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Exploring Different Breast Cancer Treatments


Just weeks after announcing she had breast cancer, Giuliana Rancic has decided to undergo a double mastectomy and immediate reconstruction. Rancic said the decision was not an easy one, but that she wanted to take the stigma away, saying, "At first the word 'mastectomy' seemed so scary to me, but after doing the research and seeing the advancements, the surgery has come a long way in the past 20 years. The results can be incredible."

Still, a mastectomy is just one option. In light of this news, we decided to explore some of the different breast cancer treatments available. While each case of breast cancer is obviously different, and picking a treatment option will depend on many factors, such as the size of the tumor, we wanted to break down the options available and make the process of choosing a treatment a little easier. We went to Dr. Richard Bleicher, a breast surgeon at Fox Chase Cancer Center in Philadelphia and Dr. Linda Vahdat, an oncologist at the Weill Cornell Physician's Organization in New York to get their opinions on the various options.

According to Dr. Bleicher, if a person is in reasonably good health, all treatment options should provide a similar survival rate and risk of the cancer recurring. But there are situtions in which certain treatments might not work for patients.

"For instance, patients with multiple spots of cancer in different areas of the breast widely separated that cannot be removed with a single excision are usually not considered lumpectomy candidates because they have a higher risk of recurrence," Dr. Bleicher says. "Patients who have heart disease or poor cardiac function may not be recommended for certain types of chemotherapy because of the stress it places on their hearts."

Here are some common treatment options:

1. Lumpectomy. A lumpectomy is a form of breast conservation, and according to WebMD is a good option for people who have a tumor that's less than five centimeters in diameter. It's often followed by a round of radiation, so it helps if the patient is reasonably fit and healthy.

2. Chemotherapy. Chemotherapy uses drugs to kill cancer cells either by killing them directly or by preventing them from dividing. 

3. Hormone therapy. Hormone therapy is similar to chemotherapy in that it kills cancer cells, but it does so by removing hormones and stopping cancer cells from growing. It's often given with Tamoxifen, a risk-lowering drug, to women who have been diagnosed with either the early stages of breast cancer or metatastic breast cancer.

4. Mastectomy. There are technically a few different kinds of mastectomies. For example, Christina Applegate underwent a prophylactic double mastectomy in 2008, removing both breasts.

Depending on where cancer is found, a patient may opt for a total mastectomy (also known as a simple mastectomy), where the entire breast that has cancer is removed; patients can also opt for a modified radical mastectomy, where a surgeon removes the breast that has cancer, some lymph nodes, the lining over the chest muscles, and sometimes even part of the chest wall muscles. If the cancer is small enough, a patient could undergo a partial mastectomy, where only part of the breast tissue surrounding the cancerous cells is removed.

"I see patients coming in constantly who say, 'I want a mastectomy, so I won't have to deal with this again,'" Dr. Bleicher says. "The reality is that a mastectomy is not the panacea that everyone thinks it is."

Dr. Vahdat agrees.  "There's no 'best' breast cancer treatment," she says. "While a mastectomy is about 98 percent effective, no one treatment is 100 percent effective."

In Rancic's case, she admitted that fear played a role in her decision to undergo a mastectomy, telling People magazine that she didn't want to look over her shoulder the rest of her life, wondering if the cancer would come back. She's far from the only one both Dr. Bleicher and Dr. Vahdat say they've seen a recent trend toward mastectomies, and the research backs up their claims, with a growing number of women opting to have both breasts removed even when cancer's only found in one. 

The most important thing to remember, Dr. Vahdat stresses, is that you have many options when it comes to treatment, so it's important to do your homework. By understanding the myriad options that are out there, you can ensure that you pick the right one for you.