Breast Cancer Care
Breast Cancer Care
Breast cancer is a malignant tumor that develops from cells in the breast. More commonly breast cancer either begins in the cells of the lobules, which are the milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple. Less commonly, breast cancer can begin in the stromal tissues, which include the fatty and fibrous connective tissues of the breast. Over time, cancer cells can invade nearby healthy breast tissue and make their way into the underarm lymph nodes, small organs that filter out foreign substances in the body. If cancer cells get into the lymph nodes, they then have a pathway into other parts of the body.
Breast cancer is the second most common cancer in women after skin cancer in the United States and according to the American Cancer Society, about 1 in 8 U.S. women will develop invasive breast cancer over the course of her lifetime. Breast cancer can occur in both men and women, but it is very rare in men.
There are several ways to treat breast cancer, depending on its type and stage. Some treatments are called local therapies, meaning they treat the tumor without affecting the rest of the body. Types of local therapy used for breast cancer include surgery and radiation therapy. These treatments are more likely to be useful for earlier stage (less advanced) cancers, although they might also be used in some other situations.
Breast Cancer Treatment Options
3D-Conformal Radiation Therapy and Intensity-Modulated Radiation Therapy (IMRT)
3D-Conformal Radiation Therapy and Intensity-Modulated Radiation Therapy (IMRT) are two forms of External Beam Radiation Therapy (EBRT). During 3D-Conformal treatments, a device called a “multi-leaf collimator” will shape the individual radiation beams to “conform” to the shape of your tumor according to the data and instructions it receives from the system computer. IMRT uses thousands of radiation “beamlets” from many different angles to deliver a single dose of radiation. The intensity of the “beamlets” can change during the treatment session to modulate the dose, so that the tumor receives a very precise high dose of radiation, while minimizing damage to surrounding, normal tissue.
Before each session, a radiation therapist will carefully position you on the treatment table using a body immobilizer for precise body placement. Image guidance will be used to confirm the location of the tumor before the therapy begins. During your treatment sessions, the radiation delivery system will revolve around you, delivering the radiation according to the plan set by your radiation oncologist. Each treatment session lasts from 10 to 30 minutes. Typically, you will be scheduled for five sessions a week for five to six weeks. The sessions are pain-free and require no sedation so you can return to your normal activities right away.
Accelerated Partial Breast Irradiation (APBI)
Accelerated Partial Breast Irradiation (APBI) is almost always delivered with a specialized form of High Dose Rate Brachytherapy (internally delivered radiation therapy), but it can also by done with short-course external radiation. APBI is ideal for early stage breast cancer cases where breast preservation is a priority. In APBI Brachytherapy, your general surgeon will insert a catheter through the skin and into the cavity left by the removed tumor. Once inserted, it is left in place for the rest of the treatment course. During treatment, a computer-controlled machine inserts tiny radioactive “pellets” into the catheter to deliver the radiation directly to the tumor. APBI is an effective, post-lumpectomy radiation therapy to destroy any remaining cancer cells in the breast tissue and to help prevent a recurrence. It reduces your breast cancer treatment from six weeks to two sessions per day, six hours apart, for five days. This means much less stress on you and your family, less time away from home and work and a quick return to your normal routine. It requires no sedation so you can drive yourself back and forth to treatments.
Chemotherapy may be used as a breast cancer treatment before or after surgery. Treatment typically lasts from three to six months. Your oncologist may recommend one of three different forms of chemotherapy. Neo-adjuvant or primary systemic chemotherapy is used before radiation or surgery to help shrink the tumor. Adjuvant chemotherapy is used after radiation or surgery to destroy any remaining cancer cells. Systemic chemotherapy circulates throughout the body via the bloodstream when the cancer is metastatic.
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