Breast Cancer

Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. The breast is made up of lobes and ducts. Each breast has 15 to 20 sections called lobes, which have many smaller sections called lobules. Lobules end in dozens of tiny bulbs that can produce milk. The lobes, lobules, and bulbs are linked by thin tubes called ducts.

Each breast also has blood vessels and lymph vessels. The lymph vessels carry almost colourless fluid called lymph. Lymph vessels lead to organs called lymph nodes. Lymph nodes are small bean-shaped structures that are found throughout the body. They filter substances in a fluid called lymph and help fight infection and disease. Clusters of lymph nodes are found near the breast in the axilla (under the arm), above the collarbone, and in the chest.

The most common type of breast cancer is ductal carcinoma, which begins in the cells of the ducts. Cancer that begins in the lobes or lobules is called lobular carcinoma and is more often found in both breasts than are other types of breast cancer. inflammatory breast cancer is an uncommon type of breast cancer in which the breast is warm, red, and swollen.

Treatment of breast cancer may include chemotherapy, radiotherapy, hormonal therapy and / or immunotherapy. Commonly these treatments are given after your surgery, however, in certain circumstances treatment may need to be given pre-operatively.

The choice of treatment options depends on several factors including your general health and other medical conditions, fitness, the breast cancer specifications and subtypes. Each individual will be assessed and dealt with based on these factors. Our discussion with you will focus on these issues and the balance between potential benefits and side effects.

Breast cancer chemotherapy:

 

 

 

 

Chemotherapy has been shown to be effective in treating breast cancer and reducing the risk of  recurrence. Commonly, chemotherapy is given post operatively and is described as “adjuvant” therapy. There is large number of chemotherapy schedules that can be used. We will discuss with you which one is the best option for you. Generally, chemotherapy is delivered as a day case where you need to come to the Oncology unit and have your blood tested before going ahead with your chemotherapy cycle. Should there be any unexpected changes, we will make sure this is explained to you and an alternative measure is taken. It is expected that the chemotherapy treatment will take about half a day. Most chemotherapy schedules are delivered once every 3 weeks for 4-6 cycles.

Commonly used chemotherapy schedules are listed below. Click on the link provided for full information.

1. FEC

2. FEC-D (FEC-T)

3. AC

Breast cancer Radiotherapy:

Radiotherapy refers to treatment of breast cancer using X rays. This is a very common form of therapy and usually given after your surgery particularly if you had a wide local excision, however, selected patients may require this treatment even after a mastectomy. Radiotherapy is usually directed to your affected breast, but in some cases we may need to consider radiotherapy to your lymph node region as well.

Treatment is usually on outpatient basis. Each visit lasts for about 10-15 min on average. You are expected to require between 15 and 29 daily treatment sessions (called fractions) excluding the weekends. The number of fractions depends on type of surgery you had and the disease stage as well. We also take into account your general health and fitness and if you have any other medical condition that may interact with this therapy. The treatment will be planned and delivered at the regional radiotherapy centre in Glasgow (The Beatson West of Scotland Cancer Centre). For detailed information on breast radiotherapy, click here.

Breast Radiotherapy

Breast cancer Hormonal therapy:

Breast cancer can be treated with hormones. This can provide you with significant benefits in addition to the benefits you may gain from chemotherapy, radiotherapy and surgery. Commonly, hormonal therapy includes using a tablet form; however, surgical removal of the ovaries is another way of hormonal treatment. This is called Oophorectomy. A third option is in the form of an injection / implant under the skin which is usually given once every month using a drug called Goserelin (Zoladex). For general information on hormonal therapy, click here. For more detailed and drug specific information, you can click on the drug names below.

1. Tamoxifen

2. Letrozole

3. Anastrazole

4. Exemestane

5. Zoladex

Breast cancer Immunotherapy (biological therapy):

Certain subtypes of breast cancer can be treated with biological agents. Trastuzumab, known as Herceptin, is now well established as a treatment option for patients who have a HER2 positive tumour type which is the case in about 20% of patients. Your tumour will be tested routinely for this and if positive, we will discuss this treatment option with you. Herceptin is given intravenously once every 3 weeks and for a total of 18 cycles. This is the case in the post operative treatment setting; however, the same drug can also be used in cases cancer cells have already spread to other parts of the body.

Click on the link for more information regarding Herceptin.

 

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