The term adjuvant therapy refers to any additional cancer treatment a person undergoes following the primary treatment of the cancer, which typically is surgery to remove the actual tumor. Adjuvant therapy is then given to help reduce the risk that the cancer will reappear.
In the treatment of breast cancer, primary therapy consists of surgery. Depending on where the breast cancer is located and how large in size it is, one of two types of surgeries may be performed to remove the cancer. The first, referred to as breast-sparing surgery (or a lumpectomy or partial mastectomy), occurs when a surgeon will only remove the area of the breast that is affected by the cancer. The second, known as a mastectomy, is where the surgeon removes the entire breast. During each of these two types of surgeries, the surgeon will also likely remove some lymph nodes under the arms in order to check to see if the cancer has spread from the breast.
Even if tests confirm that the breast cancer has not yet spread, it can be too early to detect whether or not a few cancer cells have broken away and have spread to other parts of the body. For this reason oncologists give adjuvant therapy to help kill any remaining cancer cells left behind following surgery. Breast cancer adjuvant therapy may include one or more of the following treatments:
Radiation therapy is the use of high-energy rays to kill the breast cancer cells. It can be given externally, meaning the radiation stems from a large machine, or internally, where the radiation is placed in a small tube and inserted into the breast through a tiny incision.
Prior to diagnosis, a biopsy is usually performed to confirm the presence of cancer cells in the breast. Other tests are typically performed on this tissue to determine whether the tumor is hormone receptor positive or negative. If it is positive, it means the cancer relies on the hormones estrogen and progesterone to grow. Hormone therapy is used in those breast cancers that are hormone receptor positive because it blocks the cancer cells from using these hormones.
Given intravenously and by pill, chemotherapy works to kill the rapidly dividing cancer cells. Typically, a combination of two or more chemotherapeutic agents are given following surgery. Studies have shown that the use of adjuvant chemotherapy helps to prevent early-stage breast cancer from recurring.
A gene called HER-2 stimulates has been shown to aid in the growth of breast cancer in women who overexpress this gene. Genetic tests can be conducted to determine whether a woman has HER2-positive breast cancer in order to determine whether or not the use of a targeted therapy that works only in this type of breast cancer should be given.
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