Breast Cancer Treatment Options

Please use the drop-down boxes to explore different treatments for breast cancer. Everybody's care pathway is unique and will vary depending on the type of breast cancer you have.

The Cancer Therapy Team at Salisbury District Hospital offer ‘prehabilitation’ which is the work done to build up your physical and mental health before your cancer treatment starts. This aims to put you in the best place possible to manage the treatment to come. You can find out more about the Cancer Therapy Team here.

Macmillan Cancer Support have also put together the following information and videos: Prehabilitation videos for people living with cancer.

How is Breast Cancer treated?

The treatment of breast cancer involves a multi-disciplinary team approach. Members of this team are specialists in the surgery, pathology, drug treatment (chemotherapy) and x-ray treatment (radiotherapy) of breast cancer.

Surgery for Breast Cancer

There are two main types of operation:

Breast Conserving Surgery (often referred to as a Wide Local Excision or Lumpectomy)

This is the removal of the tumour with a small margin of normal healthy tissue. The aim is to keep as much of your breast as possible while ensuring the cancer has been completely removed.

The breast tissue removed during surgery will be tested to check the margin around the cancer. If there are cancer cells at the edges of the margin, you may need further surgery to remove more tissue.

Mastectomy

A simple mastectomy is the removal of all breast tissue including the skin and nipple area.

A mastectomy may be recommended when:

The cancer takes up a large area of the breast
There's more than one area of cancer in the breast

Long term survival rate is the same for breast conserving surgery followed by radiotherapy, as for a mastectomy.

Axillary Surgery

Sentinel Lymph Node Biopsy

Sentinel lymph node biopsy is used for axillary sampling. It identifies whether or not the first, or sentinel lymph node (or nodes) is clear of cancer cells.

A sentinel lymph node biopsy is usually carried out at the same time as your cancer surgery. A small amount of radioactive material (radioisotope) and a blue dye is injected into the area around the cancer to identify the sentinel lymph node(s). Once removed, the sentinel node(s) are examined under a microscope to see if it contains any cancer cells.

If the sentinel mode does not contain cancer cells, this usually means the other nodes are clear too, so no more will need to be removed.

Axillary Clearance

If the results show that there are cancer cells in the sentinel node(s) you may be recommended to have further surgery to remove some or all of the remaining nodes (axillary clearance), or radiotherapy to the underarm.

Please click here for information on Breast Reconstruction Surgery at Salisbury.

Please follow this link to The Breast Cancer Now Charity for more information on Surgery for Breast Cancer.

Chemotherapy for Breast Cancer

Chemotherapy is a treatment using anti-cancer drugs to destroy cancer cells. Different types of chemotherapy drugs are used to treat breast cancer and can be administered in different ways and at different points in your treatment pathway.

How chemotherapy works?

Cancer cells divide and grow in a different and uncontrolled way and chemotherapy drugs can interfere with the cancer cells to change the way they grow.

Chemotherapy is a systemic treatment; meaning this affects the whole body.

Chemotherapy prior to surgery is known as neo-adjuvant chemotherapy.

Chemotherapy after surgery is known as adjuvant chemotherapy.

Please follow this link to The Breast Cancer Now Charity which will explain chemotherapy for breast cancer in more detail.

Will I need chemotherapy?

If you have a primary breast cancer, whether you have chemotherapy depends on a number of factors:

• The size of your breast cancer
• Whether any axillary lymph nodes are affected by cancer cells
• The grade of your cancer
• The oestrogen receptor and HER2 status.

Your medical team may weigh up the benefits of chemotherapy using an online predict tool which calculates the benefit you might experience from chemotherapy treatment and how likely it is that the cancer will return (also known as cancer recurrence).

Radiotherapy for Breast Cancer

What is radiotherapy?

Radiotherapy uses high energy x-rays to destroy cancer cells. Radiotherapy is given to destroy any cancer cells that may have been left in the breast and surrounding area. Radiotherapy affects normal cells as well, but they are able to repair themselves more readily. Radiotherapy can destroy and shrink cancerous growths and is very effective in preventing cancer cells reappearing after surgery.

Radiotherapy equipment in this region is available in Southampton, Poole, Basingstoke and Bath. If radiotherapy is considered appropriate, you will usually be referred to the unit most convenient for you.

When is radiotherapy given?

Radiotherapy is given after surgery to reduce the risk of breast cancer coming back in the breast, chest area or lymph nodes. If you're having chemotherapy after surgery, radiotherapy is usually given after chemotherapy.

Radiotherapy may be delayed for a medical reason, for example if you need to wait for a wound to heal or if you develop a seroma (a collection of fluid that sometimes forms under a wound after an operation).

Which areas are treated?

When deciding which areas to treat and how, your clinical team will consider factors such as the location, grade, size and stage of your cancer.

Radiotherapy is usually given following breast conserving surgery (lumpectomy). It is given to the remaining breast tissue on that side. Occasionally it may be recommended to the chest wall after a mastectomy and if some of the lymph nodes under the arm are affected. If breast cancer spreads elsewhere in the body at a much later stage, radiotherapy can be used to improve symptoms such as pain affecting the bones.

Common side effects of Radiotherapy:

Tiredness and fatigue
Skin reactions - skin may become pinker or darker over time and can cause a local skin reaction similar to sunburn (tender, itchy and sore).

We would recommend using My Trusty Sunflower cream following on from radiotherapy treatment to massage into the affected areas.

Please follow this link to The Breast Cancer Now Charity which will explain radiotherapy for breast cancer in more detail.

Hormone Therapy for Breast Cancer

Some breast cancers are stimulated by the hormone oestrogen. Hormone therapy is often of benefit in patients whose tumours are sensitive to the female hormone oestrogen(ER+).

Hormone therapy, also called endocrine therapy, is a treatment that blocks the effect of oestrogen on breast cancer cells. Different hormone therapy drugs do this in different ways. This may be Tamoxifen (for pre and post menopausal women) or other hormone tablets called aromatase inhibitors (e.g. Anastrozole or Letrozole) prescribed for post-menopausal women.

If this treatment is advised, your medical team will have a conversation with you regarding the type and duration of treatment.

Please follow this link to The Breast Cancer Now Charity for more information on Hormone Therapy.

What if I am unwell after receiving cancer treatment?

Please visit the Acute Oncology section for more information.

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