Breast cancer diagnosis and treatment
Breast cancer, when detected and diagnosed early, can be cured, or at least put into remission. Screening is very important when it comes to breast cancer because when symptoms are present, this means the cancer is larger and it has probably spread to other parts of the body. When it is caught before the symptoms begin, a woman’s prognosis is a lot more positive.
Diagnosis
The diagnosis is just as important as the treatment of breast cancer because without it, the treatment means nothing. The treatment is based off the diagnosis, and if the diagnosis is wrong, the treatment will be wrong; unnecessary time will have been wasted and the disease can become larger and spread because of a mistake in diagnosing. A team of radiologists, pathologists, and surgeons is the best way to get the most accurate diagnosis and appropriate care. There are many technologies available to detect, diagnose, and typify breast cancer.
- Clinical Breast Exam. Women should get a gynecological annual exam, in which the doctor will perform a clinical breast exam. If irregularities are found, further testing is necessary to determine whether or not it is cancer. Typically, the next step would be a mammogram or ultrasound.
- Mammogram. Yearly mammogram screenings are very important to early detection of breast cancer; actually, they are the only screening test that is done yearly. Missing a mammogram just one year can lead to a terrible outcome if an individual does indeed have breast cancer. Women should receive an annual mammogram beginning at age 40. Mammograms can detect breast cancer before a lump is formed.
- Breast MRI (Magnetic Resonance Imaging). MRI can provide a radiologist with many different images of the breast, but in a different way than mammograms. No radiation is used in an MRI; MRI’s are more expensive.
- Ultrasound. Ultrasound is used to distinguish between solid tumors and fluid-filled cysts; also, ultrasound can be used to evaluate lumps.
- Pathology Tests. If a lump is found to be suspicious in a woman’s breast, a fluid or tissue sample may be taken for further testing by a pathologist.
- Fluid Tests. A procedure, called a ductal lavage, involves sampling the cells of the breast ducts. A small tube is inserted into the nipple until the duct is reached and the sample is drawn. The cells are examined under a microscope.
- Tissue Tests. Breast biopsies can be done to determine the tissue type.
Stages of Breast Cancer
For the purpose of this article, it is important to be aware of the stages of breast cancer; after all, that is what the treatment is based off of. A team of doctors will be able to describe to you exactly the diagnosis and possible treatment, based off the stage that the cancer is in.
- Stage 0. This stage is just the presence of abnormal cells, not invasive cancer.
- Stage 1. This is the earliest stage of invasive breast cancer; the cancer, at this point, is only affecting the breast.
- Stage 2. In this stage, the cancer is 2-5 centimeters long and has or has not affected the lymph nodes under the arm.
- Stage 3. Stage 3 is divided into 3 “sub”stages. A: the cancer is 5 or more centimeters across and has spread to the underarm lymph nodes and lymph nodes behind the breast bone. B: a tumor that has grown into the chest wall or the skin of the breast. C: the tumor is any size and has spread to the lymph nodes behind the breast bone and under the arm or to the lymph nodes above or below the collar bone.
- Stage 4. This stage is distant metastatic cancer, and it has spread to other parts of the body.
Treatment
There are many options when it comes to treating breast cancer: chemotherapy, surgery, hormones, radiation, and more. The doctor will help you choose the treatment depending on the stage of the disease. The stage is related to the size of the cancer, whether or not the cancer has invaded nearby tissues, and whether it has spread to other parts of the body. When breast cancer spread, the cancer cells are usually found in the lymph nodes under the arm, but it can spread to nearly any part of the body, including the bones, liver, lungs, and brain. Treatments are as follows:
Surgery. There are different types of surgery: removing the breast cancer (lumpectomy—the tumor is removed and some of the surrounding healthy tissue); removing the entire breast (mastectomy); removing one lymph node (sentinel node biopsy—the lymph node that receives the drainage from the breast cancer is removed and tested for cancer cells); or removing several lymph nodes (axillary lymph node dissection—if the sentinel lymph node is found to have cancer cells, the axillary lymph nodes will be removed).
Radiation Therapy. High-powered beams of energy are used to kill cancer cells. Side effects can include fatigue, sunburn-like rash where the beams touched, breast tissue may appear swollen or firm, there are other side effects that are rare but more serious: arm swelling, broken ribs, or damage to the lungs.
Chemotherapy. Chemotherapy uses drugs to kill cancer cells. If there is a high chance that the cancer could recur, your doctor will probably recommend chemotherapy after surgery to decrease this chance. It is sometimes given before surgery to shrink a tumor. Side effects include hair loss, nausea, vomiting, fever, and frequent infections.
Hormone Therapy. This is used to treat cancers that are sensitive to hormones (estrogen and progesterone). It can be used with or after other treatments. The different medications will block hormones from attaching to cancer cells (Tamoxifen), stop the body from making estrogen after menopause (aromatase inhibitors), or stop hormone production in the ovaries.
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