Treatment for Breast Cancer

Breast cancer treatments vary dependant on the diagnosis, position and stage of the cancer. However mostly your treatment goal is to remove the cancer and reduce the risk of it returning or spreading to other parts of the body. 

Breast Cancer Treatment Approaches

The Breast Cancer treatment can be broken into two parts:

• Local or Direct Therapy, and
• Systemic Therapy. 

Local Therapy

Local Therapy is to control the disease in the breast and nearby lymph nodes and includes

• Breast Conserving Surgery
• Mastectomy Surgery
• Radiotherapy.

Combinations of these approaches is common for example Breast Conserving Surgery and Radiotherapy

Systemic Therapy

Systemic therapy aim to rid the body of the tiny cancer cells that may have escaped from the primary breast tumour to other parts of the body. Invasive breast cancer can potentially travel from the primary tumour to other body parts.

Systemic therapies include

• Chemotherapy,
• Endocrine Therapy and
• Targeted Therapy. 

A Multidisciplinary Approach

Multidisciplinary care (MDC) is an integrated team approach to health care, in which medical and allied health care professionals consider all relevant treatment options, and collaboratively develop an individual treatment plan for each patient. 

In Australia, it is considered a best practice for cancer treatment to be managed through a multidisciplinary team (MDT) approach. 

This means that all relevant health professionals involved in your care meet to discuss the best treatment options for you and work together to:

• Make Joint Treatment Recommendations
• Plan
• Execute and 
• Review each case
• Define Supportive Care Plans (taking into account the personal preferences of the patient).

In this way, you can be assured that your treatment is tailored specifically to you, by a team of leading cancer specialists.

Benefits of MD Care

• Receive care in accordance with national clinical standards and practice guidelines
• Access to the full range of treatment options for all patients, regardless of geographical remoteness or size of the institution
• Provides up-to-date evidence-based recommendations for effective treatment.
• All treatment options can be considered, and treatment plans tailored for individual patients
• Referral pathways are more likely to be streamlined and care is coordinated
• Security for the patient that care is being managed by a team
• Increased access to information, particularly about psychosocial and practical support
• Increased patient satisfaction with care

The Multidisciplinary Team

There are several specialties that meet to discuss your individual case. The following health professionals may be involved in the care of a woman with cancer:

Core Team Members

• General practitioner: provides ongoing care and works with other members of the treatment team
• Surgeon: specialises in surgery, including biopsies
• Pathologist: examines cells, tissue and blood from the body
• Radiologist: examines mammograms, ultrasounds, X-rays and other imaging results and may perform biopsies or help locate cancers prior to surgery
• Radiation oncologist: specialises in radiotherapy
• Radiation therapist: assists in planning and giving radiotherapy
• Medical oncologist: specialises in cancer drugs such as hormonal therapies, chemotherapy and targeted therapies

Other Team Members

• Cancer care nurse: specialises in caring for people with cancer
• Oncology nurse: specialises in caring for people with cancer
• Research nurse: assists in the planning and coordination of clinical research studies and clinical trials
• Psychologist, psychiatrist or counsellor: specialise in providing emotional support and managing anxiety and depression
• Social worker: specialises in providing emotional support, counselling and advice about some practical and legal matters
• Welfare worker: provides practical support and advice
• Physiotherapist, occupational therapist: assist with exercise and pain management
• Dietitian: specialises in providing advice about what to eat
• Palliative care specialist, palliative care nurse: specialises in providing practical support and symptom relief
• Community/district nurse: provides care and support at home
• Community palliative care team: provide practical support and symptom relief at home
• Plastic surgeon: specialises in reconstruction after surgery
• Pharmacist: specialises in supplying, dispensing and manufacturing drugs
• Pastoral care/religious representative: provides spiritual support.

Surgeons

Your surgeon will present your case to the multidisciplinary meeting as your surgeon. There will be other cancer surgeons present. Together they will agree on the best course for your surgical management.

Pathologists

The Pathologist who attends the MDT meeting is there to present the microscopic findings of any cytology or histology findings to assist in the planning of your definitive treatment

Radiologists

The Radiologist uses their imaging expertise in the diagnosis and sampling of abnormalities. Like the Pathologist, the Radiologist is a core member of the multidisciplinary cancer team. The Radiologist and Pathologist will interact as the diagnostic part of patient care, with an important aspect of the MDT being the correlation between the Radiologist’s imaging findings and the Pathologist’s histologic or microscopic findings.

Medical Oncologists

A medical oncologist treats cancer using chemotherapy or other medications, such as targeted therapy or immunotherapy. At the meeting, it will be decided whether it is appropriate for you to see a medical oncologist.

Radiation Oncologists

A Radiation Oncologist is a medical specialist doctor with training in the use of radiation therapy (also called radiotherapy) to cure or reduce the symptoms of cancer and in the overall care of cancer patients. Many patients will require a consultation with a radiation oncologist, and this will be discussed at the meeting.

Cancer Care Nurses

Cancer nurses are a key point of contact between oncologists and patients and are important for the continuity of care of cancer patients. The Cancer care nurse will be present at the meeting to ensure she is fully up to date with your treatment recommendations.

Genetic Cancer Team

The genetic cancer team at Prince of Wales Hospital provides individuals with an accurate assessment of their personal risk for developing cancer or ovarian cancer and offers a plan for follow-up and preventive care. You will be referred to the genetics team if your doctor or anyone else at the multidisciplinary meeting believes you are at risk of a potential gene mutation.