Treating breast cancer Staged using TNM which is T tumor size N axillary lymph nodes M metastasis Sentinel lymph node biopsy Sentinel lymph nodes are the first nodes draining a cancer Hypothesized to be invaded from primary tumor site As number of nodes increases chances of surviving decreases Inject dye into tumor to identify sentinel nodes because the valves allow fluid to flow in one direction only Sentinel lymph node detection Surgeon injects a small dose of a low level radioactive tracer technetium 99 into the breast in the region of the tumor Technetium 99 contains less radiation than a standard x ray Blue dye is also injected to help visually track the location of the sentinel node during surgery Treatment options Dependent on stage of cancer Local or regional tumor treated with surgery radiation or chemotherapy Systematic treatments are directed to the whole body or system for metastasized cancers Complementary and holistic therapies complementary treatment options Simple total breast removal and radical mastectomy remove breast tissue breastbone and underlying tissues all the way up to top Breast conserving surgeries lumpectomy wide excision quadrectomy Breast removal mastectomy Radical mastectomy not always life saving and very rarely necessary Radiation therapy vs brachytherapy Traditional external beam radiation Brachytherapy radioactive material placed in body in the area near cancer cells internal radiation therapy Benefit radiation dose targets lumpectomy cavity minimizes normal tissue exposure Her2 breast cancer and Herceptin Herceptin body s own defense system Herceptin attaches to a Her2 cancer cell and tells your body s defense system to target Herceptin may also stop the Her2 cancer cell from telling itself to grow and divide into more cancer cells Without Herceptin the Her2 cancer cell keeps telling itself to divide APPROX 25 of breast cancer patients have tumors that are Her2 Hormone therapy Hormone receptor status is important in breast cancer treatment Around 75 of breast cancers are estrogen receptor positive ER Around 65 of ER breast cancers are also progesterone receptor positive PR We can block estrogen receptors with SERMs We can block Her2 receptors with Herceptin Tamoxifen First SERM In a study half were given Tamoxifen while other half were given a placebo Group receiving Tamoxifen had lower rate of breast cancer Good effects reduces breast cancer risk lowers LDL cholesterol strengthens bones Raloxifene Alternative SERM Aromatase inhibitors breast Reduces risk of breast cancer without stimulation of uterine cell division which Tamoxifen does Good effects strengthens bones lowers LDL cholesterol reduce breast cancer risk reduce uterine cancer risk Androgens from adrenal glands and ovaries are changes into estrogen by aromatase in Aromatase inhibitor stops conversion to estrogen Helps stop producing excess estrogen Adriamycin The red devil common chemotherapy drug
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