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How is breast cancer treated?

Breast cancer treatment can consist of one or several of the following: surgery, chemotherapy, hormone therapy, and radiation therapy. Therapeutic options depend on the stage of the cancer (whether the cancer is only in the breast or has spread to the lymph nodes or beyond), the type of breast cancer, the number of estrogen and progesterone receptors on the tumor cells, the patient's age, health and menopausal status, and whether the cancer is recurrent.

Cancer from the breast and some of the lymph nodes under the arm are removed surgically in most breast cancer patients. Lumpectomy or partial mastectomy leaves breast tissue while total mastectomy removes the entire breast. A radical mastectomy is the removal of the cancerous breast, all the lymph nodes under the arm as well as the chest wall muscles. Radiation, chemotherapy, or hormone therapy may be administered to eradicate any remaining cancer cells.

External radiation is the administration from outside the body of high energy x-rays to kill cancer cells. Radioactive material may be delivered internally via needles, seeds, wires or catheters. [National Cancer Institute - Breast Cancer Treatment] In addition, radiation beams may be directed at the tumor site during an intraoperative procedure.

Cancer drugs, or chemotherapy, stop cancer cells from dividing or kill cancer cells directly. Chemotherapy can be administered systemically by oral and intravenous dosing or directly to the targeted tissue. Docetaxel (a taxoid by the trade name Taxotere), and the anthracyclines Adriamycin (trade name doxorubicin) and epirubicin (trade name Ellence) are some of the chemotherapeutic drugs administered after surgery (known as adjuvant therapy).

Hormone therapy removes or blocks certain hormonal effects to prevent tumor growth promotion. Tamoxifen (trade names Tamofen, Nolvadex, and Soltamox) is the standard hormone therapy, which slows cancer growth and prevents recurrence by preventing the binding of estrogen and progesterone to cancer cells. Aromatase inhibitors are a new class of hormone therapy which decrease the production of certain hormones and include anastrazole (trade name Armidex), letrozol (trade name Femara), and exemestine (trade name Aromasin). Aromatase inhibitors are generally administered when tamoxifen has failed in postmenopausal women with metastatic breast cancer.

The new breast cancer treatment trastuzumab (trade name Herceptin) is a monoclonal antibody that binds to the HER2/neu surface protein present in about 25% of breast cancers. Herceptin is the first therapy to target a breast cancer gene. Sometimes Herceptin is administered with platinum containing chemotherapies or docetaxel (trade name Taxotere).

Other new breast cancer therapies are under evaluation in clinical trials and include bone marrow transplantation (BMT), immune cell transplantation, and a breast cancer vaccine.

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Jul 25, 2008
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