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Chemotherapy in Breast Cancer: Stages and Costs

Chemotherapy In Breast Cancer: Stages And Costs

Introduction

In India the average of women who may get afflicted with breast cancer is lesser than that of women in western nations by 10 years. In the year 2023, around two and a half lakh cases of breast cancer were reported in India. Here is a look at chemotherapy in breast cancer: stages and costs for a better understanding of treatment options.

What Are The Different Stages Of Breast Cancer?

Before we look at chemotherapy in breast cancer: stages and costs here is a look at the different stages of breast cancer. This helps doctors determine the best treatment plan for improved outcomes. The different stages range from 0 to IV, and are on the basis of tumor size, lymph nodes affected, and metastasis.

  • Stage 0: This is known as non-invasive, where the cancer cells are only in the ducts or lobules without affecting surrounding breast tissue. Different sub-types include Ductal Carcinoma In Situ, and Lobular Carcinoma In Situ. Treatment options include lumpectomy or mastectomy, radiation and/or hormonal therapy.
  • Stage I: This is known as early-stage invasive cancer, where the cancer has spread beyond the ducts/lobules into surrounding breast tissue. This is classified on the basis of the size of the tumor, such as Stage IA and Stage IB. Treatment includes surgery, radiation and/or hormonal therapy, chemotherapy, targeted therapy.
  • Stage II: This is known as larger tumor or with spread. The classification on the basis of tumor size include Stage IIA and Stage IIB. Treatment includes surgery, radiation, chemotherapy, hormonal therapy, or targeted therapy.
  • Stage III: Known as locally advanced cancer, this is a stage where the cancer has spread more extensively to nearby lymph nodes.  The different sub-types are Stage IIIA, Stage IIIB, and Stage IIIC.  Treatment options include neoadjuvant chemotherapy, surgery, radiation, and hormonal or targeted therapy.
  • Stage IV: This is known as metastatic cancer, where the cancer has spread to distant organs, like the bones, liver, lungs, or brain. Treatment includes chemotherapy, hormonal therapy, targeted therapy, immunotherapy.

There is a staging system used to classify breast cancer, known as TNM. T for Tumor considers the size of the primary tumor. N for Nodes, evaluates lymph node involvement. M for Metastasis looks for the presence of distant spread. 

What Are The Different Options Of Cancer Treatment For Breast Cancer?

Determining the right treatment for breast cancer treatment depends on the type, stage, and overall health of the patient. Main treatment options include the following:

  1. Surgery – this is almost always typically the first step, to remove the tumor. Different types of surgery include lumpectomy, mastectomy and reconstructive surgery.
  2. Radiation therapy – relies on high-energy rays to kill cancer cells or shrink tumors and is used after surgery.
  3. Chemotherapy – uses drugs to kill cancer cells and stop their growth. This includes neoadjuvant chemotherapy before surgery, adjuvant chemotherapy after surgery.
  4. Hormonal therapy – is used for hormone receptor-positive breast cancers.
  5. Targeted therapy – works on specific proteins or genes in cancer cells.
  6. Immunotherapy – helps in boosting the immune system to fight cancer.
  7. Palliative care – is used in advanced stages, and when cure is not possible to offer relief from pain, manage symptoms, and improve quality of life.

The ideal choice of treatment for different stages of cancer can be broadly suggested, as below: 

  • Stage 0 – Surgery with or without radiation/hormonal therapy.
  • Stage I–III – Surgery with chemotherapy, radiation, hormonal therapy, or targeted therapy.
  • Stage IV (Metastatic) – Chemotherapy, targeted therapy, and immunotherapy, with supportive care.

How Effective Is Chemotherapy Breast Cancer?

As part of understanding of chemotherapy in breast cancer: stages and costs let us look at the effectiveness of chemotherapy. This depends on several factors, including the type and stage of breast cancer, the overall health of the patient, and the choice of chemotherapy regimen.

Effectiveness in:

  •  Early-stage breast cancer – Chemotherapy increases chances of long-term survival, and lowers the risk of recurrence.
  • Locally advanced breast cancer – Chemotherapy shrinks tumors, making it easier for the surgery, improving possible outcomes.
  • Metastatic breast cancer – Chemotherapy helps to extend survival and improve quality of life.

Effectiveness of chemotherapy depends on the following:

Cancer type and receptor status – Hormone therapy is more suitable for hormone receptor-positive cancers when compared with chemo. Chemo is effective when combined with HER2-targeted therapy for HER2-positive cancers. Chemo is effective for triple-negative breast cancer. Similarly, chemo is effective for high-grade, rapidly growing tumors and younger healthier patients.

Success rates of chemotherapy can be summarized as follows:

  • In early-stage breast cancer, risk of recurrence is reduced by 20–50%.
  • In HER2-positive breast cancer, a combination of chemo with HER2-targeted therapy can help in 60–80% of cases.
  • In metastatic breast cancer, chemo helps extend survival by several months to years.

Side effects of chemotherapy include fatigue, nausea, hair loss, and increased risk of infection. Latest treatment options of chemo are adjusted in such as manner so as to balance effectiveness and bring down side effects.

What Is Breast Reconstruction?​

To conclude the points about chemotherapy in breast cancer: stages and costs, lets look at breast reconstruction. This is a surgical procedure intended to rebuild or restore the shape, appearance, and size of a breast after surgery for partial or complete removal. This is performed for women born with abnormalities or trauma to the breast.

The different types of breast reconstruction include the following:

  • Implants – This reconstruction uses silicone or saline implants to create a breast shape. This may also involve tissue expanders to stretch the skin prior to placing the implant.
  • Flap surgery – Also known as autologous tissue reconstruction, this uses tissue from other parts of the body, like the abdomen, back, thighs, or buttocks. This creates a more natural-looking and feeling breast.
  • Combination reconstruction – Uses implants as well as autologous tissue for better shape and support.
  • Nipple and areola reconstruction – Post restoration of breast, the nipple and areola can be recreated for a better natural look.

When is reconstruction performed?

It is either performed immediately, at the same time as the removal surgery. It may also be performed after recovery from the initial surgery or cancer treatment. 

Breast reconstruction offers such as restoration of body symmetry, and helps to improve self-esteem of women afflicted with cancer. There are risks associated the procedure such as possible infection, scarring, or surgical complications.

Is Genetic Testing Available For Breast Cancer?

Yes, genetic testing is available for breast cancer. Advanced genetic testing facilities in Tamilnadu are widely used to identify individuals with inherited genetic conditions. Women with these inherited conditions, are at risk of developing breast cancer.  Tests are carried out on samples of blood, saliva or swab from the cheek. The approximate costs for the tests in India is estimated to be in the range of 10,000 INR to 50,000 INR.

January 17, 2025 Cancer