If your sentinel node biopsy results are negative, or free of tumor cells, then your remaining lymph nodes are left intact. This reduces your risk of developing lymphedema, and preserves healthy tissue that doesn't need to be surgically disturbed. But, if the node is positive, other nearby nodes need to be examined for cancer. The pathology report of the sentinel node should be sent while the surgeon is still in the operating room, which allows the surgeon to proceed with an axillary node dissection if necessary and saves the patient a second surgery. Knowing if the cancer has spread to the nearby lymph nodes impacts the recommendations for treatment of the patient's breast cancer.
Breast Cancer Treatment
1 AnswerDr. Mehmet Oz, MD , Cardiology (Cardiovascular Disease), answered
Researchers are now looking for biological markers that can predict if a ductal carcinoma in situ (DCIS) is at low or high risk for becoming invasive, thereby answering the question about what treatment, or combination of treatment is best. This "molecular profiling" will hopefully provide answers that will help women and their doctors make better decisions about treatment. For instance, one study found the risk for subsequent invasive cancer 8 years after a DCIS diagnosis was highest (20% higher) if the original tumor could be felt during a breast exam vs. found incidentally on mammography, or if she was positive for 3 biomarkers. If these results are replicated, a test for these markers will help guide decisions.
4 AnswersMany types of breast cancer require the hormones estrogen or progesterone for growth. In these cases, hormone-blocking medications can be used to cut off the fuel supply for the breast cancer cells. For example, for estrogen receptor (ER) positive breast cancers, hormone therapy works to block the production of estrogen, or to prevent estrogen from reaching the tumor cells that need it to grow.
1 AnswerHealthyWomen answeredSeveral studies have compared aromatase inhibitors with tamoxifen as adjuvant therapy in post-menopausal women with breast cancer and found that aromatase inhibitors better reduce the risk of cancer recurrence than using tamoxifen by itself for five years. The drug schedules that appear to be the most helpful include the following:
- Tamoxifen for two to three years followed by an aromatase inhibitor to complete five years of total treatment
- Tamoxifen for five years, followed by an aromatase inhibitor for five years
- An aromatase inhibitor for five years
1 AnswerDr. Dede Bonner , Health Education, answered
In general, starting hormone therapy in the first year after a breast cancer diagnosis is important. But this is not a cut-and-dried decision, and there’s currently debate in the medical community about the timing of these drugs. Drug manufacturers put marketing pressure on oncologists and may give them conflicting or profit-driven information in an attempt to sell more of their drugs faster. Ask your doctor for the rationale behind his recommendation for your individualized care.
3 AnswersHealthyWomen answeredHormone therapy, also called hormone treatment or endocrine therapy, can slow or block the growth of hormone-sensitive tumors by interfering with the hormone action or by blocking your body's ability to produce hormones.
Here are a few ways that cancer can be treated with hormone therapy:
- Block estrogen production
- Block the effects of estrogen
- Block ovarian function
1 AnswerRiverside Cancer Care Center answeredLike other medical treatments, hormone therapy is a systemic treatment. It is most often used to help prevent a recurrence of breast cancer, but it can also be used to treat more aggressive cancers. Anti-hormonal therapy works by blocking naturally occurring hormones that can enhance some tumor cells. Depending on the diagnosis, you and your physician may discuss anti-hormonal treatment as a possible therapy.
2 AnswersDr. Dennis L. Citrin, MD , Hematology & Oncology, answered
The use of hormone blockers to treat breast cancer, which is also known as endocrine treatment, is effective for estrogen receptor positive breast cancer, which is stimulated by estrogen. This kind of breast cancer accounts for well over half of all breast cancers diagnosed and is particularly common among older women. Hormone blockers reduce the estrogen stimulation of breast cancer and therefore help fight the disease. Endocrine treatment frequently produces excellent remissions that can last for years.
1 AnswerSome common types of breast cancer hormone therapy include:
- SERMs (selective estrogen receptor modulators): These drugs bind to estrogen receptors in the breast cancer cells to block estrogen from reaching cancer cells, which prevents their growth. Tamoxifen is a commonly-used hormone therapy used to prevent breast cancer recurrence. This drug is also used for post-menopausal women at high risk for developing breast cancer.
- Aromatase inhibitors: These breast cancer hormone therapy drugs block estrogen production by binding to the enzyme responsible for producing estrogen (the aromatase enzyme). Once estrogen production is halted, the cancer cells starve from lack of estrogen, which prevents them from growing and dividing.
2 AnswersIn general chemotherapy is used in breast cancer when the risk of recurrence is higher. Things like size, grade, lymph nodes involved with cancer, HER2 neu, ER/PR status all play a part. More recently we are using a gene based test called Oncotype which can be used on estrogen positive tumors to help determine the risk of recurrence.
It can get complicated and really warrants a thorough discussion with your medical oncologist regarding what are the risks of your breast cancer coming back compared to the benefits and risks of chemotherapy.