Breast Cancer is the most common cancer affecting women globally, as well as in India. Each year, more than 80,000 women in India are diagnosed with breast cancer. Cancer occurs as a result of mutations, or abnormal changes in the genes responsible for regulating the growth. Breast cancer is the uncontrolled growth of breast cells.
Normally, the cells replace themselves through an orderly process of cell growth, and healthy new cells take over as old ones die out. But over time mutations can 'turn on' certain genes and 'turn off ' others in a cell. The changed cell gains the ability to keep dividing without control or order, producing more cells just like it and forming a tumour.
A tumour can be benign (not dangerous to health) or malignant (has the potential to be dangerous). Benign tumours are not considered cancerous: their cells are close to normal in appearance, they grow slowly, and they do not invade nearby tissues or spread to other parts of the body. Malignant tumours are cancerous. Left unchecked, malignant cells can spread beyond the original tumour to other parts of the body.
Usually, breast cancer begins in the cells of the lobules. Less commonly, breast cancer can begin in the stromal tissues, which include the fatty and fibrous connective tissues of the breast. Over time, cancer cells can invade nearby healthy breast tissue and spread to the underarm lymph nodes, and to other parts of the body.
When a woman finds an abnormal mass on examination or an abnormal area is detected by screening mammogram, a careful history and physical examination should be carried out. A thorough physical examination of the breast should be done by a doctor. Here’s a list of medical methods through which, diagnosis for breast cancer is undertaken.
Breast cancer is considered to be a systemic disease in most cases. This means that while the primary disease in the breast is obvious, there is the possibility of microscopic disease elsewhere. Hence, treatment is required for the local area and distant sites. Local treatment is removal or destruction of the local tumour by either surgery or radiation. The treatment of distant sites is either by chemotherapy or hormonal treatment. Patients may need one form of treatment or all the four forms of treatment either simultaneously or in sequence.
Surgery is the most common treatment for breast cancer. It involves the removal of the tumour and some surrounding healthy tissue through an operation.
Sentinel lymph node biopsy
At APCC, our surgery procedures include Sentinel Lymph Node Biopsy (SLNB) where the sentinel lymph node is identified, removed, and examined to determine whether cancer cells are present.
Breast Conservation Therapy
Breast Conserving Surgery (BCS) with radiation therapy is now a standard therapy for low grade Breast Cancer. It is the safe and preferred therapeutic procedure for all early-detected breast cancers because it provides the same level of overall survival as mastectomy.
Accomplishing a good cosmetic effect is of key importance when using BCS. It is balanced with width of excision, and achieving low local reoccurrence rate.
Reconstructive surgery is an option for patients who have undergone a mastectomy. This is a surgery to re-create a breast using either tissue taken from another part of the body or synthetic implants.
Radiation therapy may be used to treat breast cancer at almost every stage. It is an effective way to reduce your risk of breast cancer recurring after surgery.
For early stage breast cancer, radiation is directed only to the tumour bed cavity. Accelerated Partial Breast Irradiation (APBI) is attracting more attention from both physicians and patients as an alternative to adjuvant whole-breast irradiation in early stage breast cancer, suggesting similar in-breast recurrence rates as whole breast irradiation.
Late side effects
Once breast cancer treatment ends, most side effects of the treatment go away. However, some long-term side effects and health effects may occur months or even years after treatment ends. These late effects of treatment vary from person to person. Some of the late effects of radiation are:
Immunotherapy for Lung Cancer
Proton radiation is slowly emerging as a powerful option for the treatment of breast cancer. Using the Braggs Peak phenomenon we ensure there is no exit dose and a significantly lower entrance dose than conventional X-rays. This way damage to critical tissue near the breast, like the lungs and heart, is dramatically reduced.
The data for proton therapy in breast cancer is still evolving and not routinely done. It is indicated on a case to case basis after detailed discussion with the oncologists.
In Chemotherapy, intense drug regimen is used to kill cancer cells. Usually, more than two drugs are used for the treatment. When given post-surgery, chemotherapy is called adjuvant chemotherapy and, in this setting, it is used to take care of microscopic disease elsewhere. When given before surgery, it is called Neo-adjuvant chemotherapy and, in this setting, the purpose is to reduce the size of a large tumour, and make it surgically removable. Whether it is adjuvant or neo-adjuvant - it is administrated several times over a period of months with breaks between treatments.
Hormonal therapy, alternatively known as endocrine therapy, is now a widely used treatment for most tumours that test positive for either estrogen or progesterone receptors. This type of tumour uses hormones to fuel its growth. Blocking the hormones can help prevent cancer recurrence, and death from breast cancer, when used either by itself or after adjuvant or neo-adjuvant chemotherapy.
In this treatment modality, we start the process with a detailed investigation that covers tests to identify the genes, proteins, and other factors in the tumour. Post results, we target the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. These treatments are highly focused and effective in blocking the growth and spread of cancer cells while limiting damage to healthy cells.
At APCC, our focus is to help our patient get back to an active and confident life at the earliest. We believe that a robust support system that is there for our patients – emotionally, physically and spiritually – is a vital cog in the rehabilitation process.
We leverage our deep experience in integrated cancer care, the wide network of Apollo Cancer Survivors, and the skills of a vibrant team to help chart the roadmap for our patients to reclaim their lives.