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| Breast Cancer |
Surgery
Surgery remains the treatment most commonly practiced. The surgeon removes the tumor, which will be analyzed by the pathologist, to specify the size, aggressiveness, presence or absence of hormone receptors. These data are essential in choosing the treatment option. The type of surgery (total removal of the mammary gland, or lumpectomy) depends primarily on the clinical size of the tumor. In the same operation, is performed with axillary lymph node on the same side as the tumor, to detect any cancer foci in the lymph nodes examined. This dissection can be limited by the methods of scintigraphic study coupled with the frozen section examination performed in the operating room, and shows the absence or presence of cancer cells in the first lymph nodes removed (sentinel node). It is important to examine these nodes because they filter the lymph that comes from within and circulates throughout the body. They represent the first sites of tumor extent. If the lymph nodes examined were positive, there may be cancer cells during migration in the body. This risk will determine the choice of therapy after surgery. All information gathered in the "staging". Different types of surgeries are performed in the treatment of breast cancer. The technique used depends on several factors but mainly on the size and location of the tumor:
* Lumpectomy: removal of the tumor.
* Partial mastectomy: removal of the tumor, a portion of surrounding tissue and the lining of the pectoral muscles near the tumor.
* Modified radical mastectomy: removal of the breast and the lining of the pectoral muscles (keeping the muscles).
* Radical mastectomy or Halsted operation: removal of the entire breast, chest muscles, and some fatty tissue and skin. It is no longer practiced to this day as very mutilating.
Radiotherapy
Radiation therapy uses high-energy radiation to kill cancer cells and prevent their development. Like surgery, it is a local treatment, without any action on potential metastatic sites remotely. It can be administered in different ways:
* Or from a source of radiation external;
* Or from radioactive materials directly implanted in the womb. This is known as "brachytherapy".
Both methods can be combined. External radiation therapy is usually performed on an outpatient basis. At the end of this conventional radiotherapy, an overlay can be performed radiotherapy to the tumor site. This additional radiation therapy can also be applied by brachytherapy. In the latter case, the patient should be hospitalized for a short period. Radiotherapy is often used to complement surgery, either before (known preoperative radiotherapy, the aim being to reduce the size of the tumor) or after (it is then postoperative radiotherapy, the aim prevent a recurrence of the tumor).
Chemotherapy
It has a single drug or a combination of anti-tumor agents (most common), there is a treatment whose interests the general circulation throughout the body (treatment called "systemic" as well as hormone treatments as opposed to "local" as surgery or radiotherapy). It can be administered before or after surgery. If it is prescribed to destroy potential metastatic sites after surgery, it is called "adjuvant". Its indications depend on a number of factors called "prognostic". The main drug treatments combine the molecules of doxorubicin (anthracycline family), cyclophosphamide or fluorouracil. Molecules from a tree, yew, also made their appearance: they are the taxanes used in metastatic breast cancer and recently in an earlier stage of the disease.
Hormone
Hormone treatment is "systemic". It aims to prevent, in some cases, tumor cells receiving the hormones necessary for their development. His administration is decided depending on the hormone receptor status in tumor tissues. This method is to inhibit the production of hormones implicated, either by administration of anti-hormones, either by suppressing the production of these hormones (definitively: surgical castration or radiotherapy, or transiently: chemical castration). The choice between chemotherapy, hormonal therapy or both, is a function of patient age, hormonal status and the detection of hormone receptors. If positive, hormone therapy is usually effective.
Targeted therapies
Targeted therapies specifically attack cancer cells without touching healthy cells. One of the targeted therapy is based on "monoclonal antibodies". They are manufactured specifically for antibodies recognize an antigen expressed by a tumor. These monoclonal antibodies can either target the tumor directly, or its environment. Trastuzumab (Herceptin ®) is one of these molecules, whose mode of action is to address the overexpressing tumors (that is to say too much of) a protein (HER2). It is used alone or in combination with chemotherapy. Other targeted therapies will inhibit the growth of blood vessels needed for tumor development. "Hungry", this, will stop proliferating or die. These are molecules called "antiangiogenic" such as sunitinib. The "borderline lesions". These cancers "in situ" or noninvasive, should be considered separately. Treatment can range from conservative surgery to mastectomy, the choice of treatment depends mainly on the histological type encountered. In some cases, radiation therapy may be necessary after partial surgery. In contrast, treatment of inflammatory cancer chemotherapy based on early and aggressively, then surgery and / or radiotherapy, and as appropriate, a hormone.
Surgery remains the treatment most commonly practiced. The surgeon removes the tumor, which will be analyzed by the pathologist, to specify the size, aggressiveness, presence or absence of hormone receptors. These data are essential in choosing the treatment option. The type of surgery (total removal of the mammary gland, or lumpectomy) depends primarily on the clinical size of the tumor. In the same operation, is performed with axillary lymph node on the same side as the tumor, to detect any cancer foci in the lymph nodes examined. This dissection can be limited by the methods of scintigraphic study coupled with the frozen section examination performed in the operating room, and shows the absence or presence of cancer cells in the first lymph nodes removed (sentinel node). It is important to examine these nodes because they filter the lymph that comes from within and circulates throughout the body. They represent the first sites of tumor extent. If the lymph nodes examined were positive, there may be cancer cells during migration in the body. This risk will determine the choice of therapy after surgery. All information gathered in the "staging". Different types of surgeries are performed in the treatment of breast cancer. The technique used depends on several factors but mainly on the size and location of the tumor:
* Lumpectomy: removal of the tumor.
* Partial mastectomy: removal of the tumor, a portion of surrounding tissue and the lining of the pectoral muscles near the tumor.
* Modified radical mastectomy: removal of the breast and the lining of the pectoral muscles (keeping the muscles).
* Radical mastectomy or Halsted operation: removal of the entire breast, chest muscles, and some fatty tissue and skin. It is no longer practiced to this day as very mutilating.
Radiotherapy
Radiation therapy uses high-energy radiation to kill cancer cells and prevent their development. Like surgery, it is a local treatment, without any action on potential metastatic sites remotely. It can be administered in different ways:
* Or from a source of radiation external;
* Or from radioactive materials directly implanted in the womb. This is known as "brachytherapy".
Both methods can be combined. External radiation therapy is usually performed on an outpatient basis. At the end of this conventional radiotherapy, an overlay can be performed radiotherapy to the tumor site. This additional radiation therapy can also be applied by brachytherapy. In the latter case, the patient should be hospitalized for a short period. Radiotherapy is often used to complement surgery, either before (known preoperative radiotherapy, the aim being to reduce the size of the tumor) or after (it is then postoperative radiotherapy, the aim prevent a recurrence of the tumor).
Chemotherapy
It has a single drug or a combination of anti-tumor agents (most common), there is a treatment whose interests the general circulation throughout the body (treatment called "systemic" as well as hormone treatments as opposed to "local" as surgery or radiotherapy). It can be administered before or after surgery. If it is prescribed to destroy potential metastatic sites after surgery, it is called "adjuvant". Its indications depend on a number of factors called "prognostic". The main drug treatments combine the molecules of doxorubicin (anthracycline family), cyclophosphamide or fluorouracil. Molecules from a tree, yew, also made their appearance: they are the taxanes used in metastatic breast cancer and recently in an earlier stage of the disease.
Hormone
Hormone treatment is "systemic". It aims to prevent, in some cases, tumor cells receiving the hormones necessary for their development. His administration is decided depending on the hormone receptor status in tumor tissues. This method is to inhibit the production of hormones implicated, either by administration of anti-hormones, either by suppressing the production of these hormones (definitively: surgical castration or radiotherapy, or transiently: chemical castration). The choice between chemotherapy, hormonal therapy or both, is a function of patient age, hormonal status and the detection of hormone receptors. If positive, hormone therapy is usually effective.
Targeted therapies
Targeted therapies specifically attack cancer cells without touching healthy cells. One of the targeted therapy is based on "monoclonal antibodies". They are manufactured specifically for antibodies recognize an antigen expressed by a tumor. These monoclonal antibodies can either target the tumor directly, or its environment. Trastuzumab (Herceptin ®) is one of these molecules, whose mode of action is to address the overexpressing tumors (that is to say too much of) a protein (HER2). It is used alone or in combination with chemotherapy. Other targeted therapies will inhibit the growth of blood vessels needed for tumor development. "Hungry", this, will stop proliferating or die. These are molecules called "antiangiogenic" such as sunitinib. The "borderline lesions". These cancers "in situ" or noninvasive, should be considered separately. Treatment can range from conservative surgery to mastectomy, the choice of treatment depends mainly on the histological type encountered. In some cases, radiation therapy may be necessary after partial surgery. In contrast, treatment of inflammatory cancer chemotherapy based on early and aggressively, then surgery and / or radiotherapy, and as appropriate, a hormone.
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