Breast cancer treatment

Breast cancer is the most common type of oncology in women. According to the World Health Organization, in 2020, it was diagnosed in 2.2 million people. This incidence rate is observed every year. But there is good news: over the past 5 years, 7.8 million patients have overcome breast cancer. When therapy is started at an early stage, the probability of recovery reaches 90%.

At Oxford Medical, treatment is carried out by highly qualified oncologists and surgeons with many years of experience. For each patient, they draw up an individual therapy program, guided by state and international protocols.

At Oxford Medical, there is a modern oncology department with a high-tech surgical hospital. It is equipped with expert-class equipment and employs oncologists and oncological surgeons with many years of experience. Thanks to this, we provide the maximum quality of medical care.

To schedule a consultation, call our contact center or write to the chat on the website.

Approximately 10% of patients develop breast cancer due to a mutation in the BRCA1 and BRCA2 genes. According to some reports, it increases the risk of the disease by 60-80%. In the remaining cases, the cause of the neoplasm is considered to be the presence of several risk factors.

These include:

• female gender;
• age over 40 years;
• benign breast tumors;
• early sexual development (up to 12 years);
• late onset of menopause (after 55 years);
• lack of pregnancies and childbirth;
• artificial termination of pregnancy;
• refusal to breastfeed;
• overweight;
• insufficient physical activity;
• diabetes mellitus;
• hypertension;
• long-term use of oral contraceptives or other hormonal drugs;
• smoking;
• excessive alcohol consumption;
• unfavorable environmental environment;
• previous radiation therapy, exposure to carcinogens.

In the presence of many risk factors, the likelihood of the disease increases, but this does not mean that the tumor will necessarily develop.

If the above symptoms appear, you should consult a mammologist. He will conduct an examination and study the medical history, after which he will prescribe a diagnosis. First of all, women under the age of 40 undergo an ultrasound of the breast, and after 40, a mammogram. If the study confirms the presence of a neoplasm, a biopsy is recommended.

A biopsy is a simple procedure during which, under ultrasound control, a specialist punctures the breast with a thin needle and takes a sample of tumor tissue. The latter is sent to the laboratory for histological analysis. Only it allows you to accurately determine whether the tumor is malignant or not. If so, an immunohistochemical study is immediately performed to assess the molecular properties - the treatment tactics and prognosis depend on them.

After this, the patient is prescribed other examinations to determine the size of the tumor, its prevalence and the presence of metastases.

To do this, the following are performed:

• laboratory tests;
• X-rays;
• computed tomography and other instrumental studies.

It is generally accepted to distinguish 5 stages of cancer:

• Stage 0 - the tumor is very small and is diagnosed only on X-ray or computed tomography;
• Stage 1 - the tumor size is up to 2 cm, there is no lymph node involvement and metastases;
• Stage 2 - the tumor size is from 2 to 5 cm or less, but with an increase in lymph nodes;
• Stage 3 - the tumor size is about 5 cm, there is damage to nearby tissues and lymph nodes;
• Stage 4 - the tumor size is more than 5 cm, there are metastases in other organs.

This system is considered simplified. To determine the stage of cancer, oncologists use the international TNM classification, where T (tumor size) - the size of the tumor, N (nodes) - damage to the lymph nodes, M (metastasis) - the presence of metastases.

So, according to the T index, the stage of breast cancer may correspond to:

• T1 - the tumor size is less than 2 cm;
• T2 – size from 2 to 5 cm;
• T3 – more than 5 cm;
• T4 – tumor spreads to the chest and skin.

According to the N index, the following are distinguished:

• N0 – lymph nodes are not damaged;
• N1 – there are metastases in the axillary lymph nodes, but they are not fused together;
• N2 - there are fused metastases in the axillary lymph nodes, or damage to the internal mammary lymph node;
• N3 – multiple metastases in the lymph nodes.

According to the M index, the following are distinguished:

• M0 – no distant metastases;
• M1 there are distant metastases.

Thus, the diagnosis may look like T1N1M0, T2N0M0, T2N1M0, etc.

Also important is the histopathological grading (G), i.e. the degree of difference between malignant cells and normal cells and the speed of their division. This parameter determines the aggressiveness of the tumor.

The following are distinguished:

• GX - the degree of malignancy of the tumor cannot be assessed;
• G1 - highly differentiated tumor cells, their structure only slightly differs from normal, which indicates a low probability of metastasis;
• G2 - moderately differentiated tumor cells, which differ significantly from healthy ones;
• G3 - poorly differentiated tumor cells;
• G4 - undifferentiated tumor cells, the neoplasm behaves aggressively, develops rapidly and responds poorly to treatment.

Complex therapy is used to treat breast cancer.

Depending on the stage and type of cancer, the patient may be prescribed the following types of treatment:

• surgical removal of the tumor;
• chemotherapy;
• radiation therapy;
• targeted therapy;
• hormonal therapy;
• immune therapy.

In the early stages of cancer, surgery is usually performed first.

Depending on the size and location of the tumor, the following are performed:

• lumpectomy - removal of part of the breast tissue;
• mastectomy - removal of the entire breast;
• mastectomy with removal of the lymph nodes.

Oxford Medical specialists try to perform organ-preserving surgeries in all cases where possible. In breast cancer, lumpectomy is recommended if the tumor is small and there is no damage to adjacent tissues and lymph nodes. Mastectomy may be necessary if the tumor is large, has spread into the skin or chest wall, is small in size, and in some other cases.

After mastectomy, women are offered reconstructive surgery. Depending on the wishes and state of health, it can be done simultaneously with tumor removal or after reconstruction.

In addition to surgery, other treatment may be required. If the tumor is hormone-dependent, hormonal therapy is prescribed. If there are receptors sensitive to HER2, targeted therapy is used.

Chemotherapy can be prescribed both before surgery to reduce the size of the tumor and perform radical removal, and after treatment of metastases and prevention of relapse. It is also performed for palliative purposes.

Radiation therapy for breast cancer is prescribed mainly after surgery, like chemotherapy, for preventive purposes, as well as for the treatment of metastases and relief of symptoms in patients at the last stage of the disease.

In each case, oncologists develop an individual treatment program.

The risk of breast cancer depends on genetic factors that cannot be influenced, and lifestyle.

Experts noted that the incidence is lower in women who:

• have children;
• have breastfed;
• have not had abortions;
• have given up smoking and drinking alcohol;
• have a normal body weight;
• exercise regularly;
• have a balanced diet;
• have not taken hormonal contraceptives for more than 10 years.

If one of the close relatives has breast cancer, women are recommended to undergo diagnostics for the presence of mutations in the BRCA1 and BRCA2 genes. If the result is positive, they are advised to monitor their health more carefully.

Regardless of being in the risk group, girls after 18 years of age are shown to undergo an annual ultrasound of the breast glands, and women over 40 years of age - mammography. You should also perform a breast self-examination at least once a month, feeling their structure, and if you detect any abnormalities, immediately consult a doctor.