TREATMENT:

The Breast Cancer treatment uses:

1. Surgery.
2. Radiation
3. Chemotherapy
4. Hormones therapy

Options are determined based on:
Histologic and stage of disease.


1. Surgery: May be palliate or curative.
The choice of procedure is based on:
· Histologic stage and factors relating to the operative risk of the patient, such as age and concurrent medical illnesses.

Procedures:

v Lumpectomy (partial or segmental mastectomy) plus axillary lymphadenectomy and postoperative radiation therapy are combined as the treatment of choice for most stages I and II B.C.
Lumpectomy is defined as removal of the primary lesion, with clear gross margins around the tumor.
Axillary lymphadenectomy is defined as removal of level I or II nodes.
v Modified radical mastectomy (Patey´s operation) removes the skin, the entire breast, and the axillary contents.
The original operation as described also involves removing the pectorals minor muscle but this part is often not included because adequate lymph node removal does not require it.
v Halted radical mastectomy removes the pectorals major muscle in addition to the muscle that is removed with a modified radical mastectomy.
This operation, which is cosmetically deforming is indicated only when the pectorals muscle is directly involved.
v Simple mastectomy includes removal of all breast tissue, including the nipple areola complex. The major use for this procedure is noninvasive breast cancer. It is sometimes combined with a level I axillary nodes dissection.

2.Radiation therapy: Can be used to treat primary and metastatic disease.

v Along with lumpectomy and axillary dissection.
v As palliative therapy in patient with bone or central nervous system metastases.


v As adjuvant therapy after mastectomy in high risk patient.

3. Chemotherapy is used in several settings:

v As adjuvant therapy it is designed specifically to eradicate the risk of occult distant disease in stage I and stage II patients.
A triple drug regimen is the most common form of treatment and involves:
Six month cycles of cyclophosphamide, methotrexate and fluorouracil.
v As neoadjuvant therapy is given before surgical therapy of local decease.

4. Hormones therapy uses tamoxifen (an antiestrogen) for 2 to 5 years, in most cases generally for post menopausal patients.