In principle, several methods are available for the treatment of breast cancer – which are used individually or in combination. Which methods are used depends primarily on the type of breast cancer, how far it has grown into the surrounding tissue and whether metastases have already formed. In addition, age and previous illnesses also play a role in the therapy. The aim is to cure the disease (curative therapy); in some cases, however, it is only possible to relieve the symptoms and try to prevent or slow down the spread of the tumor (palliative therapy). Particularly proven and current is the treatment of breast cancer in special breast (cancer) centers.
Breast cancer: therapy by different routes
The following options are available for the treatment of breast cancer:
- Surgery
- Chemotherapy
- Radiotherapy
- Anti-hormone therapy
- Targeted therapy
Surgery for the treatment of breast cancer
Surgery is usually at the beginning of therapy for breast cancer. If possible, an attempt is made to preserve the breast operated – this succeeds in about two-thirds of cases. This involves removing the cancer cells (including metastases, if necessary) and some tissue around them. Axillary lymph nodes of the affected arm are only removed if a sentinel lymph node is affected by cancer cells – otherwise it is assumed that the cancer has not yet spread.
If the tumor is too large for breast-conserving surgery, if there are multiple tumor sites, or if the tumor is particularly aggressive, the entire breast is removed (mastectomy). The missing breast can be reconstructed by plastic surgery; alternatively, breast prostheses are fitted for the bra.
Chemotherapy for breast cancer
Chemotherapy uses drugs (cytostatics) to kill cancer cells in various ways. However, healthy cells are also affected in the process – which explains the side effects. For this reason, chemotherapy is given in several cycles – with recovery breaks in between.
Radiation therapy: irradiation of the tumor.
Radiation can be used to kill cancer cells left over after surgery, reducing the risk that the cancer will return (recur). To do this, radiation therapy is used (sometimes with chemotherapy) to shrink large tumors before surgery (neoadjuvant therapy) or to treat metastases (especially in bone). Rarely, radiation is used as the sole therapy for breast cancer.
Anti-hormone therapy for hormone-dependent tumors.
This treatment method is used for so-called hormone-dependent tumors, that is, when the breast cancer grows under the influence of hormones. This can be detected during tissue examination after surgery. Typical representative of the drugs used is tamoxifen.
Other options for therapy
In so-called “targeted therapy” (targeted therapy), substances are used that, unlike chemotherapy, attack only the tumor cells. Examples include trastuzumab, which blocks cancer-promoting messenger substances, and bevacizumab, which cuts off the blood supply in the tumor.
Bisphosphonates, which are otherwise used for bone protection in osteoporosis, are thought to reduce the risk of recurrence in breast cancer. So far, however, they have been approved in breast cancer only for therapy in bone metastases.
Other measures in the treatment of breast cancer
In addition to specific therapies, additional treatment is provided for pain, side effects – for example, of chemotherapy – and the after-effects of surgery; psychological support is also offered to those affected by breast cancer.
