By Kelly Jad'on

A breast cancer diagnosis means making choices in the treatment of the disease. Each year, hundreds of women are diagnosed with breast cancer. "In 2009, an estimated 192,370 new cases of invasive breast cancer will be diagnosed among women in the United States." The American Cancer Society reports that outside of skin cancer, breast cancer is the most common among women – 1 in 4 cancers diagnosed is breast cancer. Of these malignancies, most are also invasive, spreading into the tissue around the breast.

Depending upon the stage and type of cancer, treatment decisions are best made jointly by the patient and her physician. Together they consider optimal treatment for the stage and biological characteristics of the cancer, with regard to the patient’s age and preferences, but also taking into account potential risks and benefits.

Factors necessary to consider when weighing treatment options:

• Type of breast cancer
• Size of the tumor
• Grade of the tumor
• Involvement of lymph nodes
• Localized or has spread?
• Estrogen/progesterone receptor status and HER-2-Neu status

Unless you’re a woman in New England, where there are higher rates of lumpectomy and radiation therapy, most women will have a mastectomy. Kenneth D. Miller, M.D., a practicing medical oncologist and assistant professor of medicine and oncology at the Yale Cancer Center, and the editor of Choices In Breast Cancer Treatment, writes that having to make treatment choices involving surgery and chemotherapy is quite shocking. He adds that "although about 80 percent of women are now considered good candidates for lumpectomy followed by radiation, many of these women opt for mastectomy instead, feeling that the mastectomy surgery gives them a greater sense of security.”

Given prior to surgery, systemic therapy, (also known as neoadjuvant therapy,) whether biologic, chemo, or hormone therapies, are used to shrink a tumor and make surgery possible.

Adjuvant therapies are those applied after surgery for breast cancer and include hormonal therapy and chemotherapy. Contributor to Choices in Breast Cancer Treatment, Lillie Shockney R.N., suggests that women who opt out of chemotherapy are natural “risk-takers.” There is a 2-5% increase in survival rate for those who undergo adjuvant treatment.

Chemotherapy side effects are more well known in the general population than they used to be: metallic taste in the mouth, hair loss, sick feeling, burning skin, stomach troubles, and mouth sores. The benefits, according to many firsthand survivor accounts, are certainly worthwhile--seeing your children grow up and spending more time with your spouse, for example.

Hormonal therapy may utilize Tamoxifen, which is especially favored by doctors for women who are pre- or postmenopausal and who have “tumors that are positive for estrogen or progesterone receptors.” Side effects include hot flashes, nausea, and vaginal dryness.

Radiation is used both prior to surgery to shrink a tumor, or afterward to destroy any remaining cancer cells. The procedure may by external, or internal—as brachytherapy—using a radioactive substance within a needle, seed, or wire, placed in or near the cancer.

What's on the horizon in breast cancer treatment?

Understanding how the genes of cancer cells work. (Sloan-Kettering's study: Researchers Find Genetic Key to Breast Cancer's Ability to Survive and Spread--Published in Cancer Cell/ Jul 2009) The study found that therapies which target latent breast cancer cells before they spread should be supported. This lack previous lack of understanding is what has accounted for the "majority" of breast cancer deaths. Though breast cancer death rates have decreased since 1990, due to raised awareness on the part of women, it is estimated that approximately 40,610 women will die from breast cancer in the United States in 2009.

5 Stars

Choices in Breast Cancer Treatment: Medical Specialists and Cancer Survivors Yell You What You Need to Know (Johns Hopkins Press/ Jan 2008) Edited by Kenneth D. Miller, M.D.

Christina Applegate: Her Personal Decision

Copyright © 2006-2009, Basil & Spice. All rights reserved.