About the Author
Dr. Kiran Paranjape
A Professional Orthopedic Surgeon.
As with any cancer, the treatment of breast cancer is divided into local control and systemic control.
The local control of the disease is achieved with complete and adequate removal of the cancerous breast tissue usually by radical mastectomy. In this procedure whole breast along with the lymph nodes draining from the breast tissue are removed one piece. As these lymph nodes also drain the lymph from upper limb, chances of development arm swelling are very high. Hence, in modified radical mastectomy, only the palpable part of breast tissue and lymph nodes are removed and axillary lymph node is biopsied and removed only if it is involved. Additionally, intercostal lymph nodes are removed to achieve more complete local removal.
Following surgery, the mutilaed breast is reshaped either by self augmentation mammoplasty where remaining healthy breast tissue is used to reconstruct the breast or by implant mammoplasy where shape of the breast is restored by inserting silicon implant.
The systemic control of the disease is achieved with radiotherapy and chemotherapy. It may be given pre-operatively to prevent inadvertent spread of cancer cells while handling the tissue during the surgery or post-operatively to take care of residual cancer cells.
In radiotherapy high frequency X ray radiation is applied to chest area to kill the residual cancer cells. Multiple high intensity low duration sittings with linear accelerator having cobalt-60 isotope is highly successful in achieving this.
In the chemotherapy, one or more anticancer drugs are given to the patient either orally or intravenously. This is basically a two step approach. Estrogen is the hormone normally required for the growth of breast tissue. Hence the cancerous tissue arising from normal breast tissue is also dependent on estrogen for its growth. The estrogen is mainly produced in ovaries and stimulates development of breast by getting attached to the estrogen receptors in breast tissue. Tamoxifen acts by reducing the sensitivity of estrogen receptors in breast tissue. It is the gold standard anticancer chemotherapeutic agent. It belongs to a family of drugs called estrogen receptor modulators. Surgical removal of ovaries by oophorectomy cuts the supply of estrogen at its source. Luteinizing hormone-releasing hormone analogue helps in reducing the side effects of ovarian ablation. In monotherapy, only one drug is used e.g. Tamoxifen. In multitherapy, more than one drug is used .e.g. Tamoxifen with Carboplatin. Multitherapy is more advantageous as less dosage of the individual drug needs to be administered hence lesser are the side effects while it has high overall success rate.
Regular self breast exam with timely intervention by a specialist ensures a high success rate.
Check my next article on "Prostate Cancer".
Disclaimer: The information contained in this article is for the general public awareness only. The patient is advised to take proper medical opinion before undergoing any treatment mentioned herein. The author and publisher are not responsible for any consequences thereof.
Published by Dr. Kiran Paranjape on October 14, 2005 07:02 AM
