| Objective of This Article This article summarizes information of breast cancer symptoms, breast cancer staging and treatment from the National Cancer Institute. For details, one must consult with his/her medical doctor or review the information described in NCI's website: http://www.cancer.gov/cancertopics/pdq/treatment/breast/Patient/page1 Breast Cancer Staging Most breast cancer starts in the milk duct, some start in the lobules (milk-producing glands), and the rest starts in other tissues. A tumor can be noninvasive or invasive. A noninvasive breast cancer (carcinoma in situ) is a tumor that has not spread beyond where it began. It can be "ductal carcinoma in situ" (confined to the ducts) or "lobular carcinoma in situ" (confined to the lobules). Lobular carcinoma in situ is not a true cancer, but it may lead to getting cancer later. An invasive tumor has spread beyond where it started, and there are three stages of invasiveness including localized, regional and distant stages. In localized stage, the tumor is confined within the breast. In regional stage, the tumor has spread to the tissue surrounding the breast, e.g. lymph nodes. In distant stage, the tumor has spread away from the breast to other tissues or organs. Breast Cancer Staging The process used to find out whether the cancer has spread within the breast or to other parts of the body is called breast cancer staging. Breast cancer is grouped into 5 stages from 0 to IV, based on the tumor size, nodal status (if lymph nodes are involved) and metastasis (if the tumor has spread). In Stage 0, the cancer cells are confined in the duct or lobule where they started. In Stage I, the tumor is small, about 2 cm or less in diameter. Cancer cells are not in the lymph nodes or outside of the breast. In Stage II, the tumor grows to 2-5 cm (about 1-2 inches). Cancer cells appear in the lymph nodes. Or, the tumor grows bigger than 5 cm wide, but the lymph nodes are still negative. In Stage III, the tumor has grown larger than 5 cm wide, and cancer spreads to lymph nodes. Or, cancer spreads to multiple lymph nodes, chest wall and skin. In Stage IV, the breast cancer is metastatic. The cancer has spread to somewhere in the body. Tests To determine the type of breast cancer, doctor takes a biopsy of the tumor. Knowing the details about the tumor helps the doctor understand how quickly the cancer might grow and what treatments may be best. Typically, doctors want to know patients' hormone receptor status and HER2 status. It has been known that estrogen and progesterone play an important role in the growth of some types of cancers. An estrogen- receptor-positive tumor is called "ER+", and a progesterone-receptor-positive tumor is called "PR+". It has been shown that hormonal therapy is useful for ER+ and PR+ tumors. Similarly, HER2 status also influences the selection of treatments. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process: Chest x-ray, CT scan, Bone scan and PET scan. Breast Cancer Risk Factors The risk factors include female gender, aging, personal history of breast cancer, family history of breast cancer, genetic factors (cancer causing mutations in BRCA1 (BReast CAncer gene 1) and BRCA2 (BReast CAncer gene 2), and hormonal factors (as earlier age at first period, later age at birth of first child, later age at menopause, having no children). Breast Cancer Treatment Once a patient has been diagnosed with breast cancer, surgery is done to remove as many of the cancer cells in the body. The surgery may remove the entire breast (mastectomy) or remove only the tumor and some normal tissue around it (lumpectomy). However, cancer cells are very tiny and hard to be detected. It is possible that some cancer cells are still in the breast, or even in lymph nodes or elsewhere in the body after surgery. Consequently, recurrence may occur. To prevent recurrence, patients are needed to receive adjuvant therapies. Adjuvant treatments typically include chemotherapy, radiation, hormonal therapy and targeted biological therapy. In chemotherapy, a chemical interfering cancer cell communication and growth is supplied to patients. In hormonal therapy, a drug reducing the amount of estrogen in the body or blocking the effect of estrogen is dosed to patients. It has been shown that estrogen causes some tumors to grow. In targeted biologic therapy, monoclonal antibodies are injected into patients' body to recognize a specific protein on certain cells and signal the body's immune system to destroy the cancer cells. Surgical treatment Most patients with breast cancer have surgical treatment to remove the cancer from the breast. Some of the lymph nodes under the arm are usually taken out and looked at under a microscope to see if they contain cancer cells. Breast-conserving surgery, an operation to remove the cancer but not the breast itself, includes the following: * Lumpectomy: Surgery to remove a tumor (lump) and a small amount of normal tissue around it. * Partial mastectomy: Surgery to remove the part of the breast that has cancer and some normal tissue around it. The lining over the chest muscles below the cancer may also be removed. This procedure is also called a segmental mastectomy. Patients who are treated with breast-conserving surgery may also have some of the lymph nodes under the arm removed for biopsy. This procedure is called lymph node dissection. It may be done at the same time as the breast-conserving surgery or after. Lymph node dissection is done through a separate incision. Other types of surgical treatment include the following: * Total mastectomy: Surgical treatment to remove the whole breast that has cancer. This procedure is also called a simple mastectomy. Some of the lymph nodes under the arm may be removed for biopsy at the same time as the breast surgical treatment or after. This is done through a separate incision. * Modified radical mastectomy: Surgical treatment to remove the whole breast that has cancer, many of the lymph nodes under the arm, the lining over the chest muscles, and sometimes, part of the chest wall muscles. * Radical mastectomy: Surgical treatment to remove the breast that has cancer, chest wall muscles under the breast, and all of the lymph nodes under the arm. This procedure is sometimes called a Halsted radical mastectomy. Chemotherapy may be given before surgery to remove the tumor. When given before surgical treatment, chemotherapy will shrink the tumor and reduce the amount of tissue that needs to be removed during surgical treatment. Treatment given before surgery is called neoadjuvant therapy. Sentinel lymph node biopsy followed by a surgical treatment Sentinel lymph node biopsy is the removal of the sentinel lymph node during surgery. The sentinel lymph node is the first lymph node to receive lymphatic drainage from a tumor. It is the first lymph node the cancer is likely to spread to from the tumor. A radioactive substance and/or blue dye is injected near the tumor. The substance or dye flows through the lymph ducts to the lymph nodes. The first lymph node to receive the substance or dye is removed. A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are not found, it may not be necessary to remove more lymph nodes. After the sentinel lymph node biopsy, the surgeon removes the tumor (breast-conserving surgical treatment or mastectomy) Radiation therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. Hormone therapy Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances produced by glands in the body and circulated in the bloodstream. Some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy is used to reduce the production of hormones or block them from working. The hormone estrogen, which makes some breast cancers grow, is made mainly by the ovaries. Treatment to stop the ovaries from making estrogen is called ovarian ablation. Hormone therapy with tamoxifen is often given to patients with early stages of breast cancer and those with metastatic breast cancer (cancer that has spread to other parts of the body). Hormone therapy with tamoxifen or estrogens can act on cells all over the body and may increase the chance of developing endometrial cancer. Women taking tamoxifen should have a pelvic exam every year to look for any signs of cancer. Hormone therapy with an aromatase inhibitor is given to some postmenopausal women who have hormone- dependent breast cancer. Hormone-dependent breast cancer needs the hormone estrogen to grow. Aromatase inhibitors decrease the body's estrogen by blocking an enzyme called aromatase from turning androgen into estrogen. For the treatment of early stage breast cancer, certain aromatase inhibitors may be used as adjuvant therapy instead of tamoxifen or after 2 or more years of tamoxifen. For the treatment of metastatic breast cancer, aromatase inhibitors are being tested in clinical trials to compare them to hormone therapy with tamoxifen. Targeted therapy Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Monoclonal antibodies and tyrosine kinase inhibitors are two types of targeted therapies used in the treatment of breast cancer. PARP inhibitors are a type of targeted therapy being studied for the treatment of triple-negative breast cancer. Monoclonal antibody therapy is a cancer treatment that uses antibodies made in the laboratory, from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells. Monoclonal antibodies may be used in combination with chemotherapy as adjuvant therapy. Trastuzumab (Herceptin) is a monoclonal antibody that blocks the effects of the growth factor protein HER2, which sends growth signals to breast cancer cells. About one-fourth of patients with breast cancer have tumors that may be treated with trastuzumab combined with chemotherapy. Tyrosine kinase inhibitors are targeted therapy drugs that block signals needed for tumors to grow. Tyrosine kinase inhibitors may be used in combination with other anticancer drugs as adjuvant therapy. Lapatinib is a tyrosine kinase inhibitor that blocks the effects of the HER2 protein and other proteins inside tumor cells. It may be used to treat patients with HER2-positive breast cancer that has progressed following treatment with trastuzumab. PARP inhibitors are a type of targeted therapy that block DNA repair and may cause cancer cells to die. PARP inhibitor therapy is being studied for the treatment of triple-negative breast cancer. High-dose chemotherapy with stem cell transplant High-dose chemotherapy with stem cell transplant is a way of giving high doses of chemotherapy and replacing blood -forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body’s blood cells. Studies have shown that high-dose chemotherapy followed by stem cell transplant does not work better than standard chemotherapy in the treatment of breast cancer. Doctors have decided that, for now, high-dose chemotherapy should be tested only in clinical trials. Before taking part in such a trial, women should talk with their doctors about the serious side effects, including death, that may be caused by high-dose chemotherapy. ___________________________________________________________________________________ Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials. Follow-up tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups. SOURCE OF INFORMATION: www.cancer.gov ____________________________________________________________________________________ N.B. Estrogen has long been associated with the initiation and promotion of breast cancer. Inhibiting estrogen synthesis can be effective in the prevention and treatment of the disease. Some studies have shown the potential benefits of butein on cancer prevention. Scientists from Hong Kong Chinese University found that water extracts of dong quai stimulated the growth of estrogen receptor-positive (MCF-7) breast cancer cells and augmented the estrogen receptor-negative (BT- 20) breast cancer cell proliferation. [Lau CB, Ho TC, Chan TW, Kim SC., Use of dong quai (Angelica sinensis) to treat peri- or postmenopausal symptoms in women with breast cancer: is it appropriate? Menopause. 2005 Nov-Dec;12(6):734-40.] |
 |  |  |  |  |
breast cancer symptoms, breast cancer staging, breast cancer treatment
September 5, 2011
September 5, 2011
THIS WEBSITE TALKS ABOUT THE SIDE EFFECTS AND THE POTENTIAL HEALTH BENEFITS OF HERBS, SUPPLEMENTS. However, the information in this
website is for reference only. Please, discuss with your doctor before taking any medicine or supplement. All rights reserved 2011.
website is for reference only. Please, discuss with your doctor before taking any medicine or supplement. All rights reserved 2011.
 | |  | |  | |  | |  | |  |
________________________________________________________________________________
Herbal / Dietary Supplements / Foods that may lower the risk of certain types of cancer: Avocados
Banana, Bitter Melon, Brown Seaweed, Capsicum, Cauliflower, Celery, Chlorophyll, Cordyceps, Curcumin,
Dandelion, Ellagic acid, Oldenlandia, Falcarinol, Fenugreek, Feverfew, Fish Oil, Forskolin, Galangal, Garlic, Gotu
Kola, Green Tea, Grape Seed Extract, Honokiol, Orange, Isothiocyanates, Linseed Oil, Limes, Lycopene,
Maitake, Milk Thistle, Onion, Peony, Phellinus, Quercetin, Pterostibene, Pycnogenol, Reishi, Rhubarb, Saffron,
Stinging Nettle, Sweet Potatoes, and more. (Please read the warning section)
Drugs listed in this website for chemotherapy:
Xeloda, Avastin, Herceptin, Tykerb,
___________________________________________________________________________________
WARNING
Some studies do show the anti-cancer activities of certain herbs and supplements, but most of the studies were
done in test-tube or animals. It is unclear if they are effective in human body. Further, the composition of the
products in market are not necessary the same as those in the studies.
Cancer cells can spread very quickly, while most of the herbs/supplements take long time to see the effects (even
though they are active in our body). Some targeted drug products, including monoclonal antibodies, are cancer
cell specific, they are potent and have less side effects (compared to conventional anti-cancer drugs). Patients
must discuss with their doctors for the right treatment.
Herbal / Dietary Supplements / Foods that may lower the risk of certain types of cancer: Avocados
Banana, Bitter Melon, Brown Seaweed, Capsicum, Cauliflower, Celery, Chlorophyll, Cordyceps, Curcumin,
Dandelion, Ellagic acid, Oldenlandia, Falcarinol, Fenugreek, Feverfew, Fish Oil, Forskolin, Galangal, Garlic, Gotu
Kola, Green Tea, Grape Seed Extract, Honokiol, Orange, Isothiocyanates, Linseed Oil, Limes, Lycopene,
Maitake, Milk Thistle, Onion, Peony, Phellinus, Quercetin, Pterostibene, Pycnogenol, Reishi, Rhubarb, Saffron,
Stinging Nettle, Sweet Potatoes, and more. (Please read the warning section)
Drugs listed in this website for chemotherapy:
Xeloda, Avastin, Herceptin, Tykerb,
___________________________________________________________________________________
WARNING
Some studies do show the anti-cancer activities of certain herbs and supplements, but most of the studies were
done in test-tube or animals. It is unclear if they are effective in human body. Further, the composition of the
products in market are not necessary the same as those in the studies.
Cancer cells can spread very quickly, while most of the herbs/supplements take long time to see the effects (even
though they are active in our body). Some targeted drug products, including monoclonal antibodies, are cancer
cell specific, they are potent and have less side effects (compared to conventional anti-cancer drugs). Patients
must discuss with their doctors for the right treatment.