Breast cancer is a global health challenge, affecting millions of people every day. It knows no boundaries, striking women and men of all ages and backgrounds. Yet, amidst this challenge, there is hope on the horizon.
Advances in breast cancer treatment have ushered in a new era of personalized medicine and targeted therapies. Innovations like HER2-targeted drugs, immunotherapies, and precision medicine are reshaping breast cancer treatment, providing personalized therapies and better results. Each breakthrough takes us a step closer to a future where breast cancer’s impact diminishes, and survivors flourish, driven by pioneering science and relentless resolve.
Breast Cancer: Causes and Types
Breast cancer is a type of cancer that occurs when the breast cells grow abnormally. They divide faster than the healthy cells and accumulate, creating a lump or mass in the breast. The exact cause of breast cancer is not known, but it is associated with a complex interaction of genetic mutation, lifestyle, and environmental factors. Different types of breast cancer are listed below:
- Angiosarcoma – It begins from the lining of blood vessels and lymph vessels
- Inflammatory breast cancer – It is rare and spreads quickly causing the affected breast to become red, swollen, and tender. It arises when cancer cells obstruct the lymphatic vessels in the skin covering the breast.
- Ductal carcinoma in situ (DCIS) – It begins from the milk duct of the breast and is mostly non-invasive. It is considered as the earliest form of cancer.
- Lobular carcinoma in situ (LCIS) – Abnormal cells form in the lobules (milk glands) of the breast. LCIS is not considered as cancer but being diagnosed with it indicates the risk of breast cancer.
- Invasive lobular carcinoma – It starts from the lobules of the breasts, the cancer cells break out from the lobules and are likely to spread to the lymph nodes and other areas of the body.
- Paget’s disease of the breast – It is a rare type of breast cancer that occurs mainly after 50. It starts on the nipple and spreads to the dark skin areas (areola) around the nipple.
- Recurrent breast cancer – It is a type of breast cancer that reoccurs after treatment. It happens when some of the cancer cells survive the treatment and multiply thus recurrent breast cancer.
- Male breast cancer – It occurs when there is an abnormal formation of cells in the male breast tissue and it rarely happens. It is more common in older men though it can affect any age group.
Symptoms of Breast Cancer
- Unusual presence of lump or thickening of the breast
- Changes in the breasts’ size, shape and appearance
- Appearance of pitting or redness on the skin over the breast
- Peeling, scaling or flaking of the skin of the nipples.
- Inverted nipple
Breast cancer is the most common type of cancer among women. The incidence of breast cancer in India has increased over time due to lack of awareness and education. Breast cancer cannot be prevented, but being knowledgeable about the disease, early detection and getting appropriate therapy at the right time will increase the chance of survival. Studies state that 14% of women are suffering from breast cancer in India.
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Recent Advances in Breast Cancer Treatment
Breast cancer affects millions of lives every year making it the most important health concern. Researchers and healthcare professionals are continuously working to make advancements in the diagnosis and treatment of breast cancer. Several improvements that are revolutionized are described below:
Improving breast cancer screening methods – Improvement in the screening method of breast cancer will help to detect the cancer at an early stage and allow early treatment. Early diagnosis of breast cancer increases the survival rate, decreases the cost of treatment, and reduces morbidity.
Division of breast cancer into subtypes – Scientists are now able to classify breast cancer into subtypes; HR (hormone receptor) positive, HER2 positive, Triple negative breast cancer, and HER2-low breast cancer. Information about the subtypes of cancer and their behavior will guide in treatment decisions.
- HR-positive breast cancer treatment – HR-positive breast cancer expresses estrogen or progesterone receptors in excess and hormone therapies are the main treatment for it. However, targeted drugs are now developed in addition to hormone treatment. Some of the FDA-approved drugs for HR-positive cancer treatments are palbociclib (ibrance), everolimus (afinitor), elacestrant (orserdu), abemaciclib (verzenio), etc.
- HER2-positive breast cancer treatment – HER2-positive cancer has a high level of HER2 protein and targeted therapies are the main treatment. Common FDA-approved drugs are trastuzumab (herceptin), pertuzumab (perjeta), tucatinib (tukysa), lapatinib (tykerb) etc.
- Triple-negative breast cancer (TNBC) treatment – TNBC is the most difficult breast cancer to treat as it lacks both hormone receptors and HER-2 overexpression. They do not respond to therapies targeted to these proteins. However certain treatments are started to be approved. These include sacituzumab govitecan-hziy (trodelvy), prembolizumab (keytruda), PARP inhibitors such as olaparib (lynparza), talazoparib (talzenna).
- HER2-low breast cancer treatment – HER2-low breast cancer is the newly defined subtype of breast cancer and accounts for more than half of all metastatic breast cancers. HER2 low tumors are cells that contain lower levels of HER2 protein on their surface. They do not respond to drugs that target HER2 protein. However, there is a recently approved drug called trastuzumab deruxtecan (Enheretu) for the treatment of this cancer.
Recent Advances in Breast Cancer Surgery
Surgery is usually the first choice of treatment for breast cancer especially at an early stage. There are different types of surgery options for breast cancer treatment. Apart from traditional mastectomy, many advanced techniques have been introduced by researchers and surgeons in recent years. Also you can find some of the best breast cancer hospitals in India with state-of-art equipment. Below here are some of the type of treatments available in India:
Mastectomy – It is a type of breast surgery in which the entire breast is removed.
Contralateral prophylactic mastectomy – It is a risk-reducing mastectomy in which the other breast that does not have cancer is also removed.
Sensation-preserving mastectomy – Unlike traditional mastectomy, during the surgery the nerves are preserved or grafted intentionally using a technology called “resensation”. This can help avoid complete loss of breast sensation and or post-mastectomy pain syndrome associated with traditional mastectomy.
Breast conservative surgery – It is also referred to as lumpectomy or partial mastectomy. During the surgery, only the part of the breast having the cancer lump and the surrounding breast tissue around the lump is removed.
Breast reconstructive surgery – It is a type of surgery performed to recreate breasts after mastectomy or lumpectomy. It can be done immediately after the breast surgery or even a month or year later. There are different types:
- Flap reconstruction: The surgeon used tissue from the patient’s own body to form new breasts. The tissues are mainly taken from the belly, thigh, back or bottom.
- Implant reconstruction: To recreate the breast tissue, a surgeon used saline or silicone implants.
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Oncoplastic surgery – While performing the surgery, the surgeon used a breast lift or breast reduction procedure concurrently with the lumpectomy. The breast shape is improved and the defect left by the lumpectomy is filled in with a breast reduction or lift.
Sentinel lymph node dissection – The sentinel lymph node is first identified by injecting a radioactive substance and or dye near the area of the tumor. It is then removed and analyzed once it is located. If it is clean, there is no need to remove the other lymph nodes. It is less invasive and has fewer side effects though it is not suitable for everybody.
There are several treatment options for breast cancer. The key to successive treatment lies in early detection and getting treatment at the right time. Breast cancer treatment cost in India can significantly vary depending on several factors. The stage of cancer, the type of treatment required, the location of treatment, and coverage of an individual’s health insurance are the common factors that influence breast cancer treatment cost in India.
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