乳腺癌-Breast Cancer

Radiotherapy
Radiotherapy is a treatment which uses high energy beams of radiation which are focussed on cancerous tissue. This kills cancer cells, or stops cancer cells from multiplying. (There is a separate leaflet which gives more details about radiotherapy.)

For breast cancer, radiotherapy is mainly used in addition to surgery. For example, if you have breast-conserving surgery it is usual to have radiotherapy to the affected breast after the operation. This aims to prevent breast cancer returning in the same breast. When radiotherapy is used in addition to surgery it is called 'adjuvant radiotherapy'.

Chemotherapy
Chemotherapy is a treatment of cancer by using anti-cancer drugs which kill cancer cells, or stop them from multiplying. See separate leaflet called chemotherapy for more details.

When chemotherapy is used in addition to surgery it is known as 'adjuvant chemotherapy'. For example, following surgery you may be given a course of chemotherapy. This aims to kill any cancer cells which may have spread from the main tumour site. Chemotherapy is sometimes given before surgery to shrink a tumour so that surgery may have a better chance of success. Chemotherapy may be used to treat breast cancer which has spread to other areas of the body.

Hormone treatments
Some types of breast cancer are affected by the 'female' hormone oestrogen (and sometimes progestogen). These hormones stimulate the cancer cells to divide and multiply. Most oestrogen and progestogen is made by the ovaries. Treatments which reduce the level of these hormones, or prevent them from working, are commonly used in people with breast cancer. This hormone treatment works best in women with 'hormone responsive' breast cancer, but they sometimes work in cancers classed as non-hormone responsive. Hormone treatments include:

• Oestrogen blockers. Tamoxifen has been available for many years and is widely used. It works by blocking the oestrogen from working on cells. It is usually taken for five years. It is most commonly prescribed to women who have had an operation to remove a breast tumour. A newer drug called Toremifene has a similar action to tamoxifen
• Drugs which stop you from making oestrogen. There are a number of drugs which work by stopping the body from making oestrogen (or progestogen). Even women past the menopause make some oestrogen and can benefit from this type of treatment.
• An alternative which may be considered for women before the menopause is to remove the ovaries (or to destroy them with radiotherapy). This stops oestrogen from being made.

In summary
The treatment plan can vary greatly from case to case and depends on many different factors.

What is the prognosis (outlook)?

The outlook is best in those who are diagnosed when the cancer is still small, and has not spread. Surgical removal of a tumour in an early stage may then give a good chance of cure. The outlook has improved in recent years because of the routine mammography offered to women between the ages of 50 and 70. More breast cancers are being diagnosed and treated at an early stage.

In general, the more advanced the cancer (the more it has spread) then the less chance that treatment will be curative. Factors which influence the outlook include whether the cancer is hormone responsive, and the grade of the cancer cells.

The treatment of cancer is a developing area of medicine. New treatments continue to be developed and the information on outlook above is very general. The specialist who knows your case can give more accurate information about your particular outlook, and how well your type and stage of cancer is likely to respond to treatment.

Screening for breast cancer

Women in the UK aged between 50 and 70 are invited to have a routine mammography every three years. Mammography is a special x-ray test and aims to detect breast cancer at an early stage when treatment is most likely to be curative.

Genetic testing and mammography screening (and preventative treatments in some cases) may also be offered to younger women with a strong family history of breast cancer. See your doctor if you feel this applies to you.

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