Breast Cancer Treatment
Lumpectomy surgery
Lumpectomy
surgery is a procedure to remove the tumor and a small portion of the
surrounding healthy tissue. Lumpectomy is usually recommended for patients whose
tumors are small.
Lumpectomy may
also be performed in patients whose larger tumor size is preceded by
chemotherapy to shrink the tumor.
Mastectomy surgery
Mastectomy
surgery is a surgery performed by an oncological
surgeon
to remove the entire tissue in the breast. Generally, mastectomy is
done when the patient's condition cannot be treated with a lumpectomy.
There are several
types of mastectomy surgery, namely:
- Simple
-
Mastectomy is a procedure to remove all breast parts, including the
nipple, areola, and skin. Depending on the severity, some lymph nodes can
also be removed.
- Skin-sparing
-
Mastectomy is the removal of breast tissue, nipples, and areolas.
Once removed, the breast will be reshaped using tissue from other parts of
the body.
- Nipple-sparing
-
Mastectomy this type of mastectomy is done to remove breast tissue without
including breast skin and nipples. However, if there is cancer in the
tissues under the nipple, the nipple will also be removed.
- Modified radical
-
Mastectomy is a procedure that combines a simple mastectomy
and removal of all lymph nodes in the armpit.
- Radical
-
Mastectomy aims to remove the entire breast, lymph nodes in the
armpit, and chest muscles (pectoral).
- Double
-
Mastectomy is a preventive measure in women at high risk of
developing breast cancer by removing both breasts.
Surgical Removal of Lymph Nodes
Surgical removal
of lymph nodes can be done in conjunction with surgical removal of tumors in
the breast or separately. There are two surgical methods for removing lymph
nodes, namely:
- Sentinel lymph node biopsy (SLNB)
-
SLNB is a method of removing lymph nodes in the armpit in minimal amounts,
limited to lymph nodes that are most at risk of developing cancer from the
breast.
- Axillary lymph node dissection (ALND)
-
ALND is the removal of several lymph nodes, usually less than 20, to
prevent the spread of cancer from the breast.
Radiotherapy
Radiotherapy is a
procedure to destroy cancer cells using high-powered rays, such as X-rays and
protons. Radiotherapy can be done by firing light into the patient's body using
a machine (external radiotherapy) or by placing radioactive material into the
patient's body(brachytherapy).
External
radiotherapy is usually done after the patient has completed a lumpectomy,
while brachytherapy is done if the risk of re-emergence of breast cancer
is low. Radiotherapy can also be done after a mastectomy to treat large cancer
and has spread to the lymph nodes.
Radiotherapy or
radiation therapy in breast cancer can last for 3 days to 6 weeks, depending on
the type of therapy performed and the patient's condition as a whole.
Hormone Therapy
Hormone therapy is used to treat breast cancer that is
affected by the hormones estrogen and progesterone.
Hormone therapy
can be done before or after the surgical procedure to prevent cancer cells from
reappearing. In addition, this therapy can also be done to overcome cancer that
recurs after treatment or cancer that has spread to other parts of the body.
Methods used in
hormone therapy include:
- Selective estrogen receptor
modulator drugs, such as tamoxifen, toremifene, and fulvestrant, inhibit
the hormones estrogen and progesterone from attaching to cancer cells
- Administration of aromatase
inhibitors, such as anastrozole and letrozole, stops the hormone estrogen production after menopause.
- Surgical procedures or administration
of medicines to stop the production of hormones in the ovaries.
Chemotherapy
Chemotherapy is the administration of certain drugs through
infusions or injections to kill rapidly growing cancer cells. Chemotherapy can
be done before surgery to shrink the size of cancer to make it easier to
remove.
Chemotherapy may
also be done after surgery to destroy cancer cells left behind after the
surgical procedure. Chemotherapy after surgery is also done when cancer cells
have spread to other parts of the body or when the cancer is at risk of recurrence.
In addition,
chemotherapy can also be done to overcome advanced cancer, primarily if cancer
has spread to the body's armpit area or other areas.
Drugs that are
often used in chemotherapy are usually a combination of the following 2-3 drugs:
- Anthracylines, such as doxorubicin
and epirubicin
- Taxanes, seperti paclitaxel dan docetaxel
- Cyclophosphamide
- Carboplatin
- 5-fluorouracil atau capecitabine
- Gemcitabine
- Vinorelbine
Chemotherapy
drugs are given in a cycle followed by a period of rest so that the body can
recover from the effects of the drug. This cycle usually lasts within 2-3
weeks, with a schedule of administration that depends on the type of
medication.
Target Therapy
Targeted therapy
is the administration of drugs to inhibit the growth of specific cancer cells.
Unlike chemotherapy which can damage healthy cells, the drugs used in target
therapy do not harm healthy cells.
For example, one
of the drugs used in targeted therapy aims to inhibit the work of the HER2
protein, which helps cancer cells grow more aggressively.
Some drugs used
in targeted therapy are trastuzumab, pertuzumab, and lapatinib. These
medications can be given in drinking or injecting and can treat early-stage or
advanced cancer.
Source: https://www.alodokter.com
