Breast cancer

All that you need to know about breast cancer treatment

Breast cancer is a malignant type of tumor that develops within the breast. This type of cancer is the most common cancer in women. Although this disease still causes many deaths each year worldwide, its mortality rate has been constantly decreasing since the 1990s. Indeed, several parameters make most breast cancer treatments effective nowadays. These are: the early detection of the breast tumor, the performance of regular mammograms and the improvement of research and analysis such as sentinel lymph node biopsy.

Breast cancer types

According to the French National Cancer Institute, 95% of breast cancers are adenocarcinoma of the breast. This type of pathology develops from the epithelial cells of the mammary gland. There are several types of breast cancer, depending on their location, their stage, etc.

Adenocarcinoma of the breast

Adenocarcinoma are the most common type of breast cancers. Tumors develop from the epithelial cells of the mammary glands. Adenocarcinoma are classified into two subcategories: 

Adenocarcinoma in-situ

Ductal carcinomas in situ is a type of breast cancer in which cancerous cells develop inside the ducts or globules without infiltrating the surrounding tissues. According to the French National Cancer Institute, adenocarcinoma in-situ account for 8 to 9 out of 10 cancers.

Invasive adenocarcinoma

Unlike ductal carcinomas in situ, infiltrating adenocarcinoma can result in a spread of tumor cells to other organs, and to the axillary lymph nodes. This is called metastatic breast cancer.

Triple negative breast cancer

In fact, most triple negative breast cancers are invasive ductal carcinomas. However, it is possible in some cases that an adenocarcinoma in situ is also triple negative. Triple negative breast cancer is characterized by the absence of hormone receptors or the HER2 protein within the cancerous cells. Due to the absence of these specific receptors, triple negative cancers do not respond to hormone therapy or targeted therapy treatments.

Inflammatory breast cancer

Unlike adenocarcinomas, inflammatory breast cancers affect skin tissue.

The various treatments of breast cancer

Several treatments allow a good management of breast cancers. Their indication depends on the characteristics of the tumor. They can be used alone or in combination with other treatments.

Radiation therapy

External radiotherapy is the most indicated type of radiotherapy to treat breast cancers. This treatment consists in the use of radiation to destroy cancer cells and stop their multiplication. The main advantage of this technique is that the rays that are directed towards the area to treat preserve tissues as well as the surrounding organs.

Chemotherapy

Chemotherapy is a medical treatment administered by injections in most cases. Chemotherapy is mainly offered to women who are at risk of recurrent breast cancer. Chemotherapy using drugs slows the growth of cancer cells. It is hence the most popular treatment in the context of advanced breast cancer. 

People often think that the adverse effects of chemotherapy are systematic. This is not the case, as it can happen that patients don’t feel them. 

The most common side effects in women are:

  • Hair loss
  • Nausea and vomiting
  • Oral lesions
  • Sore muscles

Hormone therapy

Hormone therapy is a type of breast cancer treatment that aims to change the levels of certain hormones to slow the spread of cancer cells. This treatment is indicated only when breast cancer hormone receptors can respond. Hormone therapy is offered to the patients in order to limit the risk of cancer cells spreading. It is also used to reduce the size of a tumor before surgery, to treat recurrent breast cancer or even to lower the risk of recurrence.

Targeted therapies

There are different targeted therapies. These drugs are used to target some characteristics of cancer cells. Targeted therapy is thus suitable for HER2 breast cancers.

Surgery

Surgery is performed in order to remove the tissue affected by cancer cells. Surgery is usually performed before the administration of other treatments, however in some cases, it may be performed prior to chemotherapy or hormone therapy. Indeed, this is done to reduce the size of the tumor in order to maximize the efficiency of the operation. 

There are three types of surgery: lumpectomy or breast-conserving surgery, which involves removing only the tumor. Mastectomy is the third type of surgery. It involves removing the entire breast. 

The risk of breast cancer recurrence

A clinical examination associated with anatomopathological analyzes of the breast tissues make it possible to identify the risks of recurrence. The main factors of risk include the following:

  • The initial size of the tumor
  • The patient's age
  • The type of cancer and its stage
  • The presence or the absence of hormone receptors
  •  HER2 protein status
  •  Obesity or overweight

When the cancerous cells reach the lymph nodes, the risk of recurrence is higher.

Breast reconstruction

After a mastectomy or a conservative surgery, breast reconstruction may be considered. Depending on the patient and the type of mastectomy that was performed, the breast reconstruction can be performed immediately, or it can be delayed. There are two methods for performing reconstructive surgery.

Breast reconstruction with implants

This technique lies on the insertion of a breast implant to give the breast a natural shape. This type of reconstructive surgery is the most common in France. It can be carried out after a mastectomy, without any time limit.

Breast reconstruction with flap surgery

With flap reconstruction, the volume of the breast is restored using tissue taken directly from the patient. The intervention is more complex than breast reconstruction with implants, but it offers more natural results. Today, thanks to innovative tools such as FLUOBEAM®, it is possible to assess the quality of tissue perfusion in real time. This technique, based on fluorescence imaging, limits the risk of necrosis or postoperative complications.
To remember

A yearly breast screening  from the age of 25 can detect cancer at an early stage. Mammograms are also an effective means of screening for women aged 50 and above.