types of hormone therapy are called aromatase inhibitors -- examples are anastrozole, letrozole, and exemestane. They block the production of estrogen in the body by preventing conversion of testosterone to estrogen, thus lowering the levels of estrogen in the blood. Aromatase inhibitors only work in postmenopausal women and are superior to tamoxifen in postmenopausal women, with breast cancer.
While on tamoxifen, you should continue to have your yearly pelvic exams, and notify your doctor of any unusual bleeding or pain. The typical length of time you will take tamoxifen or aromatase inhibitors is five to 10 years.
Sometimes a treatment called ovarian ablation is used to treat breast cancer. Ovarian ablation means making the ovaries of premenopausal woman nonfunctional, either by removing them with surgery, by treating the ovaries with radiation, or by blocking the pituitary hormone that makes the ovaries function with the use of a group of drugs known as LHRH or GnRH agonists.
Biological Therapy for Breast Cancer
is a newer approach that works with your immune system to fight cancer. In about 25% of women with breast cancer, an excess of a protein known as HER2 makes the cancer spread more quickly. There are several biological therapies that are used to fight HER2-positive breast cancer. Options include Herceptin, Perjeta, Tykerb, and Kadcyla. These may be used along with other medicines. For HER2-negative breast cancers, Afinitor is used to treat women with advanced, hormone-receptor positive breast cancer.