Breast cancer learn about the key therapies
Breast cancer is the most common cancer among women worldwide, with millions of new cases diagnosed each year. However, contrary to widespread perception, treatment is not limited to surgery or chemotherapy.
Advances such as Oncotype DX and MammaPrint make it possible to analyze the genetic profile of the tumor and predict each patient’s response to treatment. There are three main types of treatment available: surgical, radiation and systemic. Each plays a specific role, and together they improve survival, reduce relapses and preserve patients’ quality of life.
Surgical treatment:
the first step in most cases
Surgery is, in most cases, the starting point for breast cancer treatment. Its goal is to remove the tumor and preserve as much breast tissue as possible through different types of procedures, depending on each patient’s case:
❂ Conservative surgery: Currently, between 70% and 80% of patients can opt for conservative surgery, in which only the tumor is removed along with a small margin of healthy tissue.
According to Dr. Carola Allemand, an expert in mastology at the Italian Hospital in Buenos Aires, studies show that breast-conserving surgery can be as effective as radical mastectomy in terms of cancer treatment, with better aesthetic and emotional outcomes.
❂ Mastectomy and reconstruction: in some cases, when the tumor is extensive or the skin or nipple is involved, a mastectomy may be necessary, in which the entire breast is removed. Today, this procedure is usually accompanied by reconstruction, which is performed during the same surgery.
There are different types: from conservative mastectomies (which preserve the nipple-areola complex) to reconstructions with prostheses or DIEP flaps (which use tissue from the abdomen to recreate the breast).
❂ Cryoablation: This is a minimally invasive option for older women or those with comorbidities. By freezing the tumor, the cancerous tissue is destroyed without the need for traditional surgery.
Radiation therapy: eliminating what cannot be seen
After surgery, some patients require radiation therapy to destroy any residual cancer cells and prevent recurrence.
In this type of therapy, it is important to consider that less is more. Advances in radiotherapy reflect a global trend toward therapeutic de-escalation: offering the minimum necessary treatment without compromising oncological safety.
Types of radiation therapy:
❂ External radiation therapy: the most common type. It is applied to the entire breast or chest wall.
❂ Partial irradiation: concentrates the dose only on the area where the tumor was located, reducing side effects.
❂ Intraoperative radiotherapy (IORT): administered during surgery, in a single session, with excellent results in patients with small, low-risk tumors.
Systemic treatment: acting from within
Systemic treatment is used to eliminate cancer cells that may have spread to other parts of the body. Its choice depends on the characteristics of the tumor and the risk of recurrence.
Types of systemic therapies:
❂ Chemotherapy: destroys rapidly growing cancer cells. It is used before or after surgery.
❂ Hormone therapy: blocks the action of hormones in tumors with positive hormone receptors (ER and PR).
❂ Targeted therapies: such as trastuzumab or pertuzumab, act specifically on HER2-positive tumors.
❂ Immunotherapy: stimulates the immune system to recognize and destroy malignant cells, useful in triple-negative tumors.
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