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HealthInfo Canterbury

How is breast cancer treated?

If you're diagnosed with breast cancer you'll be treated with some combination of surgery, chemotherapy, and radiation therapy. The exact combination you have will depend on the type of cancer you have and the stage you're at – you'll be involved in making this decision.

Surgery

mammography resultSurgery may involve just removing the cancer itself and leaving the rest of your breast alone. This is called a lumpectomy, wide local excision, or breast conserving surgery. Not all women can have a lumpectomy, but if it's suitable for you it can reduce the impact on your body shape, or the need for any further surgery.

You may need to have your entire breast removed – this is called a mastectomy. Some larger-breasted women can have the cancer removed and their breasts reduced in size at the same time (this is a therapeutic mammoplasty). Talk to your surgeon about whether this is an option for you.

Invasive breast cancer can spread to the lymph nodes under the armpit on the same side as the cancer. Because of this, some women need to have these nodes removed.

The lymph nodes can be checked using diagnostic breast imaging. This may not find any suspicious lymph nodes. But you may still have a further procedure called a sentinel node biopsy to sample your lymph nodes.

If the diagnostic breast imaging finds suspicious lymph nodes, you'll have an ultrasound-guided fine needle test before surgery.

If your lymph nodes contain cancer cells, your doctors will recommend axillary node dissection. In this procedure, your surgeon removes at least 70% of the lymph nodes under your armpit. This is done during your mastectomy or lumpectomy surgery.

After a mastectomy, some women can have breast reconstruction. This depends on the type of cancer and the need for any further treatment such as radiotherapy. It also depends on factors such as your age, smoking history and body weight, and whether you have severe diabetes.

If breast reconstruction is an option for you, you might have a reconstruction at the same time as your mastectomy. This is called an immediate reconstruction. Or you might have to wait until you've finished your breast cancer treatment. This is called a delayed reconstruction.

Talk to your surgeon about whether any of these options are suitable for you

Chemotherapy and radiotherapy

Your treatment team will include an oncologist (on-kol-o-gist), a doctor who specialises in treating cancer. Your oncologist will help to decide what other treatment your cancer needs. This often includes chemotherapy, which involves medicine being given through one of your veins (intravenously) over several weeks. Some women have chemotherapy before surgery to reduce the size of the growth, which can give them better options for surgery. This is called neo-adjuvant chemotherapy.

You may also be offered radiation treatment, especially if you've had a lumpectomy. If your cancer is receptor positive you may also be offered continuing medication to help treat it and reduce the chance of it coming back.

If you have a prosthetic breast rather than breast reconstruction, you can get a subsidy to help you pay for it.

On the next page: What support is available?

Written by HealthInfo clinical advisers. Endorsed by oncoplastic breast and general surgeon, Canterbury DHB. Page created May 2018.

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Review key: HIBCA-57360