Breast Cancer Facts, Myths, and Controversies by Madelon L. Finkel Ph.D

Author:Madelon L. Finkel Ph.D.
Language: eng
Format: epub
Publisher: ABC-CLIO
Published: 2021-08-14T16:00:00+00:00

CHAPTER EIGHT

Breast Cancer Treatment Options: Which Treatments Are the “Best”?

While the diagnosis of breast cancer can be devastating, this disease is not uniformly fatal, and there are some very effective treatment options widely available. Medical research has made, and continues to make, great strides in unlocking the secrets of breast cancer with new techniques for diagnosis, new treatment modalities, and advances in molecular genetics. There are many differences in its etiology and pathology, with some cases characterized by slow growth and other cases being highly aggressive. Breast tumors differ based on the expression of estrogen receptors (ERs), progesterone receptors (PRs), and human epidermal growth factor 2 (HER2) oncogene (i.e., a gene that has the potential to cause cancer). The type of treatment will be dictated by many factors, including patient characteristics, type of breast cancer, and hormone receptor status. The good news is there are so many options to consider. A “one-size-fits-all” approach is a thing of the past.

Cancer Staging

It is important to understand that breast cancer is not one entity. In order to determine the nature of the cancer, a staging system was developed to describe where a cancer is located, the size of the tumor, if or where it has spread, and whether it is affecting other parts of the body. Cancer is typically labeled in stages from I to IV, with IV being the most serious. Staging is an important indicator of the extent of cancer growth and is often crucial for identifying appropriate treatment options. It also helps physicians discern prognosis.

Most cancer staging systems include information about where the tumor is located in the body, the cell type (i.e., adenocarcinoma or squamous cell carcinoma), size of the tumor, whether the cancer has spread to nearby lymph nodes, and whether the cancer has spread to a different part of the body (i.e., metastasized). Although staging of a cancer is important, treatment options are often influenced by other factors such as age, ethnicity, and comorbid conditions. Not every woman with the same staging will receive the same treatment or will have the same prognosis.

Stage 0 indicates that abnormal cells are present, but the cancer is where it started (in situ) and hasn’t spread. This is called carcinoma in situ (CIS). CIS is not cancer, but it could become cancer. Abnormal cells may be present, but they have not spread to nearby tissue. Ductal carcinoma in situ (DCIS) is an example of Stage 0 breast cancer. Overall, the relative five-year survival rate for Stage 0 cancer is 100%.

Stage I refers to a cancer that is small and has not spread. Stage 1 breast cancer is considered early breast cancer, with an overall five-year survival rate of 98%.

Stage II has two parts: Stage IIA refers to a cancerous tumor that has not spread to the lymph nodes. Stage IIB refers to a tumor that has spread to the axillary lymph nodes. Regarding breast cancer, the relative five-year survival rate for Stage IIA is 88% and 76% for Stage IIB.

Stage III also has two parts: Stage IIIA refers to a cancer that has spread to the lymph nodes.

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