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Treatments for Breast Cancer
MEDICAL ANIMATION TRANSCRIPT: Treatment options for breast cancer include surgery, chemotherapy, radiation therapy, hormone therapy, and targeted therapy. There are several surgical options, depending on the severity of the cancer. A lumpectomy removes the tumor and a clear margin of surrounding tissue. This procedure is always followed by radiation therapy treatment to kill unseen cancer cells. Mastectomies involve removing the entire breast. After a mastectomy, a woman has the option to have reconstructive surgery, where a new breast is created using implants or skin flaps. In some cases, the surgeon is able to preserve the nipple. Sentinel lymph node removal is typically performed in addition to lumpectomies and mastectomies if there's is no clinical evidence that cancer has spread to the lymph nodes. Here, your surgeon will remove one or more of the first lymph nodes draining the breast, and check it for the presence of cancer cells. If these nodes are clean, it is not necessary to remove more lymph nodes. However, if cancer has spread to these lymph nodes, a complete axillary lymph node dissection, or removal of most or all of the lymph nodes in the armpit area may be recommended. Chemotherapy is a treatment that uses drugs to stop the growth of cancer cells by either killing them or inhibiting their cell division. Once the drugs enter the bloodstream, they can travel and reach cancer cells throughout the body. Radiation therapy is performed following surgery or in combination with chemotherapy. It uses high energy radiation beams or particles to kill the remaining cancer cells, or keep them from growing. The main types of radiation therapy are external beam radiation, internal radiation, also known as brachytherapy, and intraoperative radiation. In external beam radiation, such as intensity modulated radiation therapy, or IMRT, a machine called a linear accelerator delivers radiation beams from outside of the body to the cancer. It treats the breast from different angles while precisely targeting the tumor. Internal radiation therapy can be used after a lumpectomy or for women with early stage cancer. It treats cancer from inside the breast using hollow applicator tubes with a radiation source passed through them. In intraoperative radiation therapy, radiation is delivered during a breast sparing surgery, such as a lumpectomy, after the tumor is removed. The radiation source may be an external beam that comes from a linear accelerator. Or the radiation may be applied internally by inserting the spherical applicator from a mobile x-ray device into the breast. In either case, the radiation is limited to just the tissue that surrounded the tumor. Most breast cancers are hormone receptor positive, which means they need hormones in order to grow and spread. Hormone therapy works by blocking the cancer cells from receiving the natural hormones that they need. Tests on the tumor show if it has these hormone receptors. Targeted therapy uses specially designed drugs, such as monoclonal antibodies that act on specific molecules inside or outside of cancer cells. Tests on the tumor samples can tell whether they have target molecules for these drugs. For example, Herceptin is an antibody drug that targets and slows the growth of HER2 positive tumors. These tumors have a high amount of HER2 receptors, which are the target molecules for the drug.