Empower yourself: understanding treatment options for breast cancer

“You have breast cancer,” are four words no one wants to hear. As scary as they may sound, it’s important to know that advancements in treatment are allowing patients to live longer, healthier lives. If you are one of the nearly 287,850 women diagnosed with invasive breast cancer, or another 51,400 diagnosed with non-invasive breast cancer this year, it is important for you to understand your options. 

In general, breast cancer treatment typically includes a combination of therapies, such as breast surgery, medical oncology (chemotherapy or hormonal therapy), and radiation oncology.

Nearly all women will require surgery as part of their breast cancer treatment. Many times, surgery is done first after a diagnosis has been made but there are also times where systemic therapies can be used first to help shrink the tumor. Common types of surgery include: 

• Excisional biopsies, which are done when a needle biopsy was not conclusive or if the results of a biopsy do not match concerning features on mammogram, ultrasound, or MRI. 
• Breast-conserving surgery (sometimes called a lumpectomy or partial mastectomy, and examination of the lymph nodes), which removes the tumor and some surrounding tissue. 
• Mastectomy, which removes the entire breast, is more commonly recommended if the tumor is large (greater than five centimeters), if there is a genetic mutation increasing the risk of future breast cancers, or if there are multiple tumors in the breast. While surgery can sound overwhelming, there are certain procedures that, if appropriate, can help spare the nipple or reconstruct the breast following removal. 

Systemic therapies may be recommended before or after surgery. This includes chemotherapy, hormonal or endocrine therapy, targeted agents and/or immunotherapy. Chemotherapy, when provided prior to surgery, may help shrink the tumor and allow for a less invasive procedure. When chemotherapy is given after surgery, it may help kill cancer cells that were left behind and help prevent recurrence. Depending on the genomic and genetic makeup of a person’s cancer, targeted therapy or immunotherapy may be prescribed as well. And in many instances, hormonal therapy, which blocks the effects of estrogen on breast cancer cells, is offered at the end of treatment to help reduce the risk of recurrence. 

In addition to systemic therapies, radiation therapy is often administered. Over the past several years, radiation therapy has advanced, allowing for a more targeted and precise approach that spares surrounding healthy tissue. Radiation therapies for breast cancer include: 

• External beam radiation therapy (EBRT), which aims a carefully shaped x-ray beam from multiple angles directly toward the treatment site within the breast, chest wall, or under the arm. 
• Accelerated partial breast irradiation (APBI), which can either be delivered from outside the body or from within the body with the use of tiny radioactive seeds temporarily placed inside a catheter placed during surgery. Treatment is usually delivered in one week, making it a convenient option for women with early-stage disease. 
• Intraoperative radiation therapy (IORT), which is delivered at the time of surgery, is also a convenient type of treatment offered for early-stage invasive cancers. Because of its condensed dose, some follow-up radiation treatments are sometimes needed. 

GenesisCare offers all the above radiation therapy techniques and additionally, through our advanced AlignRT® technology, many of our centers can provide: 

• Tattoo-free treatments, so patients aren’t left with a permanent visual reminder about treatments in the future. 
• Heart protection for radiation to the left side of the body, utilizing a deep inspiration breath hold (DIBH) technique, as well as prone breast radiation therapy, which decreases the risk of side effects to the heart. 

At GenesisCare, we offer a multidisciplinary, comprehensive approach to breast cancer and will help you choose the right treatment plan based on your individual needs and health situation. Our experienced clinical team designs care plans that focus on treating you, not just your diagnosis.