Breast Cancer Staging and Treatment Options: A Guide for Patients

Q: Breast Cancer Staging and Treatment Options: A Guide for Patients

Hello： Based on your description, your mother's breast cancer is likely classified as Stage II. <br>Generally, the surgical removal of 20 axillary lymph nodes affected by cancer is sufficient, and no further surgery is necessary. <br>Subsequent treatments may include radiation th

Breast

Hello Dr.
Wu: My mother underwent surgery a few days ago to remove breast cancer, which was approximately 1.7 cm in size.
Initially, we thought it was early-stage, but after the surgery, 20 lymph nodes were tested and all were positive (there is also suspicion of residual lymphoma due to its proximity to nerves).
I would like to ask what stage this is considered? The doctor mentioned that there is a 50-70% chance of survival over 3-5 years; is this true? Is it possible to perform another surgery to clean it out completely, and would that be better? Or is chemotherapy a better option? I recently read about a medication for lymphoma; is that true? How can it be accessed? Also, where can the treatment be administered? How can it be used? Can it be used together with Xiaohongmei? Can you help my mother?

Xiao Zheng, 20~29 year old female. Ask Date: 2006/05/31

Dr. Wu Jingtang reply Breast and Thyroid

Hello: Based on your description, your mother's breast cancer is likely classified as Stage II.
Generally, the surgical removal of 20 axillary lymph nodes affected by cancer is sufficient, and no further surgery is necessary.
Subsequent treatments may include radiation therapy, chemotherapy, and hormone therapy.
The chemotherapy you mentioned should be determined based on the entire pathology report, including the status of various hormone receptors, to decide which drug combination to use.
There have been significant advancements in breast cancer chemotherapy in recent years, so there is no need for excessive worry; you can discuss the follow-up treatment plan with the attending physician.
As for "targeted therapy," it is currently covered by health insurance only for metastatic cases under specific conditions.
If you have further pathology results, discussing them will provide a clearer understanding of the patient's situation.
Sincerely, Dr.
Wu Ching-Tang, Surgery.

Reply Date: 2006/05/31

More Info

Understanding breast cancer staging and treatment options is crucial for patients and their families as they navigate the complexities of diagnosis and care. Based on the information provided, your mother has undergone surgery for breast cancer, and the findings indicate that the cancer has spread to the lymph nodes. This is a significant factor in determining the stage of the cancer and the subsequent treatment options.

Breast Cancer Staging
Breast cancer is typically staged using the TNM system, which stands for Tumor size (T), Node involvement (N), and Metastasis (M). In your mother's case, the tumor size is approximately 1.7 cm, and the involvement of 20 lymph nodes suggests a more advanced stage. Generally, if cancer has spread to multiple lymph nodes, it is classified as Stage IIIC or even Stage IV, depending on the presence of distant metastasis. The exact stage can only be confirmed by a healthcare professional who has access to all the diagnostic information.

Survival Rates
Regarding the survival rates you mentioned (50-70% for 3-5 years), these statistics can vary widely based on numerous factors, including the specific characteristics of the cancer (such as hormone receptor status and HER2 status), the patient's overall health, and how well the cancer responds to treatment. It's essential to discuss these statistics with your mother's oncologist, who can provide a more personalized prognosis based on her unique situation.

Treatment Options
1. Surgery: If there is a concern that not all cancerous tissue has been removed, a second surgery (re-excision) may be considered. This decision should be made in consultation with her surgical oncologist, who can assess the risks and benefits of further surgery.

2. Chemotherapy: Given the lymph node involvement, chemotherapy is often recommended to reduce the risk of recurrence and to target any remaining cancer cells. The oncologist will determine the appropriate chemotherapy regimen based on the cancer's characteristics and the patient's overall health.

3. Targeted Therapy: If the cancer is hormone receptor-positive, hormone therapy (like Tamoxifen or aromatase inhibitors) may be an option. If HER2-positive, targeted therapies such as trastuzumab (Herceptin) may be indicated. The mention of "淋巴癌有一種藥" (a drug for lymphatic cancer) likely refers to targeted therapies that are being developed for various types of cancer, including breast cancer.

4. Radiation Therapy: This may be recommended after surgery, especially if there is a significant risk of local recurrence, particularly if lymph nodes are involved.

Additional Considerations
- Clinical Trials: If your mother is interested in exploring new treatment options, clinical trials may be available. These trials often provide access to cutting-edge therapies that are not yet widely available.

- Supportive Care: It's also essential to consider supportive care options, including counseling, nutritional support, and palliative care, to help manage symptoms and improve quality of life.

Conclusion
Navigating breast cancer treatment can be overwhelming, but understanding the staging and available options is a vital first step. It is crucial to maintain open communication with your mother's healthcare team, who can provide tailored advice and support throughout her treatment journey. Encourage your mother to ask questions and express her concerns, as this will help her feel more empowered and informed about her care.

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