Oncological Treatment of Breast Cancer

At Clinic Helena, an oncologist plans your individual breast cancer treatment in connection with your breast cancer surgery. Oncological treatment means cancer treatments that can include drug therapy, radiation therapy, and hormonal therapy. Drug therapies for cancer are often referred to as cytostatic therapy or chemotherapy. In the past, the term “cytotoxic” was also used, but it does not describe well the healing effect of modern cytostatic drugs.

Oncological treatment is used to ensure that the tumour is destroyed completely and that no cancer cells remain in the body after cancer surgery.

On this page:

Planning for Further Ttreatment of Breast Cancer
Cytostatic Therapy for Breast Cancer
Quick Examinations and Treatment
Radiation Therapy for Breast Cancer
Hormone Therapy for Breast Cancer
Individual Treatment at Clinic Helena
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Planning for Further Ttreatment of Breast Cancer

After breast cancer surgery, a pathologist analyses all removed tissue sections and makes a final evaluation of the extent of the patient’s breast cancer. Based on the findings, an oncologist then plans the oncological aftercare. This treatment also known as adjuvant therapy includes cytostatic therapy, radiotherapy, and hormonal therapy as needed.

In certain cases, oncological care with chemotherapy is performed before surgery, for example in cases of inflammatory breast cancer (neo-adjuvant treatment).

When choosing the right oncological treatment, the oncologist considers:

The type and size of the tumour
The aggressiveness (gradus)
Cell invasion in neighbouring tissue like small vessels, lymph ducts or nerves
Immuno-histological receptor (estrogen-, progesterone-, HER2) status
Cell proliferation activity (Ki67) define the oncological after care.

Cytostatic Therapy for Breast Cancer

The purpose of cytostatic therapy is to totally destroy or at least prevent the growth of cancer cells in the body. Cancer cells grow faster than healthy cells and these fast-growing cells are most susceptible to destruction. Some healthy cells are also lost during the treatment. Therefore, blood levels are monitored at regular intervals allowing the oncologist to adjust the dosage according to the patient’s individual response.

The treatment is begun one month after the breast cancer surgery. Our oncologists plan the postoperative chemotherapy individually for each patient, depending on the type, size, stage and grade of the breast cancer at the time of diagnosis.

In addition to chemotherapy, in Clinic Helena all patients who undergo breast-conserving surgery also receive radiotherapy. If necessary, radiotherapy will also be given after mastectomy surgery.

How is cytostatic therapy done?

Cytostatic drugs are usually administered intravenously as injections into a vein or as a drip (infusion) at the hospital’s chemotherapy outpatient clinic. New anticancer drugs are constantly being developed and many of these can be given as tablets or capsules. The tablets and capsules can be taken at home, while the drips are administered in the hospital’s medical treatment unit.

The treatment in the hospital lasts for a few hours, after which the patient returns home. Anti-nausea medication is also given either orally or by injection.

How long does cytostatic treatment last?

Usually, cytostatic therapy consists of six doses at three weeks’ interval. A course of chemotherapy comprises a combination of various cytostatic drugs. The treatment is given in cycles because not all cancer cells are destroyed simultaneously; each cycle destroys only a certain proportion of the cancer cells. In between the cycles, the normal, healthy cells recover faster than the remaining cancer cells.

Taxotere treatment is combined with Herceptin treatment if there are HER2 receptors in the breast cancer cells. It can either be administered weekly or also every 3 weeks during the cytostatic treatment. The duration of treatment varies from individual to individual and can last up to a year.

What drugs are used in the cytostatic treatment of breast cancer?

The most common form of breast cancer is treated with the CEF combination (C = cyclophosphamide, E = epirubicin, F= fluorouracil). It is administered intravenously.

The treatment is begun one month after the surgery. The dosage is calculated according to the area of the patient’s skin. Treatment is repeated at three-week intervals, provided that the normal blood cells recover sufficiently within that time. Usually, the treatment is repeated a total of 6 times.

If the breast tumour has grown relatively big and the cell morphology indicates that it is more aggressive, a cytostatic drug called Taxotere is used. It is administered intravenously. The treatment is begun one month after the surgery and is repeated three times at three-week intervals. After three cycles, the treatment is continued with the CEF combination, administered three times at three-week intervals.

Taxotere treatment is combined with Herceptin treatment if there are HER2 receptors in the breast cancer cells. Herceptin is given together with Taxotere nine times at one-week intervals. Herceptin is not a cytostatic drug but a targeted drug that blocks receptors. Herceptin does not affect healthy cells.

Chemotherapy Before Breast Cancer Surgery

In some cases, cytostatic therapy, or chemotherapy, is started before surgery to shrink the tumour. The decision to start treatment is made on an individual basis, for example to allow breast-sparing surgery in a broad local disease or to enhance the treatment of an inflammatory disease.

Today’s trend in the world is to give cytostatic treatments even before surgery. This was also done 30 years ago. In Finland, oncologists are critical of this. Only when there is scientific evidence that patients cope better will we move on to this practice.

In this case, the choice of drug is of great importance. At present, it seems that in the so-called triple-negative (missing all receptors) breast cancer, young people in particular could benefit from platinum-based cytostatic drugs before surgery. On the other hand, breast cancer, for example, with metaplastic features, is often very resistant to cytostatic drugs, in which case surgical treatment would be paramount.

Inflammatory Breast Cancer

When treating inflammatory breast cancer (the breast is red and swollen), three cycles of chemotherapy at three-week intervals are given already before the surgery (neoadjuvant therapy). The surgery is performed between cycles, and another 3-6 cycles of chemotherapy are given after the surgery according to the oncologist’s instructions.

Triple-negative Breast Cancer

Also, in the so-called “triple negative” type of breast cancer as well as in widespread cancer cases neoadjuvant therapy will be given.
Receptor-negative (estrogen, progesterone, and herseptin receptor-deficient) cancers as well as locally widespread cancers can also be treated partially or completely before surgery.

If the white blood cell count is too low after chemotherapy, the growth of white cells is stimulated by G-CSF treatment. This medication is usually given subcutaneously under the skin.

There are interesting studies which develop individual, targeted treatments for different stages of the disease. In the future, the adjuvant chemotherapy will be more and more individual depending on the nature of the tumour.

Quick Examinations and Treatment

If you have already been diagnosed with breast cancer or if, on the basis of your symptoms, you suspect it, you can access Helena Puonti’s consultation quickly and without a referral.

Why choose Clinic Helena:

World-class expertise in breast cancer treatment, using the most modern methods.
Helena Puonti’s unique Sensing Breast-method – available only at Clinic Helena.
We devote ourselves to helping You recover completeley from your illness.

+358442378021

Side Effects of Chemotherapy

Most of the symptoms relating to the side effects of chemotherapy can be prevented or alleviated. All of them will disappear with time. Many normal, fast-regenerating healthy cells of the body are sensitive to cytostatic drugs. Millions of new cells are produced every day in, for example, the bone marrow, as well as in the scalp and in the mucous membranes of the mouth and the intestines.

Chemotherapy also destroys some of the healthy cells in the bone marrow, scalp and mucous membranes. Side effects related to this include low blood counts, hair loss, and digestive and intestinal problems.

Hair and Chemotherapy

The regeneration of cells in the scalp can be disrupted by chemotherapy, causing hair loss in some patients. Sometimes hair comes off in large clumps. Hair loss can also occur on other parts of the body, including the eyebrows, beard, and pubic hair.
The nails are part of the skin and can also fall out. All patients receiving chemotherapy can be provided with a wig. When chemotherapy is over, hair and body hair will grow back.

Nausea Caused by Chemotherapy

Nausea incidences and duration of them are individual. Nausea occurs most often within three days of treatment. Anti-nausea medication is given well before the beginning of chemotherapy. It will be continued for as long as there are symptoms. The choice of a suitable diet can also prevent nausea. It’s worth listening to your own body to know what foods suit best for you.

Decreased Appetite During Treatments

In addition to chemotherapy, the cancer itself can cause loss of appetite and weight. It is advisable to eat small doses often during treatment. It is advisable to eat small portions at frequent intervals.

Cold food causes less nausea than hot food and might be easier to eat if mucous membranes in the mouth have been damaged.

Nutritional drinks are recommended if eating is difficult.

Eating fresh fruits and berries is advised as your body absorbs vitamins better from them than from tablets. You should pay attention to a sufficient protein and calory intake.

Some plant estrogens (phytoestrogens) are claimed to protect against breast cancer. These can be found in rye bread and broccoli, for example.

Dryness and Ulceration of Mucous Membranes

The body’s mucous membranes are not always regenerated fast enough during cancer treatment. This can cause mouth ulcers, a dry mouth, nausea, diarrhoea and intestinal problems.
The mouth can be protected from drying with different oils, for example, Ceridal spray is a tasteless and easy to dispense product. Triamcinolone tablets available from a pharmacy can be used for ulcers. Sour dairy products (sour milk, yogurt) or probiotics might also be helpful.

The symptoms will disappear after a while once chemotherapy ended.

Fatigue During Cytostatic Therapy

Fatigue during cytostatic therapy is often due to various factors in our blood. The red blood cells transport oxygen to all organs and tissues of the body. Chemotherapy decreases the number of red blood cells in the body. This can result in a lower level of hemoglobin, which can cause tiredness and paleness.

The white blood cells protect the body against bacteria and viruses. When the body’s white blood cell count drops, susceptibility to infection increases. The risk of infection is usually the highest 7-14 days after chemotherapy. It is advisable to avoid contact with people with a cold during that time. If a patient develops a high temperature at home, she should contact the clinic.

Blood platelets (thrombocytes) help the blood to coagulate and wounds to heal.
Usually, the bone marrow manages to recover, and the blood counts return to normal between cycles of chemotherapy. This will be monitored by blood tests.

Radiation Therapy for Breast Cancer

Radiation therapy is a commonly used method used to treat breast cancer. Radiation therapy is given approximately one month after cytostatic therapy.
All breasts operated with the breast-conserving method receive radiation therapy to prevent recurrence of the disease. After mastectomy surgery, radiotherapy is given if the tumour is large in size and/or there are clear metastases in the armpit.

Radiation is targeted to the breast area and in most cases also the armpit area. Sometimes also the lymph nodes in the supraclavicular area will be included in the radiation area.

How long does breast radiotherapy last?

The duration of radiotherapy for breast cancer is usually 3 weeks. For young patients or large breast tumours, an additional fourth week of radiation therapy is currently also recommended.

Side effects and recovery from radiotherapy

The side effects of radiotherapy for breast cancer are often minor and most commonly skin-related symptoms such as skin swelling, pain, and redness. Radiation therapy does not normally cause hair loss or nausea.

Skin irritation and other symptoms can be effectively prevented with instructions from our medical staff.

Dry skin “burns” more easily, so using moisturizers is beneficial. You should start using them after stitch removal at the latest. When applying moisturizers, the breast skin can be lightly massaged, allowing the skin’s blood circulation to recover better.
Occasionally, swelling may occur in the breast. To minimise the swelling, lymph therapy can be started, but only after the breast skin has recovered from radiotherapy.

During breast cancer radiotherapy, it is often advisable to take sick leave due to the regular nature and exact timing of treatments.

Recovery from the side effects of radiotherapy for breast cancer is individual, but usually, the side effects begin to subside rapidly within a few weeks of the end of the treatment.

Hormone Therapy for Breast Cancer

In most cases, after chemo- and radiotherapy, the doctor may still prescribe the patient hormone therapy known as anti-estrogen therapy. The goal of hormonal therapy is to lower the estrogen levels as much as possible as estrogen accelerates the division of cancer cells. Hormone therapy is used if estrogen and progesterone receptors are found in the tumour.

The duration of hormone therapy is 5-10 years, depending on the case.

Hormone therapy can also have side effects. Some experience early “menopausal symptoms,” heavy sweating, fatigue, and sleep disturbances. These should be discussed with your oncologist.

Sometimes it is possible to change the drug to a different medicine. In general, the side effects of hormonal drugs are minor.

Individual Treatment at Clinic Helena

It is possible to arrange oncological treatment at Clinic Helena as part of a comprehensive breast cancer treatment. If necessary, the patient can also continue the treatment with an oncologist in their home country. Clinic Helena specialises in breast-conserving surgery, oncological treatment, breast reconstructions, and breast cancer rehabilitation.

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