Progress in the treatment of breast cancer has been painfully slow. Treatment changes can occur after physicians and their patients have been convinced that a new treatment is equal or superior to another already in use. Treatment of breast cancer depends on a woman's age and health as well as the type, extent, and location of the tumor, and if the cancer has remained in the breast or has spread to other parts of the body. Treatment may include surgery, chemotherapy, hormone therapy, radiation or a combination of treatments.

There are various surgical techniques that might differ in the amount of breast tissue that is removed with the tumor, such as whether it has spread away form the breast or with in it and the patients feelings towards which surgery. The surgeon normally removes some lymph nodes under the arm as part of the operation, so they can test for the presence of cancer cells. One surgical treatment includes Lumpectomy, also called breast conservation. The surgeon removes the cancerous area and the surrounding area of the normal tissue. A second incision may be made in order to remove the lymph nodes (Andrew). The treatment aims to maintain a normal breast appearance when surgery is done; less painful and least amount of time to recover which are all positive points.

After the lumpectomy, a six to eight week course of radiation therapy is used to treat the remaining breast tissue. Most women who have small, early stage breast cancer are first-rate candidates for this treatment. There are however women who are not typically eligible for a lumpectomy including those who have already had radiation therapy to the affected breast. Women who have two or more areas of cancer in the same breast that is too far apart to be removed through on incision.

As well as having cancer that was not completely removed during the first surgery (Andrew). Another choice that women have with surgery is partial or segmental mastectomy. This is where the surgeon removes more breast tissue than a lumpectomy. The cancerous area and surrounding outskirts of normal tissue are removed, and radiation therapy is given after surgery for six to eight weeks.

This treatment also is a less painful procedure and less costly. Now if the cancer cells have moved to spreading through the lymph nodes, then they will be recommended to get chemotherapy. In chemotherapy, the patient takes cancer fighting medications that travel trough the body to slow the growth of cancer cells or even kill them. If no cancer cells are found in the tissue other than the breast, chemotherapy may be given in addition to surgery to reduce the risk that the cancer will come back (Spatt). It also may be used as a primary treatment for women with more advanced cases of breast cancer to reduce the size of the tumor for more convenient surgical removal. In these cases high doses of chemotherapy kill cancer cells, but also kill stem cells, blood-producing cells in the bone marrow (Spatt).

Some women in sophisticated stages of breast cancer may undergo chemotherapy followed by a bone-marrow transplant to restore healthy stem cells, although it is not clear whether the method helps prolongs a woman's survival. Long term physical therapy might have to come in later after chemotherapy is done; as well as not the cheapest procedure to conduct. Hormone therapy exploits some of the chemicals the body naturally produces. Example; some breast cancer cells thrive on the hormone estrogen, which is produced in the ovaries. Hormone therapy slows the growth of cells by preventing them form using estrogen (Grayson).

One of the drugs engaged in hormone therapy is tamoxifen, which can prevent breast cancer in women who carry a mutation of the brca 2 gene, which produces tumors that require estrogen to grow. Tamoxifen does not how ever reduce the risk in women who carry the BRCA 1 gene, which produces tumors not affected by estrogen. Tamoxifen my also prevent new cancers from forming in the other breast. Tamoxifen's chemical cousin, raloxifene, has shown similar results in preliminary studies (Grayson). The most radical forms of hormone therapy are the removal of the ovaries by surgery or the virtual destruction of the ovaries by radiation treatments to prevent these organs from secreting estrogen. While tamoxifen blocks estrogen from being used by breast cancer cells to stimulate further growth, other types of drugs under investigation reduce the amount of estrogen available in the body of postmenopausal women.

As menopause the ovaries cease to produce estrogen, but estrogen production continues in other tissues, including breast tissue (Andrew). Another drug recently approved for treating breast cancer is monoclonal antibody called transuzumab, marketed under the brand name Herceptin. This drug targets cells that overproduce HER-2, a protein implicated in about one-third of all breast cancer cases. Herceptin suppresses rapid tumor growth, enhancing the effectiveness of chemotherapy (Andrew). Women with family history of breast cancer may choose to undergo genetic testing to determine if they carry mutated forms of the BRCA 1 or BRCA 2 genes. There is no way to know for sure if a women who carries these genes will develop breast cancer, but some statistics show that about 50 to 60 percent of women with these genes will develop breast cancer by the age of 70 (Grayson).

With being put through hormone therapy there are also risk factors of still getting breast cancer after being highly medicated. The medications are also something that have to be taken for long periods of time and are costly. Radiation therapy is a form of cancer treatment that uses high levels of radiation to kill cancer cells or keep them form growing and dividing back while minimizing damage to healthy cells. Radiation is delivered to the affected breast and in some cases, to them lymph nodes under the arm or at the collarbone. The therapy is usually given after a lumpectomy and sometimes after a mastectomy to reduce the risk of local recurrence of cancer in that breast (Spatt). The treatments generally start several weeks after surgery so the area has some time to heal.

Once therapy treatments start, there are expected to receive small daily does of radiation over a period of several days to several weeks. Small marks resembling freckles will be tattooed on the skin along the treatment area by the radiation therapist. These marks provide a permanent outline of the treated area (Vahdat). Side affect might include skin changes; redness, swollen ness, warm and sensitive, as if you had a sunburn there. These are common, but there are long term side effects such as slight darkening of the skin, enlargement of the pores on the breast, increased or decreased sensitivity of the skin, a thinking of breast tissue or skin and a change in breast size (Vahdat).

Radiation is one of the most costly procedures done. Having the longest time frame for recovery and most side effects given. Treatments of breast cancer are determined on a woman's age and health as well as the type of cancer, extent of the tumor, and location of the tumor. If the cancer has remained in the breast or has spread to other parts of the body will also be brought in to consideration.

Treatment may include surgery, chemotherapy, hormone therapy, radiation or a combination of treatments. These are in order of which one is less costly and less physical pain given to the most. But there is no price or level of pain a woman wouldn't go through to make sure that the disease is gone. Work cited Andrew, Joe.

MD. Understanding breast cancer. 9/11/03 Grayson, Charlotte E. MD.

How do you get breast cancer and what to do about it? The Cleveland Clinic. 9/13/03. Spatt, Karen. Ph.

D. Breast cancer. 9/12/03 Vahdat, Linda T. MD.

Is breast cancer in your genes? New York Presbyterian Medical Center. 9/11/03.