Treatments are less invasive when breast cancer is detected at an early stage. Challenges for breast cancer treatment in Nepal include patient’s financial status (given the huge out-of-pocket expenditure), accessibility and availability of health services and infrastructures, etc.
Several modalities of treatment are currently available for breast cancer patients as following:
Surgery: Many breast cancer patients go under surgery in order to remove breast cancer. Normally some lymph nodes are removed from under the arm and observed under a microscope to verify if they contain cancerous cells. Surgery to preserve the breast: an operation to remove cancer but not the breast. It includes the following procedures:
- Lumpectomy: surgery to remove the tumor (mass) and a small quantity of normal tissue around it.
- Partial mastectomy: surgery to remove a part of the breast that has cancer and some normal tissue surrounding it. The protecting layers over pectoral muscles under the cancer can also be removed. This procedure is also called segmentary mastectomy.
Patients being treated with surgery to preserve the breast can also have some lymph nodes removed from under the arm to perform a biopsy. This procedure is called lymph node dissection and it can be done at the same time than the surgery to preserve the breast or later. The dissection of lymph nodes is done through a separated incision.
Other types of surgery include the following procedures:
- Total mastectomy: surgery that removes the breast that contains cancer. This procedure is also called simple mastectomy. Some of the lymph nodes can be removed from under the arm to perform a biopsy at the same moment of the surgery or after it. This is done through a separate intersection.
- Modified radical mastectomy: surgery to remove the breast that contains cancer, many of the lymph nodes under the arm, protecting layers of pectoral muscles and, sometimes, part of the muscles of the breast wall.
Chemotherapy can be administrated before the surgery to remove the tumor. When chemotherapy is administrated before the surgery, it may reduce the size of the tumor and quantity of tissue that needs to be removed during surgery. Treatment administrated before surgery is called neoadjuvant therapy. Even if the doctor removes all the cancer in the surgery, some patients may receive radiotherapy, chemotherapy, or therapy with hormones after the surgery in order to destroy any cancerous cells
that may have been left. The treatment administrated after the surgery to reduce the risk of cancer returning is called adjuvant therapy.