TREATING PRIMARY BREAST CANCER

Questions might include why a certain treatment is recommended, possible side effects, treatment duration, impact on daily life and fertility, and prognosis.

Primary breast cancer is breast cancer that has not spread beyond the breast or the lymph nodes (glands) under the arm.

The aims are to remove all the cancer in the breast and any affected lymph nodes (local control) and to destroy any cancer cells that may have already spread, reducing the risk of recurrence elsewhere (systemic treatment).

Local control refers to removing cancer from the breast and lymph nodes using surgery and radiotherapy, while systemic treatment (chemotherapy, hormone therapy, targeted therapy) is to destroy cancer cells that may have spread in the body.

Factors include the size and location of the tumor, type and grade of cancer, spread to lymph nodes, presence in lymph/blood vessels, oestrogen receptor status, HER2 status, and overall health and age.

The team may include a breast care nurse, chemotherapy nurse, clinical and medical oncologists, pathologist, radiologist, research nurse, surgeon, therapeutic radiographer, and may include other specialists like geneticists or psychologists.

The two main types are breast-conserving surgery (lumpectomy) and mastectomy (removal of all breast tissue, including the nipple area).

It involves removing the cancer with a border of normal, healthy tissue, aiming to keep as much of the breast as possible.

A mastectomy is removal of all breast tissue including the skin and nipple area. It may be recommended when the cancer takes up a large area, there are multiple areas of cancer, or with certain types like inflammatory breast cancer.

Before surgery, an ultrasound scan of the underarm is done. If it appears abnormal, a fine needle aspiration (FNA) or core biopsy is performed to check for cancer spread.

It's a procedure to identify and remove the first lymph node(s) likely to be affected by cancer for examination. If clear of cancer, no further nodes need to be removed.

Options may include further surgery to remove more lymph nodes, radiotherapy to the underarm, or no further treatment to the underarm if other therapies are being used.

Breast reconstruction is the creation of a new breast shape after surgery. It can be immediate (at the same time as cancer surgery) or delayed (months or years later).

Chemotherapy uses anti-cancer drugs to destroy cancer cells and reduce recurrence risk. It can be given before surgery (to shrink tumors) or after (to kill remaining cancer cells).

Radiotherapy uses high-energy x-rays to destroy cancer cells left after surgery. It's usually given after surgery and possibly after chemotherapy.

Hormone therapy blocks or stops oestrogen's effects on cancer cells and is only prescribed for oestrogen receptor-positive (ER+) breast cancers.

Targeted therapies are drugs that block specific cell processes, mainly used for HER2 positive breast cancer.

Bisphosphonates are drugs that can reduce the risk of breast cancer spreading in postmenopausal women and can help prevent bone damage.

Support includes emotional wellbeing resources, dietary and exercise advice, complementary therapies, work and financial guidance, and access to breast care nurses.

After hospital treatment, patients are monitored according to their needs. Contact information is provided for ongoing questions or concerns. Support resources are also available, such as Moving Forward courses and the Becca app.

Yes, patients may be invited to join clinical trials testing new treatments. Participation is voluntary and informed consent is required.

Questions might include why a certain treatment is recommended, possible side effects, treatment duration, impact on daily life and fertility, and prognosis.

Primary breast cancer is breast cancer that has not spread beyond the breast or the lymph nodes (glands) under the arm.