By Michael Sterchi, PhD, Ret.
When the diagnosis of breast cancer is made, consultation with a breast specialist is necessary.
Almost all breast cancer patients will need some form of surgery. If the cancer is small and detected early, the surgery can be very limited, but if large the surgery will need to be more extensive. Since the increase in early detection, the number of small cancers has increased dramatically. This has allowed the development of limited breast surgery. Lumpectomies (removal of the cancer and a small amount of surrounding normal breast tissue) have thus become one of the major surgical tools in treating breast cancer. However, for large breast cancers mastectomy (complete removal of the breast) may have to be carried out. If a lumpectomy is done, in almost all cases radiation therapy to the breast follows. Several decades of studies has shown that lumpectomy and radiation therapy is just as effective in curing breast cancer as mastectomy. Breast conservation has been a great advance in preserving the self-image of the breast cancer patient.
In addition to treating the cancer in the breast, attention must be paid to the lymph nodes in the armpit. If the cancer has spread to the lymph nodes, it has escaped the confines of the breast, lowering the chance of survival. Whether or not the lymph nodes are involved is determined by a sentinel node biopsy. If the node is positive then the rest of the nodes should be removed. Removal of all the nodes should be avoided if possible, for doing so may cause the involved arm to swell (lymph edema). So, the sentinel biopsy is very important.
Following the removal of the cancer with or without radiation therapy, if the lymph nodes are positive, chemotherapy is almost always indicated. Chemotherapy plays a major role in treating breast cancer. Chemotherapy sometimes in conjunction with hormone therapy, has significantly improved the outlook of patients with positive lymph nodes.
Cosmetic reconstruction of the breast after mastectomy can be carried out immediately with silicone implants or later with grafts.
Remember: Early Detection = Increased Survival.
Published Dec. 14, 2011