Women receive aggressive breast cancer treatment based on their diagnosis and evaluation of biopsy results. It's logical to presume that any diagnosis of breast cancer requires aggressive treatment when presented with a tumor. However, certain types of breast cancers necessitate a more aggressive approach. Those cancers that are fast moving and diagnosed late must be addressed with haste. In addition, the staging of cancer dictates the aggressiveness of treatment.
Neoadjuvant Therapy
Breast cancer can take many forms, including some types that require immediate treatment. Neoadjuvant therapy involves immediate treatment to restrict the growth of the cancer cells and shrink the size of the tumor. This type of therapy differs from the more standard treatment of surgery followed by chemotherapy and radiation. Neoadjuvant therapy includes chemotherapy, radiation therapy or hormone therapies for treatment. All therapies aim to reduce tumor size and halt the spread of cancer cells. Subsequent surgery for tumor removal can result in less tissue loss since the size of the cancer mass is smaller.
Lymph Node Removal
The lymphatic system houses a fluid called lymph. This system exists throughout the body and transports immune cells, cleanses the blood and releases fluid from tissue. Doctors address whether cancer has jumped to the lymph system during surgery. This jump indicates possible cancer cells in more distant parts of the body. Lymph node removal has become an integral part of aggressive breast cancer treatment. The removal and biopsy of lymph nodes allows doctors a very clear picture of the spread of cancer and they then tailor additional therapies based around lymph node findings.
Mastectomy
In the fight against breast cancer, surgeons have a limited number of tools at hand. Doctors routinely strive to remove lumps or tumors with enough surrounding tissue to establish clean margins. Clean margins surround a cancer tumor and indicate the outer limits of the tumor. Mastectomy enters into the picture when doctors cannot surgically remove the cancer for clean margins or when a woman has an aggressive type of cancer such as inflammatory breast cancer or the cancer has metastasized (moved to other parts of the body). Mastectomy involves removal of the breast entirely. Some mastectomies include the removal of lymph nodes as well.
Staging
Doctors assign a number from one to four to indicate the extent and aggressiveness of breast cancer. This staging system provides uniformity when diagnosing and helps doctors evaluate patients as they progress from one type of treatment to another. Staging does indicate aggressiveness of a cancer. Stage I indicates that cancer hasn't spread beyond the breast and the tumor size remains below two centimeters. Stage II could indicate all or parts of stage I with a tumor size up to five centimeters or some spread of cancer to the lymph nodes under the arm. Stage III means that the cancer tumor is larger than 5 centimeters, and has spread to lymph nodes in the breast and under the arm. Stage IV cancer has metastasized (spread) to other parts of the body. In relation to the other stages, Stage IV requires immediate and aggressive chemotherapy, radiation and hormone therapy to address this stage cancer to prevent spread to the bones.
Chemotherapy
Chemotherapy involves administering drugs that target cancer cells. Doctors call chemotherapy systemic treatment because it targets the "system" and any errant cancer cells that may have traveling through the body. Doctors decide appropriate chemotherapy treatment based on tumor grade as well as particular tumor information including whether a tumor responds to a certain hormone. Chemo is given in an IV and is dispensed on a regular schedule. Chemo treatment takes months and is used for all Stage II through IV breast cancers. With aggressive cancers, doctors are looking specifically for results including the reduction of tumor size or disappearance of cancer in the lymph nodes. (Reference 1 and 6)
Radiation
Unlike chemotherapy, radiation targets the tumor directly with concentrated radiation beams. According to the National Cancer Institute, radiation targets cancers to either damage the cells or destroy the cells. Radiation paired with chemotherapy is a powerful tool that doctors use to fight aggressive breast cancers. Radiation can be used to shrink larger tumors before surgery and to target an area where cancer may spread.
Tags: cancer cells, lymph nodes, chemotherapy radiation, tumor size, breast cancer, breast cancers