TREATMENT FOR BREAST CANCER

Breast cancer treatment aims to remove the cancer and reduce the risk of it returning or spreading to other parts of the body. 

There are 2 parts to breast cancer treatment: locoregional therapy and systemic therapy. 

The goal of locoregional therapy is to control the disease in the breast and nearby lymph nodes. Locoregional therapies include surgery (breast conserving surgery or mastectomy) and radiotherapy. These therapies are sometimes offered in combination with each other, and other times surgery alone is adequate. In most cases, breast conserving surgery and radiotherapy go together.

The goal of systemic therapy is to get rid of the very tiny cancer cells that may have escaped from the primary breast tumour to other sites, such as the lymph nodes, bones, liver, lungs or brain. All invasive breast cancer have the potential to travel from the primary tumour to another part of the body - these cancer cells may initially be too small to be detected on imaging. Systemic therapies include chemotherapy, endocrine therapy and targeted therapy. 

People with breast cancer are cared for by a team of medical and allied health professionals, each with their own expertise. This is known as the multidisciplinary team.

As a breast surgeon, Dr Ling is usually the first specialist you will see after a breast cancer diagnosis. Other health professionals you may receive treatment from include

• Anaesthetist: administers anaesthetic before surgery and monitors you during the operation.

• Medical Oncologist: specialises in treating cancer with drug therapies such as chemotherapy, endocrine therapy and targeted therapy.

• Pathologist: examines cells and tissue removed during a biopsy or surgery.

• Radiation Oncologist: specialises in treating cancer with radiation therapy. 

• Radiologist: specialises in the use of x-rays, ultrasound and scans to diagnose and treat disease.

• Breast Care Nurse: provides information and support to people diagnosed with breast cancer.

• Genetic Counsellor: provides advice for people with a strong family history of breast cancer or with a genetic condition linked to breast cancer.

• Dietitian: recommends an eating plan to follow during treatment and recovery.

• Exercise Physiologist: prescribes exercise to help people with medical conditions to improve their overall health, fitness, strength and energy levels.

• Physiotherapist / Occupational Therapist: assists with physical and practical problems including restoring movement and mobility after treatment and recommending aids and equipment.

• Psychologist / Counsellor: helps with managing emotions in response to diagnosis and treatment.

• Social Worker: helps with emotional, practical or financial issues. 

You may wish to get a second opinion about your diagnosis and treatment. Specialists are used to people doing this. Your GP or specialist can refer you to another specialist and send your initial results to that person. A second opinion may not be different from the one you have already had. The time taken to get a second opinion may delay your treatment slightly, but a short delay should not affect the outcome of your treatment.

You may be given the option to take part in a clinical trial that looks at new treatments or new ways of giving existing treatments. Over the years, trials have improved treatments and led to better outcomes for people with cancer. The decision to take part is entirely up to you. If you decide not to, you will still be offered the best treatment available.

• Why are you recommending this treatment for me?

• What are the pros and cons of this treatment? 

• What are the possible short-term side effects of these treatments? What are the possible long-term side effects?

• Can I take part in any clinical trials?

• When will the treatment start, how often will I take it and how long will it last?

• How can I expect to feel during treatment and in the weeks afterward?

• Will I need to take time off from work during treatment?

• How will I know if the treatment is working?

• Will the treatment lower the risk of the cancer coming back?

• Are there other treatments for me to consider? What are the pros and cons of those treatments?

Source: Guide for the Newly Diagnosed by Living Beyond Breast Cancer