Breast cancer treatment plan is made according to the type, size, stage and grade of the cancer, whether the cancer cells are sensitive to hormones or not. In addition, the general health status and preferences of the patient should be taken into account. Successfully treating breast cancer means getting rid of the cancer or controlling it for a long time.
Recent years have witnessed the development of many promising and exciting treatments for breast cancer. In this way, today, instead of a few treatment options, there are many treatment options that are personalized according to the characteristics of the patient and the cancer. Among these options, the fact that there are many situations that require the decision and choice of the patient can sometimes be challenging and confusing. It is very critical to identify a breast surgeon who can help you in this regard, who will always be with you during the treatment process, whom you can consult, trust, and who can be your "breast cancer coach". There is a need for a team of experts such as breast surgeon, medical oncologist, radiation oncologist, plastic surgeon, genetic counselor working in the company. The responsibility of coordinating this team, guiding the patient, and being a "breast cancer coach" usually falls on the breast surgeon who first sees the patient. For this reason, it is very important to find a physician with the right education, experience and expertise during the first application. For example, choosing a breast surgeon and medical oncologist who specializes in breast cancer rather than a general surgeon who does all surgeries or a surgical oncologist who treats a wide variety of cancer types seems more rational.
Today, in the treatment of breast cancer, surgical treatment, chemotherapy, radiation therapy, hormone therapy and targeted therapies. Most likely, the treatment plan will include a combination of these treatments. All of these treatments act with their own different mechanisms, and they can be extra effective when given together.
The first treatment for breast cancer is often surgical treatment. The patient and the breast surgeon will decide together on the most suitable one among the different surgical treatment options. Complete removal of the breast (mastectomy) and breast-conserving surgery (lumpectomy) as surgical treatment There are two main options, including radiation therapy.
LUMPECTOMY (REMOVAL OF BREAST CANCER)
It can also be expressed as breast-conserving surgery or wide local excision. During lumpectomy, the cancer mass and a small amount of the surrounding healthy breast tissue are removed.
MASTECTOMY (REMOVAL OF THE ENTIRE BREAST)
Mastectomy is the entire breast tissue (lobules, ducts, adipose tissue and nipple) It is the operation in which a part of the breast skin, including the breast tissue and areola is removed.Modified radical mastectomy if the axillary lymph nodes on the same side are removed together with the breast tissue; it is called simple mastectomy if the axillary lymph nodes are not removed, but only the breast tissue is removed.
Newer mastectomy techniques, such as skin-sparing mastectomy and nipple-sparing mastectomy, can also be applied in selected cases to improve the appearance and allow for reconstructive treatments. (guard) lymph node biopsy or axillary lymph node dissection is performed. Sentinel lymph node biopsy is a much more limited procedure and causes much less postoperative problems.
Sentinel lymph node is one or several lymph nodes where the lymphatic flow of the tumor is first drained. If cancer is not found in the sentinel lymph nodes, there is little chance of finding cancer in the remaining lymph nodes, so there is no need to remove the other lymph nodes. If cancer is detected in the sentinel lymph nodes, it will likely be necessary to remove the other lymph nodes in the armpit (underarm lymph node dissection). It is a treatment that kills cells. In cancers with a high risk of spreading to the body (metastasis) or recurrence, chemotherapy is used after surgery (adjuvant).
One of the main uses of chemotherapy is the treatment of cancers that have spread throughout the body, that is, metastasized. This H In addition, hormonal therapy, targeted agents and, in some cases, surgical treatment and radiation therapy can be used in patients.
Chemotherapy side effects may vary depending on the drugs used. Common side effects include hair loss, nausea, vomiting, fatigue, and an increased risk of developing infections.
RADIATION THERAPY
Using high-powered energy beams such as x-rays and protons to kill cancer cells. is the treatment. Generally, it can be applied externally with the help of a device (external radiotherapy) or by placing radioactive material in the body (brachytherapy).
Radiation therapy is commonly used after lumpectomy. In cases where the risk of cancer recurrence is low, breast brachytherapy after lumpectomy may also be an option.
Radiation therapy to the chest wall is also usually applied after mastectomy for large breast cancers and/or cancers that have spread to the lymph nodes.
Among the side effects of radiation therapy fatigue and redness of the skin in the area where the radiation is applied, rashes similar to sunburn are found. Breast tissue may also be swollen or hardened. Rarely, damage to the heart or lungs may occur, as well as more serious problems such as secondary cancers in the longer term and very rarely in the treated area. These are treatments to stop the growth of cancer cells by inhibiting the release or effects of hormones to treat positive (ER positive) and/or progesterone receptor positive (PR positive) breast cancers. It can usually be given before or after in combination with other treatments. There are several treatment options that can be used in hormone therapy:
Drugs that prevent the binding of hormones to cancer cells (selective estrogen receptor modulators)
Drugs that stop hormone production in the ovaries or surgical removal of the ovaries.
In menopausal patients, those that stop extraovarian estrogen production drugs (aromatase inhibitors)
In addition to the side effects of hormone therapy such as hot flashes, night sweats and vaginal dryness, osteoporosis and blood More serious side effects, such as blood clotting, may also occur.
TARGET-TARGET THERAPIES
Targeted therapy drugs attack certain abnormalities within cancer cells.
A few of these treatments are commonly used, some of which are breast cancer. It targets a protein that cancer cells produce in excess, called human epidermal growth factor receptor 2 (HER2). Drugs that target this protein, which helps breast cancer cells grow and survive, can damage cancer cells while protecting healthy cells.
Apart from these, there are targeted therapy drugs that focus on some other abnormalities within cancer cells. Research studies of many drugs are also ongoing.
BREAST RECONSTRUCTION
It is the reconstruction of the breast after mastectomy and some large lumpectomies. This surgery can be performed simultaneously with the surgery for cancer or later.
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