There are many different approaches for management of breast cancer and treatment options that patients may select in collaboration with health care providers. Breast cancer is a complex disease that presents in many different types, with specific biological features unique to each patient. Invasive cancers are classified based on tumor type and histological grade, which is of utmost importance when deciding the course of treatment. Contemporary advances in breast cancer treatments have been made, especially in chemotherapy, hormone and biological therapies. Treatment can be a combination of local treatments, systemic treatments, and in some cases, new targeted treatments (Watts, 2013).
Treatment for primary, localized breast cancer commonly includes surgical interventions based on tumor type, size, and stage. Certain procedures such as a local excision or lumpectomy conserve more of a woman’s breast than others, where only the breast lump and surrounding area of tissue are removed. A mastectomy is a more radical procedure that removes the entire breast. After a mastectomy, some women choose to have breast reconstructive surgery to restore their sense of body integrity (LeMone et al., 2011). Recently, surgical techniques have improved, resulting in less radical and invasive surgeries. The increase in breast conserving surgery has been related to screening mammograms. On average, screening for breast cancer detects tumors in smaller and earlier stages, enabling patients to begin treatment before the cancer advances to more invasive stages (Watts, 2013).
Sometimes, undetected cancer cells that may cause recurrence remain after surgery either locally in breast tissue, scars, and lymph nodes, or in distant areas. Therefore, after surgery it is usually recommended for the patient to follow with radiotherapy, chemotherapy, and/or hormone therapy (Watts, 2013). Radiation therapy is most commonly used with lumpectomies for early stage breast cancer. Palliative radiation is also used to treat chest wall recurrences and cancer that has developed secondarily in bone to help control pain and decrease the risk for fractures. Radiation is administered either by an external beam or tissue implants (LeMone, Burke, Bauldoff, 2011).