breast cancer treatment

With this report, women with breast cancer have access to information
on the way breast cancer is treated at the nation's leading cancer
centers. Originally developed for cancer specialists by the National
Comprehensive Cancer Network (NCCN), these treatment guidelines have
now been translated for the public by the American Cancer Society.
Since 1995, doctors have looked to the NCCN for guidance on the
highest quality, most effective advice on treating cancer. For more
than 90 years, the public has relied on the American Cancer Society
for information about cancer. The Society's books and brochures
provide comprehensive, current, and understandable information to
hundreds of thousands of patients, their families and friends. This
collaboration between the NCCN and ACS provides an authoritative and
understandable source of cancer treatment information for the public.
These patient guidelines will help you better understand your cancer
treatment and your doctor's counsel. We urge you to discuss them with
your doctor. To make the best possible use of this information, you
might begin by asking your doctor the following questions:
How large is my cancer? Do I have more than one tumor in the
breast?
What is my cancer's grade how abnormal the cells appear) and
histology (type and arrangement of tumor cells) as seen under a
microscope?
Do I have any lymph nodes with cancer (positive lymph nodes,
i.e. nodal status)? If yes, how many?
What is the stage of my cancer?
Does my cancer contain hormone receptors? What does this mean
for me?
Is my cancer positive for HER-2? What does this mean for me?
Is breast-conserving treatment an option for me?
In addition to surgery, what other treatment do you recommend?
Radiation? Chemotherapy? Hormone therapy?
What are the side effects?
Are there any clinical trials that I should consider?
Inside Breast Tissue
The main parts of the female breast are lobules (milk-producing
glands), ducts (milk passages that connect the lobules and the
nipple), and stroma (fatty tissue and ligaments surrounding the ducts
and lobules, blood vessels, and lymphatic vessels). Lymphatic vessels
are similar to veins but carry lymph instead of blood. Most breast
cancer begins in the ducts (ductal), some in the lobules (lobular),
and the rest in other breast tissues.
Lymph is a clear fluid that has tissue waste products and immune
system cells. Most lymphatic vessels of the breast lead to underarm
(axillary) lymph nodes. Some lead to lymph nodes above the collarbone
(called supraclavicular) and others to internal mammary nodes which
are next to the breastbone (or sternum). Cancer cells may enter lymph
vessels and spread along these vessels to reach lymph nodes. Cancer
cells may also enter blood vessels and spread

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