Breast Cancer Treatment

Breast cancer usually affects the cells of the ducts or the cells of the lobules and in some cases the other tissues of the breast.

Among the known causes or factors that may increase the risk are the the inherited gene mutations and the family history of breast cancer. The first step is to check the medical records, endeavour a physical exam and history of the patient's health. A physician expert will carry out a breast exam.

Additionnal or complementary exams are a Breast MRI, an ultrasound exam, a blood exam, biopsies.

As the awareness of Breast Cancer matters, we recommend that you use one of the main Breast Cancer Awareness Techniques.

Should you need more information, please refer to the Breast Cancer dedicated page.

What Are the Traditional Treatment Methods We Already Know?

There are many methods of treating breast cancer. As in all cancers, breast cancer can also be treated using traditional methods of treatment such as surgery, radiotherapy, and chemotherapy. But, additionally, hormonal therapy is also used as the main method of treatment in breast cancer.

The method of surgical approach, the extent of surgical removal of breast tissues and surrounding tissues and the methods of breast reconstruction approach, depend on the severity and the type of the breast cancer. Also, the dose of radiation and chemotherapy, the source of radiation and the medication used in chemotherapy is determined according to the condition. 

During hormone therapy (one category of treatment apart from usual ones), the doctors usually check for the hormone sensitivity of the tumor. According to the results of investigations, the tumors will be classified as;

  • Estrogen receptor positive breast cancer
  • Progesterone receptor positive breast cancer

Using hormonal therapy will reduce the size of the malignant tumor and its spread. Even though some oncologists use invasive methods such as surgical removal of ovaries as a part of hormonal treatment, there are also medications that could block, deactivate or destruct the hormone sensitive receptors of the tumor;

  • Selective estrogen receptor modulators (SERM)
    • These medications block estrogen from attaching to its receptors in the tumor cells and thereby slow its growth and kill its cells. The drugs that belong to this category are; Tamoxifen, Toremifene (Fareston), raloxifene (Evista).
  • Aromatase inhibitors
    • These are postmenopausal medications, which block the production of estrogen after the menopause by blocking the enzyme that converts androgens to estrogens. It includes exemestane (Aromasin), anastrozole (Arimidex) and Letrozole (Femara).
  • Fulvestrant (faslodex)
    • This is a medication that is used in postmenopausal women and it blocks the estrogen receptors on the tumor cells and signals the cells to destroy them. 

Biological Therapy (Targeted Therapy Second Category) – New Developments of Breast Cancer Management Medications

Biological therapy includes targeted and specific drugs instead of general drugs that were earlier used. With these medications, the treatment has shown to be more effective and the generalized damage to the healthy cells and tissues is minimized. The drugs that used in targeted therapy are;

  • Trastuzumab (Herceptin)

    • This medication blocks the human epidermal growth factor receptor 2 (HER2) and thereby reduce the growth and cause the cells to die.
  • Pertuzumab (Perjeta)

    • This is used in metastatic breast cancer together with Trastuzumab to accompany chemotherapy. It is used in women who have not received any other drug treatments earlier.
  • Ado-trastuzumab (Kadcyla)

    • This is a combination of drugs which includes Trastuzumab together with a cell-killing drug. Trastuzumab finds the cancer cells and then the cell-killing drug is released to kill them. This is a good option for women with breast cancer metastasis.
  • Lapatinib (Tykerb)

    • This is also a drug associated with the HER2 receptor and is used in advanced cancer together with chemotherapy or hormone therapy.
  • Palbociclib (Ibrance)

    • Palbociclib is used together with aromatase inhibitors with hormone receptor-positive breast cancer.
  • Everolimus (Afinitor)

    • It's used in in women with advanced breast cancer in combination with exemestane, which is an aromatase inhibitor. 

What Are the Other Medications That Are Under Research, to Be Used for Prevention and Treatment of Breast Cancer? 

While researchers still continue to look for medications that prevent breast cancer in women who are at a high risk, there are some medications such as Tamoxifen and Raloxifene that have been already approved to be used to treat and prevent breast cancer.

Also, there are many ongoing clinical studies trying to find out unintended breast cancer reduction of already known drugs.

Fenretinide – A vitamin A derivative. In a small clinical study, it showed to reduce the risk of breast cancer as effectively as tamoxifen.

Statins (Atorvastatin, Lovastatin) – These drugs are usually used to reduce high cholesterol levels, but, the researchers believe they might be effective in treating and preventing breast cancer.

Certain dietary supplements such as grape seed extract, folate, omega 3, vitamin B6 and B12, hydroxytyrosol and curcumin are also under investigations.

Poly ADP-ribose polymerase (PARP) inhibitors are still being studied. When they were used in certain clinical trials to see if they can be used in the treatment of breast cancer, certain types of breast cancers showed promising results. It was shown that this drug is useful in treating breast cancer caused by BRCA gene mutations. But, more studies and clinical trials need to be conducted further before their actions are completely understood.

The next on the list is anti-angiogenesis drugs. Angiogenesis is a process where new small blood vessels and connections are grown. In cancer tumors, the blood supply is a very important part as these growing tumors grow new vessels around them to nourish them so that they may grow well. If the blood supply of a tumor is disturbed the tumor growth and spread can be controlled. Anyhow, bevacizumab (Avastin), an anti-angiogenesis drug was under clinical studies and did not show promising results, anti- angiogenesis drugs are still considered to be an effective approach in breast cancer management. Therefore, several other drugs are being tested in clinical trials.

Bisphosphonates are medications that are usually used to treat osteoporosis but are now under clinical trials to see its affectivity in treating breast cancer. Certain drugs such as pamidronate (Aredia) and zoledronic acid (Zometa) are used to strengthen the bones that are affected by metastatic cancer lesions. Also, another clinical trial showed that zoledronic strengthens the effects of hormone therapy and chemotherapy. The patients who received zoledronic together with chemotherapy showed a greater tumor size reduction than the patients who received only chemotherapy. Also, it was shown that combining zoledronic together with chemotherapy or radiotherapy reduces the risk of cancer coming back.

Denosumab (Xgeva) is also used to strengthen the bones that are affected by metastatic cancer lesions.

Abraxane is an Albumin-Bound Nanoparticle Drugs and is known as nanoparticle albumin–bound paclitaxel.  It was released recently as a new chemotherapy drug for breast cancer. This is actually not a new drug, but a new version of administering an old drug. When Abraxane is administered as a chemotherapy drug, there is no need of giving any premedication and thereby, the related side effects can be ignored. Also, this drug reduces the infusion time of the chemotherapeutic drug.

Herceptin (trastuzumab) was lately approved for the treatment of early-stage of breast cancer that is HER2 positive. According to a study released last June more than half of women who received Herceptin as a part of chemotherapy during presurgical interventions had their tumors completely disappeared? The results were so promising that the researchers stopped the trial early and are now in use for breast cancer treatment.

Also, a study conducted by the cancer research institute in London showed that the combination of trastuzumab (Herceptin) and lapatinib (Tyverb) significantly obliterated all the signs of breast cancer in 11% of people within 11 days. The patients who received this drug combo did not need any chemotherapy as well. 

What Are the New Surgical Interventions Developed in Treating Breast Cancer?

There are various types of surgical interventions available including breast-conserving surgery, mastectomy, and oncoplastic surgery. The option of breast conserving surgery can be for women with early stages of breast cancer, but it can cause disproportionate breast size and shape. The larger size tumors obviously need a radical approach with mastectomy. On the other hand, there are doctors who conjoin cancer surgery with plastic surgery and perform necessary reconstruction during the initial surgery. If needed, further surgery to modify the other breast in order to match with the operated breast.

What Is Virotherapy and How It Can Be Used in Breast Cancer?

Virotherapy is one of the newest fields of medicine which use the viruses as a method of killing the cells of cancer tumors. Therefore the viruses are known as oncolytic viruses and these viruses eliminate cancer cells by invading into malignant tumors. Most viruses that we know show a high tropism for cancer cells. Therefore, the scientists thought that they can be used in treating cancers. As these viruses invade normal body cells and cause damage, the same theory was used by the scientists and they made oncolytic viruses out of those viruses we already know. After many studies, they found out that their theory was practically implementable and these special viruses killed cancer cells very effectively.

At the moment Oncolytic virotherapy is carried out using only one approved medication known as “Rigvir” and it is a genetically non-modified collection of viruses.

There are many more clinical studies that have not been published yet and also many more pending clinical trials. Anyhow, what we already have discovered is precious when it comes to successful detections and treatment. In the last few years, some drugs that are mentioned above increased the motivation and strengthened the hope of finding a cure for breast cancer. Even though we are not yet there, we should realize that we have come a long way and the zeal is not so far! 

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