What Kinds of Treatment can be Applied in Breast Cancer?

In small lump in the breast, operative removal of the breast and surrounding tissue may be life saving. If there are indications that not all carcinoma tissue was removed by the surgeon, irradiation with rontgen-rays may improve prognosis. Rontgen-rays have two effects. They will kill rapidly growing cells, for instance the tumors cells but also other rapidly growing cells of the body like intestinal epithelial cells, bone marrow cells and spermatozoa. This asks for very competent administration of these X-rays. The other effect is that the connective tissue in the irradiated region will become very hard and poor in blood vessels. This creates and unfavourable environment for the local growth of tumor.

How is the treatment when metastasis are present ?
The first principle, often forgotten by doctors (but not by patients) is that pain should be treated adequately. When metastasis is localized, local irradiation is often beneficial. A pain producing metastasis in a vertebra can often be irradiated with good results. When metastasis are widespread or generalized, so called systemic treatment should be tried. In tumors of most organs the only possibility is the administration of cytotoxic drugs that will like X-rays kill not only the tumor cells but all rapid growing cells of the body as well. Therefore, the administration of cytostatics is avery spesialized field in medicine and it should be done only by doctors with large experience in the field. Some tumors originate in organs that are normally under influence of hormones. This prostate is such an example and the breast also.

Breast cancer in women in the reproductive age, the tumor may grow more rapidly under the influence of estrogens from the ovarium. For many years, it has been usual to perform bilateral extirpation of the ovaries in patients with severe metastatis disease. This will result in an artificial menopause and it at least 30% of the cases in a prolonged improvement with disappearance of pain.

Tumor nodes and metastases become much smaller and even may disappear. This improvement in general will not last much longer than two years. The ovaries have also been irradiated, but the result is unpredictable. A modern treatment, obviating the need for ovariectomy, is the administration of subtances that block the effect of estrogens, so called anti-estrogens. Tamoxifen is such a substance.