Management of early breast cancer In triple-negative and human epidermal growth factor receptor 2 (HER2)-positive early breast cancer, neoadjuvant subtype-specific systemic therapy is standard, followed by surgery. In the case that pathological complete response (pCR) is not achieved, systemic therapy can be escalated. Bisphosphonates are an additional adjuvant therapy option for all postmenopausal patients and premenopausal patients receiving ovarian suppression; they also conserve bone density. If indicated, radiation therapy can be administered after surgery.
The Management of early breast cancer takes
evidence-based registered therapy options into account. Availability and reimbursement of individual diagnostic or
therapeutic options may differ regionally and require adjustments of the treatment concepts outlined here. −, negative;
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The management of early breast cancer typically involves a combination of treatments aimed at removing or destroying the cancer while preserving as much of the breast as possible. The specific treatment plan may vary based on factors such as the stage of cancer, the type of breast cancer, the patient's overall health, and personal preferences. Here is an overview of the key components of the management of early breast cancer:
1. **Surgery:**
- **Breast-Conserving Surgery (Lumpectomy):** This involves the removal of the tumor and a small amount of surrounding healthy tissue. It is often followed by radiation therapy.
- **Mastectomy:** This procedure removes the entire breast. In some cases, a double mastectomy (removal of both breasts) may be recommended, depending on the patient's risk factors.
- **Sentinel Lymph Node Biopsy:** To determine if cancer has spread to nearby lymph nodes, the surgeon may remove one or a few sentinel lymph nodes for examination.
2. **Radiation Therapy:**
- Radiation therapy is often recommended after breast-conserving surgery to target any remaining cancer cells in the breast.
- In some cases, radiation therapy may be recommended after mastectomy, especially if there is a high risk of cancer recurrence.
3. **Chemotherapy:**
- Chemotherapy may be recommended depending on the tumor size, stage, hormone receptor status, and other factors.
- It can be administered before surgery (neoadjuvant chemotherapy) to shrink tumors, making surgery more effective, or after surgery (adjuvant chemotherapy) to reduce the risk of cancer recurrence.
4. **Hormone Therapy:**
- Hormone therapy is used to treat hormone receptor-positive breast cancers.
- Medications like tamoxifen or aromatase inhibitors are often prescribed to block the effects of estrogen on breast cancer cells.
5. **Targeted Therapy:**
- Targeted therapies, such as Herceptin (trastuzumab), are used for HER2-positive breast cancers. These drugs target specific molecules involved in cancer growth.
6. **Immunotherapy:**
- Some early breast cancer patients may be eligible for immunotherapy as part of clinical trials or based on specific molecular characteristics of the tumor.
7. **Lifestyle and Supportive Care:**
- A healthy lifestyle, including regular exercise, a balanced diet, and stress management, can help support overall well-being during treatment.
- Psychological support, such as counseling or support groups, can help patients cope with the emotional and psychological challenges of a cancer diagnosis and treatment.
8. **Follow-Up and Monitoring:**
- After treatment, patients are typically monitored closely with regular check-ups, mammograms, and other imaging tests to detect any signs of recurrence.
- Long-term hormone therapy or other medications may be prescribed based on the patient's risk profile.
9. **Breast Reconstruction:**
- For patients who undergo mastectomy, breast reconstruction surgery may be an option to restore the appearance of the breast.
It's important to note that the treatment plan for early breast cancer is highly individualized. Patients should have detailed discussions with their healthcare team to understand their specific diagnosis, treatment options, potential side effects, and expected outcomes. Second opinions can also be valuable in making informed decisions about treatment.
Early detection through regular breast self-exams, clinical breast exams, and mammograms is essential for increasing the chances of successful treatment and improving long-term survival rates for breast cancer.