Breast Cancer

Surgery is commonly performed for people with breast cancer to remove cancerous tissue, identify whether the cancer has spread to the lymph nodes and, if possible, reconstruct the breast. Most people with breast cancer will receive surgery at some point during their treatment.

There are two types of surgery: breast conservation, also known as lumpectomy, where the cancer is removed with a rim of normal tissue; or mastectomy where the entire breast is removed.

After breast conservation surgery, a course of radiation therapy is usually recommended.

Cancer cells can travel from the breast in channels called lymphatic vessels and collect in nearby lymph nodes. To find out if the breast cancer has spread to lymph nodes in your underarm, one or more of these lymph nodes will be removed and looked at under the microscope. The most common form of lymph node surgery is called a sentinel node biopsy.

The sentinel lymph nodes are the first lymph nodes(s) that breast tissue, in the area of the tumour, drain into. This procedure requires injection of a special form of dye into the breast just prior to the surgery. A nuclear scan, called lymphoscintiography, and/or blue dye helps the surgeon locate the sentinel lymph nodes at the time of surgery.

If a sentinel lymph node biopsy is not appropriate or possible in your case, the surgeon will usually perform armpit surgery. This is when the surgeon removes most of the lymph nodes from the armpit, also called the axilla. Every person has a different number of axillary lymph nodes. An axillary dissection may also be recommended if cancer cells are found in your sentinel lymph nodes. This can occur as part of your breast cancer surgery or as a separate operation.

Lumpectomy

A lumpectomy, also known as breast-conserving surgery or partial mastectomy, is a procedure which focuses on removing the least amount of healthy tissue as possible when excising the breast cancer tumour/s. Lumpectomy may help in maintaining the appearance of your breast. Most women will be recommended radiation therapy after a lumpectomy.

Mastectomy

Mastectomy refers to the surgical removal of the entire breast to prevent or treat breast cancer. There are many different types of mastectomies performed today including:

Chemotherapy uses different medicines to kill and slow the growth of breast cancer cells. These drugs may be delivered at any stage of your breast cancer treatment, from shrinking large tumours before surgery to destroying potential remaining cancer cells after surgery. Chemotherapy plays an important part in reducing the risk of your breast cancer returning in both the breasts and the rest of the body.

Learn more about chemotherapy and how it is delivered.

Chemotherapy for breast cancer takes place over several sessions, given once every one to three weeks depending on the type of treatment regimen used. This is known as a cycle. Your care team will walk you through how many cycles you may need for your treatment.

Radiation therapy treatment is usually used for breast cancer patients who have had breast-conserving surgery (lumpectomy), and sometimes after a mastectomy. If you are scheduled to receive chemotherapy after your surgery, radiation therapy will typically be delivered following chemotherapy.

Although traditionally radiation therapy has been delivered over a period of five to six weeks, with recent advances in radiation therapy technology many patients can now receive their treatment across three to four weeks or even shorter in certain cases.

Radiation therapy can impact the comfort, feel and appearance of breast reconstructions. Your oncologist will speak with you about the timing of your treatments and may encourage you to delay breast reconstruction surgery until after you complete active treatment.

Types of radiation therapy commonly used for people with breast cancer include:

Some types of breast cancers feed on your body’s natural hormones for growth. Hormone therapy can be used to stop hormone-sensitive cancers from growing or returning. Hormone therapy is commonly delivered as a tablet or injection, with surgery being used in some cases to remove the ovaries, which are the part of the body that produces most of these hormones.

For many women, hormonal therapy is used in combination with chemotherapy or surgery and may be delivered over five to ten years.

Targeted therapies use specialised medicines to destroy specific proteins in breast cancer cells. These medicines are particularly effective for HER2-positive breast cancers, where the cancer cells have a higher-than-average amount of HER2 (a growth-promoting protein on the outside of breast cells).

When you are diagnosed with breast cancer, your oncologist will develop your treatment plan as part of a multidisciplinary team based on the stage of your cancer.

Common treatment options for each stage of breast cancer include: