Breast cancer has a high incidence in India, especially among women over the age of 50. Even though the condition can be detected in early stages with screening tests, the lack of awareness in India leads to a high percentage of breast cancer cases being detected only in advanced stages. Breast cancer has a relatively high 5-year survival rate. Still, it is crucial to get suitable treatment options in time. 

Timely medical intervention can ensure the risk of cancer recurrence can be kept in check and the condition can kept from spreading to other parts of the body. When it comes to breast cancer treatment, there are two types of treatments: local treatments and systemic treatments. Based on the cancer stage, its spread, and the patient’s overall health, the appropriate type of treatment option is recommended. 

But what are local and systemic treatments? And how are breast cancer treatment by stages determined? Let’s take a closer look at the various breast cancer treatments and how they are offered to patients based on their cancer stage and other varying factors.

Breast Cancer Treatment Options

As mentioned previously, there are namely two breast cancer treatment types: local and systemic treatments. Based on the patient’s overall health and their cancer diagnosis, the treatment is recommended. So, let’s get an introductory understanding of what local and systemic treatments are followed by how they’re prescribed before jumping into the individual treatment options.

What Are Local Treatments?

Local treatments, as the name suggests, are performed on the area where the cancerous tumour, often known as a malignant tumour, is present. This type of treatment is best suited for breast cancer that has not shown signs of distant metastasis. Local treatments generally include surgical treatments that involve removing the malignant tumour from the body. In some cases where the risk of cancer recurrence is high, doctors can recommend patients go for a mastectomy, which involves the removal of the entire breast. In breast cancer treatment, doctors can recommend patients go through a double mastectomy to keep their risk of cancer recurrence in check. Local treatments are often used alongside systemic treatments to offer a holistic breast cancer treatment option.

What Are Systemic Treatments?

Systemic treatments are generally non-invasive treatments that affect your entire body and not specifically where the cancer is present. This type of treatment is recommended for patients who have cancer that has metastasized, meaning cancer has spread to other body parts or nearby lymph nodes. Since the cancer is not localized, it is difficult to surgically remove each tumour as it would require intensive surgery, the likes of which may not be feasible for most patients. 

Systemic treatments try to kill the cancer cells inside the body no matter where they are using medication or radiation. In the case of medication like chemotherapy, the cancer cells are affected by chemotherapy, and it kills the cancer cells inside the body. Systemic treatments are very effective in reducing the risk of cancer recurrence, and they also help improve the cancer symptoms in advanced cancer stages.

How Do Doctors Prescribe Breast Cancer Treatments?

Breast cancer is staged from stages 1 through 4 based on the size of the tumour, the spread of the cancer, and the effects of cancer on your health. In very simple terms, stage one and two breast cancer is effectively treated with local treatments, with the latter requiring systemic treatments to be used alongside local surgical treatments. For third and fourth-stage advanced breast cancer, local treatments might not be as effective. 

Systemic treatments are recommended in such cases in various rounds to treat the cancer or at least reduce the spread and size of the cancer so that it can become operable. Although cancer diagnosis and treatment directions differ based on every case, this is a simple overall guide that can be used as a starting point when you are trying to understand breast cancer treatment by stage. With that being said, let’s review the various individual treatment options for breast cancer and how they are performed.

Localised Treatments

Lumpectomy

Lumpectomy refers to a surgical treatment that involves the removal of the malignant tumour present in one or both breasts. This treatment is highly effective for early-stage breast cancer where the size of the tumour is smaller and easily operable. The surgery can be performed both as a minimally invasive procedure and as an open surgery. 

Both methods have their own merits and cons. The procedure involves making an incision under the breast and surgically removing the malignant tumour from the inside. Lumpectomies are the least aggressive breast cancer treatments, and they can be highly beneficial if you have an early breast cancer diagnosis.

Mastectomy

Mastectomy is one of the most popular breast cancer treatments because of its effectiveness in removing the cancer and reducing the risk of its recurrence. Mastectomy involves the removal of the entire breast that has been cancer-affected. This surgery is beneficial in cases where patients have large malignant tumours or cancer has spread to different parts of the same breast. As this procedure removes the entire breast, it is known as total mastectomy. 

Often, systemic treatments like radiation therapy are required post-surgery to reduce the risk of cancer recurrence. However, patients who have undergone mastectomy do not require going through the additional treatment, making breast cancer treatment more affordable.

Axillary Lymph Node Dissection

Axillary lymph node dissection is a surgical treatment that involves the removal of lymph nodes from the armpits in patients with aggressive breast cancer. If biopsy results show that the breast cancer is spreading to nearby lymph nodes, this treatment is recommended in addition to mastectomy or lumpectomy. 

The surgery involves the removal of several lymph nodes from the armpits to reduce the risk of cancer spread. This surgery is not recommended independently. It is an effective way to prevent the spread of cancer to other body parts and it can also help patients reduce their risk of cancer recurrence.

Contralateral Mastectomy

Contralateral mastectomy is the removal of both breasts surgically when only one breast has breast cancer. This surgery is highly aggressive, but it is an effective tool in reducing your risk of breast cancer significantly. The surgery involves removing the breast with the malignant tumour and a healthy breast to reduce the risk of cancer spread. 

This surgery is very useful and often recommended to patients with a very high risk of breast cancer due to family history or other genetic causes. Even though the surgery involves the removal of both breasts, this surgery is regularly opted for by patients to reduce their risk of breast cancer recurrence and prevent complications.

Systemic Treatments

Chemotherapy

Chemotherapy is one of the most popular cancer treatments, and it is useful for every type of cancer. This systemic treatment is generally administered intravenously, and it helps kill the cancer cells inside the body. Chemotherapy is often used at different stages of breast cancer treatment. Due to the treatment’s versatility, chemotherapy can even be used before surgical treatment or even to manage symptoms like pain in advanced breast cancer cases. In some cases, chemotherapy is used to reduce the size of the tumour to make it easily operable. Similarly, chemotherapy is also used after surgical treatment to kill off any remaining cancer cells inside the body.

Immunotherapy

Immunotherapy is a type of systemic breast cancer treatment that involves using medication to strengthen your body’s immune system and help it find the cancer cells so that the immune system works and removes the cancer itself. Cancer as a disease, in most cases, hides from the immune system, which allows it to be undetected and attacked by our body’s immune response. Immunotherapy strengthens the immune system and helps it identify the cancer cells inside the body. In this manner, the immune system can eliminate the cancer cells itself without the need for surgical or other systemic treatments. Immunotherapy is highly effective for certain types of breast cancer.

Radiation Therapy

Radiation therapy is a special type of cancer treatment that has become more readily available in India over the last few decades. This treatment involves precisely pointing x-rays and protons that emit radiation in your body to kill cancer cells and treat advanced cancer. Radiation therapy can be recommended to patients who have undergone lumpectomy post-surgery as well. The procedure involves lying down on a bed while a machine moves around your body and emits radiation very specifically to different parts of the body. As this treatment is very precise, the risk of radiation affecting other parts of your body or increasing your risk of other cancer types is very rare. It can, however, have certain side effects, so be sure you discuss it with your doctors before proceeding.

Targeted Therapy

The main thing about cancer as a disease is that it causes cells to multiply unpredictably and fast. This cell reproduction is often fueled by certain chemicals, which can be blocked using medication. With no fuel to continue the multiplication of cells, the cancer cells die out slowly or at least stop expanding any further. This is known as targeted therapy. For certain types of breast cancer, this treatment can be highly effective in managing the cancer and killing the cancer cells. This type of treatment is also recommended before surgery to reduce the size of the tumour. There are various targeted therapy medicines available today that can help patients improve their chances of getting cancer treatment.

Conclusion

Breast cancer has a near-perfect 5-year survival rate for early-stage diagnosis. It is made possible by the various breast cancer treatment options discussed in this article. Given the prevalence of this condition across the world, there are various options for breast cancer treatment by stage to ensure patients get the required medical care to beat cancer. Some of the treatment options discussed here are also preventative as they reduce the risk of cancer spread and recurrence. So, if you want to learn more about any of the specific treatment options, be sure to check out MASSH. We specialise in minimally invasive localised treatment of breast cancer and offer highly specific systemic treatments as well. Visit us today to consult with our specialists.