1. C11 Breast cancer Treatments

2. Breast cancer treatments
Surgical
Mastectomy
Lumpectomy
Reconstruction
Adjuvant therapy
Radiation
Chemo
SERMs

3. Mastectomy Removal of the whole breast 5 different types
“Simple” or “total”
Modified radical
Radical
Partial
Subcutaneous (Nipple- sparing)

4. “Simple or “total” mastectomy
Removal of the entire breast
No axillary lymph node dissection- occasional
No muscle is removed from beneath the breast
Who usually gets simple or total mastectomy?
Women with multiple or large areas of ductal carcinoma in situ AND women seeking prophylactic mastectomies (prevention mastectomy)

5. Modified radical Mastectomy
Removal of both breast tissue and lymph nodes
Axillary lymph node dissection is- underarm lymph nodes are removed
No muscle are removed from beneath the breast
Who usually get a modified radical mastectomy?
People with invasive breast cancer and need lymph nodes examined to see if cancer cells spread beyond the breast

6. Radical mastectomy Removal of the entire breast
Levels 1, 2, 3 of the underarm lymph nodes are removed
Removal of chest wall muscles under the breast
Who usually gets a radical mastectomy?
Recommended when breast cancer has spread to the chest muscles under the breast.

7. Partial mastectomy
Removal of the cancerous part of the breast tissue and some normal tissue around it.
Lumpectomy is technically a form of partial mastectomy, but more tissue is removed in a partial mastectomy.

8. Skin- Sparing and Nipple-sparing mastectomy
Resection of the nipple-areola complex
Removal of any existing surgical or biopsy scar
Removal of all Breast tissue
Nipple-Sparing
All of the breast tissues is removed, but the nipple-nipple- areola complex remains

10. Lumpectomy
Removal of breast tumor and some normal tissue that surrounds it
“Breast-conserving”
Preformed on patient with DCIS
Quadrantectomy
quarter of your breast is removed

11. Lymphatic Biopsy and Drainage
Sentinel lymph node Biopsy
Early stages of Breast cancer
1-3 axially lymph nodes are removed
Radioactive substance or blue dye injected
Axillary lymph node dissection
Most lymph nodes under arm, are removed and examined

12. Reconstruction
Implants
Autologous Reconstruction
FLAPS

13. Adjuvant therapy
Additional cancer treatment given after the primary treatment to lower the risk that the cancer will come back.
Chemo
Radiation
Hormone therapy
Targeted therapy
Biologic therapy
Neo Adjuvant
treatment before surgery to shrink tumor, see treatment response

14. Radiation Therapy Patients with hx of mastectomy or lumpectomy
Daily treatments
5 days a week for 5-7 weeks
Reduces recurrence by more than 70%
External
Internal

15. Radiation Therapy External One month after surgery
Combination with chemotherapy
Similar, but stronger than an xray
Focused on the spot cancer was removed

16. Radiation Therapy Internal “brachytherapy”
Places the radioactive source into a ballon or catheter inserted directly in the lumpectomy cavity
Can be used along with external beam radiation for an extra boost
Interstitial brachytherapy
Intracavity brachytherapy

17. Chemotherapy Systemic drug therapy
Distributed through the body through the bloodstream
Affects all tissues and organs in the body
More than 90 chemotherapy drugs
Destroys fast growing cells
Cycles , IVs, Pills
Tailored to the individual patient
Causes most damage to the bone marrow blood and cells of the hair follicles, the reproductive system and digestive tract

18. Serms: Tamoxifen
Block estrogen and can lower the risk for breast cancer recurrence in postmenopausal women.
Prevents estrogen from latching onto tumor cell receptors and stops them from multiplying
Prevents new cancers from developing
Shrink large tumors before surgery

19. Serms: Raloxifene Replacement of tamoxifen Fewer side effects
Originally marketed to treat osteoporosis
Decrease the risk for breast cancer by blocking the effect of estrogen and thereby stopping the growth of cancer

20. The future in breast cancer treatments
When are we going to cure cancer? - we do cure cancer, but the problem is we don’t cure enough of them and we are not curing them fast enough.
Over the past 30 years breast cancer has decrease by 1/3
More than 3.3 million breast cancer survivors in the U.S.
More specific and less toxic

21. The future in breast cancer treatments
Less is more
Simple mastectomy instead of radical mastectomy
Pulling back on treatment is hard for patients
Lumpectomy with radiation instead of a mastectomy
Remove cancer, but spare the patient from unnecessary surgical care

22. The future in breast cancer treatments
Radiation treatments have improved
Therapy that targets breast, but avoids the heart
Radiation courses are getting shorter
Instead of Dailey treatments for 6 weeks some come only for 3 weeks

23. Care for symptoms and side effects
Palliative care
Support physical, emotional, social needs
Reducing symptoms
Improving quality of life
Supporting patients and their families
Treatments: medications, nutritional support, relaxation techniques, emotional support, other therapies.
Complementary therapies: music therapy, meditation, stress management, yoga, massage, and acupuncture.

24. Benefits
Removal of cancer
Benefits out way the risks

25. Risks There are side effects to each treatment
Common side effects of surgery:
Pain, lymphedema
Common side effects of Radiation:
Changes in appearance and feel of breast
Common side effects to chemo:
Early menopause, weight gain, fatigue, cognitive function

26. Reference page