Lewis Gale Physicians November 06, 2017

Next steps following a breast cancer diagnosis.

When Mary Thomas received a breast cancer diagnosis at the age of 56, it was the most terrifying moment of her life. “It was a shock,” she said. “My appointment was on a Friday and my surgery was scheduled for the following Wednesday. So I left the office knowing what I was dealing with. Even though it was bad news, I would rather know right away, and not have to wait for the pathology report. I never dreamed that I would have breast cancer when I went in that day, but I was glad to know what I was facing when I left.” Unfortunately, more than 250,000 women in the United States face the same diagnosis as Mary did each year. Understanding your treatment options for can help ease the burden.

Defining Breast Cancer

Before starting treatment, it is important to understand how breast cancer begins. Cancer is a disease in which cells grow in an abnormal way. Normally, the cells divide in a controlled manner to replace old or damaged cells. If cells keep dividing when new cells are not needed, a mass of tissue called a tumor forms.

A tumor can be benign or malignant. A benign tumor is not cancer and will not spread to other parts of the body. A malignant tumor is cancer. Cancer cells invade and damage tissue around them. The cancer cells also can enter the lymph and blood streams, spreading to other parts of the body. Breast cancer is the development of malignant cells in the breast tissue and is the most common form of cancer in women.

Cancers are the result of genetic mutations, or changes to cells in the body, that may be caused by any number of factors. Some mutations are inherited and some come from repeated exposure to certain types of radiation or harmful chemicals. Either kind may trigger a single genetic mutation, which can result in cancer. For example, a small percentage (under 10%) of breast cancers may be linked to the inheritance of one or more tumor suppressor genes (BRCA1 and BRCA2 mutations) passed from one generation to the next. Families with a high incidence of breast cancer may consider genetic testing to determine if known genetic factors are causing the increased risk.

Treatment Options for Breast Cancer

Most breast cancers are very treatable, especially those detected early and those that are localized in the breast. The goal of treatment is to remove as much of the cancer as possible, while preserving as much of the breast and its function as possible. Additional treatment may help to prevent the spread or recurrence of cancer. The treatment plan often will involve a combination of approaches based on the characteristics of the cancer, the woman's age, general health, and prognosis. Treatment for advanced stages may include management of symptoms for comfort measures.

The healthcare team will be made up of a variety of health professionals including doctors, surgeons, nurses, and pharmacists. It is important to maintain contact with your medical team, adhere to recommended treatment, and go to any recommended appointments for best outcomes possible.

Many women receive more than one type of treatment for their breast cancer, depending on the type of cancer, how advanced it is, and the patient’s overall health. Treatments may include:

  1. Local Treatments: Localized treatments target cancer cells without impacting the rest of the body. They are most often used in the early stages of cancer, though sometimes in other situations, too.
    • Surgery— According to the American Cancer Society®, most women with breast cancer opt for some form of surgery to remove the tumor by cutting out the cancerous tissue.
    • Radiation therapy—Targets the tumor with high-energy rays, similar to X-rays, to kill the cancer cells.
  2. Systemic Treatments: Systemic treatments are typically drugs given either by mouth or introduced directly into the bloodstream. As a result, they are able to reach any part of the body. Different drugs may be used depending on the type and stage of the breast cancer.
    • Chemotherapy—Using special medicines to shrink or kill the cancer cells. The drugs can be pills you take or medicines given in your veins, or sometimes both.
    • Hormonal therapy—Blocks cancer cells from getting the hormones they need to grow.
    • Biological therapy—Works with your body’s immune system to help it fight cancer cells or to control side effects from other cancer treatments.
  3. Clinical Trials: Existing treatment protocols have been established and continue to be modified through clinical trials. These research studies are essential to determine whether or not new treatments are both safe and effective. Since highly effective treatments for many cancers remain unknown, numerous clinical trials are always underway around the world. You may wish to ask your doctor if you should consider participating in a clinical trial. You can find out about clinical trials at the US National Institutes of Health website, cancer.gov/about-cancer/treatment/clinical-trials.

Side Effects

Most women undergoing chemotherapy and/or radiation therapy have some side effects. While these treatments are aimed at killing cancer cells, they can also destroy some healthy cells in the process. Your doctor can help with ways to minimize the consequences of chemotherapy and radiation therapy as much as possible. Not all women will experience side effects but, if they do, they may include:

  • Loss of appetite
  • Nausea and vomiting
  • Weakness
  • Fatigue
  • Mouth sores
  • Hair loss
  • Weight gain
  • Early menopause
  • Bleeding
  • Diarrhea
  • Higher risk of infections

Your doctor will talk to you about the risks and benefits of targeted therapy treatment. A variety of treatments are available to help manage side effects including medication, lifestyle changes, and alternative treatments. The earlier the side effects are addressed, the more likely they will be controlled with a minimum of discomfort.

When asked what advice she would give women newly diagnosed with breast cancer, Mary said, “I would tell them to take one day at a time. Looking too far ahead could drive you crazy. I would encourage them to learn about breast cancer, but be careful about reading too much. It can get discouraging. I would also encourage them to take care of themselves. It's always there, but you can't let it take over.”

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Navigating the steps following a breast cancer diagnosis can be difficult. Dr. Jolene Henshaw, with LewisGale Physicians can help in creating a treatment plan. To schedule an appointment call the office at (540) 961-1590 or schedule an appointment online.

Book An Appointment Online with Dr. Jolene Henshaw