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Comprehensive Guide to Breast Cancer Treatments: Surgical Procedures, Radiation Therapy, and Adjuvant Therapy

Learn about various surgical treatments for breast cancer such as mastectomy, lumpectomy, and reconstruction, along with adjuvant therapies like radiation and chemotherapy. Understand the different types of mastectomies and their indications, as well as the importance of adjuvant therapies in preventing cancer recurrence. Explore the future of breast cancer treatments, including advancements in radiation therapy techniques and the role of palliative care in improving quality of life.

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Comprehensive Guide to Breast Cancer Treatments: Surgical Procedures, Radiation Therapy, and Adjuvant Therapy

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  1. C11 Breast cancer Treatments

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

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

  4. 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) “Simple or “total” mastectomy

  5. 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 Modified radical Mastectomy

  6. 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. Radical mastectomy

  7. 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. Partial mastectomy

  8. Skin-Sparing • 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 Skin- Sparing and Nipple-sparing mastectomy

  9. 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 Lumpectomy

  10. 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 Lymphatic Biopsy and Drainage

  11. Implants Autologous Reconstruction FLAPS Reconstruction

  12. 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 Adjuvant therapy

  13. 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 Radiation Therapy

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

  15. 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 Radiation Therapy

  16. 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 Chemotherapy

  17. 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 Serms: Tamoxifen

  18. 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 Serms: Raloxifene

  19. 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 The future in breast cancer treatments

  20. 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 The future in breast cancer treatments

  21. 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 The future in breast cancer treatments

  22. 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. Care for symptoms and side effects

  23. Removal of cancer • Benefits out way the risks Benefits

  24. 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 Risks

  25. Reference page • https://passionateinknowledge.com/2017/05/29/mastectomy-procedure-an-overview-and-coding-guideline/ • https://www.cancer.org/cancer/breast-cancer/treatment/radiation-for-breast-cancer.html • http://www.brainimmune.com/raloxifene-and-two-new-serms-m2-macrophage-shift-high-il-10/ • https://www.cancercenter.com/breast-cancer/ebrt/ • https://www.mayoclinic.org/tests-procedures/radiation-therapy-for-breast-cancer/about/pac-20384940 • https://www.verywellhealth.com/what-to-expect-during-sentinel-node-biopsy-430109 • https://www.verywellhealth.com/what-to-expect-during-sentinel-node-biopsy-430109 • https://www.breastcancer.org/treatment/surgery/mastectomy/what_is • https://passionateinknowledge.com/2017/05/29/mastectomy-procedure-an-overview-and-coding-guideline/ • https://www.fairview.org/patient-education/83001

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