Once the presence of cancer is confirmed, the step is to determine the stage of cancer. Depending on the clinical investigation chest X-ray, CT scan chest, Ultrasound – abdomen or PETCT scan is recommended to determine the stage of cancer.
Breast cancer requires a multimodality treatment approach, and cancer staging is crucial in deciding and scheduling therapies which are a combination following:
Surgery: It can be done first or after chemotherapy. Surgery is basically directed to remove lumps and adjacent lymph nodes in the axilla. It can be of different types.
Mastectomy: Modified radical mastectomy is the removal of the full breast with axillary lymph nodes.
Breast conservation surgery (BCS): Removal of cancerous lumps along with axillary lymph node dissection. BCS is always combined with radiation therapy in order to avoid recurrence.
Plastic reconstruction: A multitude of options are available to reconstruct the breast to enhance cosmesis, which includes rotation of tissue, using muscle and skin from nearby areas known as pedicle flap, or can be done as free flap also.
Chemotherapy - Drugs to treat cancer cells are injected into the body, these drugs have tolerable side effects, and the side effects have been minimized with new forms of chemotherapy drugs with the evolving changes in medical and treatment approaches. Chemotherapy is crucial to contain the cancer cells circulating in the blood.
Radiation therapy: Intense energy usually X-rays or proton radiation is aimed directly at the operated area to kill cancer cells to minimize recurrence.
Hormone therapy: Since breast cancer is hormone-driven it's crucial to assess the hormone receptor status. Depending on the presence or absence of hormones hormone therapy is offered at the end of the treatment process.
Targeted therapy: Similar to hormone receptors, determining the presence of HER2 Neu is essential to plan treatment approaches. Addressing the presence of HER2 Neu with suitable treatments helps to derive the best outcomes.