For tumour removal, there are also a number of alternatives:
With standard, widely recommended external beam radiation, a technician focuses two opposing beams of high-energy X-rays on the breast, angling them away from vital organs. The procedure is done five days a week, for about five weeks. Additional, even more focused, radiation is often given for another one to two weeks.
If you've had a lumpectomy for a small, early tumour and are postmenopausal, you may be a candidate for a promising new radiation approach called internal radiation therapy, or brachy-therapy. In this procedure, radioactive 'seeds' (the size of rice grains) are implanted directly into the site of the excised tumour, where cancer is most likely to recur. You only need twice a day treatments for four or five days, and side effects appear to be mild. Much about this new technique remains unknown, but early results indicate that for some women brachytherapy is as effective as standard radiation at preventing the recurrence of breast cancer.
The latest findings also show the combining radiation with breast-conserving surgery for stage 1 or 2 breast cancer offers the same odds for long-term survival as a mastectomy. But without the postsurgery radiation, the risk of a recurrence at or near the original tumour site is much higher. For this reason, if your're slated for a mastecomy, your doctor is likely to recommend radiotherapy, particularly if your tumour is large or many lymph nodes (usually four or more) are involved. Not so clear is whether radiation will benefit you if fewer (one to three) lymph nodes are involved.
TREATING DCIS
Ductal carcinoma in situ (DCIS) means that the cells lining the milk ducts have become cancer cells.
However, they are confined to the milk ducts and haven't travelled any further. Most commonly this condition is picked up by a routine mammogram as there are rarely symptoms. And they may never develop into an actual tumour. Over time, however, untreated DCIS lesions often do invade the milk duct wall, posing a risk they'll enter a blood vessel and spread elsewhere.
There's no set way to handle a DCIS. After the lesion is removed, some women opt to simply get frequent screenings. Others choose tamoxifen or similar drugs. Many get radiation treatment and still others get a mastectomy. In deciding what to do, considerations will include your age and the DCI''s size, grade and growth pattern.
OPTIONS FOR BREAST CANCER TUMOUR REMOVAL
During a lumpectomy(1), the tumour is removed along with a margin fo surrounding normal tissue (pink area). New minimalist surgical techniques involve taking out far less fat and surrounding tissue than was done, reducing the risk of dented and otherwise misshapen breasts. Also breast-conserving is a partial mastecomy
(2), in which slightly more surrounding tissue is taken out. Sometimes women with ductal carcinoma in situ (DCIS) undergo total mastectomy (3), Here all the breast tissue is removed, but underlying muscles and axilary nodes are left intact, along with enough skin to optimise reconstruction options. More complete is a modified radical mastectomy(4), in which all breast tissue, chest muscle lining and selected nodes are removed.
- If your tumour is stage 1 or 2, your surgeon should be able to remove the cancer completely, keeping your breast largely intact. Procedures called a lumpectomay or a partial partial mastecomy are used. You'll then need six or seven weeks of radiation to the breast to destroy any leftover cancer cells. Thousands of women now choose one of these breast-conserving approaches. The latest major research trials indicate your chance for long-term survival is the same with a lumpectomy as with radical or even a partial mastectomy.
- If your tumour is stage 3 or at an early stage, but you have small breasts, you may be better off having the entire breast removed with a procedure called a mastectomy. There are several variations. Most women have an operation called a modified radical mastecomy, which removes breast tissue, chest muscle lining and axillary nodes. Only if the cancer has spread to muscles in the chest will a surgeon recommend a radical mastectomy, in which the breast, nodes and muscles beneath the breast are removed. Sometimes presurgery chemotherapy shrinks a tumour sufficiently to make lumpectomy a possibility.
With standard, widely recommended external beam radiation, a technician focuses two opposing beams of high-energy X-rays on the breast, angling them away from vital organs. The procedure is done five days a week, for about five weeks. Additional, even more focused, radiation is often given for another one to two weeks.
If you've had a lumpectomy for a small, early tumour and are postmenopausal, you may be a candidate for a promising new radiation approach called internal radiation therapy, or brachy-therapy. In this procedure, radioactive 'seeds' (the size of rice grains) are implanted directly into the site of the excised tumour, where cancer is most likely to recur. You only need twice a day treatments for four or five days, and side effects appear to be mild. Much about this new technique remains unknown, but early results indicate that for some women brachytherapy is as effective as standard radiation at preventing the recurrence of breast cancer.
The latest findings also show the combining radiation with breast-conserving surgery for stage 1 or 2 breast cancer offers the same odds for long-term survival as a mastectomy. But without the postsurgery radiation, the risk of a recurrence at or near the original tumour site is much higher. For this reason, if your're slated for a mastecomy, your doctor is likely to recommend radiotherapy, particularly if your tumour is large or many lymph nodes (usually four or more) are involved. Not so clear is whether radiation will benefit you if fewer (one to three) lymph nodes are involved.
TREATING DCIS
Ductal carcinoma in situ (DCIS) means that the cells lining the milk ducts have become cancer cells.
However, they are confined to the milk ducts and haven't travelled any further. Most commonly this condition is picked up by a routine mammogram as there are rarely symptoms. And they may never develop into an actual tumour. Over time, however, untreated DCIS lesions often do invade the milk duct wall, posing a risk they'll enter a blood vessel and spread elsewhere.
There's no set way to handle a DCIS. After the lesion is removed, some women opt to simply get frequent screenings. Others choose tamoxifen or similar drugs. Many get radiation treatment and still others get a mastectomy. In deciding what to do, considerations will include your age and the DCI''s size, grade and growth pattern.
OPTIONS FOR BREAST CANCER TUMOUR REMOVAL
During a lumpectomy(1), the tumour is removed along with a margin fo surrounding normal tissue (pink area). New minimalist surgical techniques involve taking out far less fat and surrounding tissue than was done, reducing the risk of dented and otherwise misshapen breasts. Also breast-conserving is a partial mastecomy
(2), in which slightly more surrounding tissue is taken out. Sometimes women with ductal carcinoma in situ (DCIS) undergo total mastectomy (3), Here all the breast tissue is removed, but underlying muscles and axilary nodes are left intact, along with enough skin to optimise reconstruction options. More complete is a modified radical mastectomy(4), in which all breast tissue, chest muscle lining and selected nodes are removed.
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