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Breast Cancer & Treatment Options
The stages of breast cancer
Breast cancer recurrence
Impact of hormones on breast cancer
Treatment options
Hormonal Therapy
Chemotherapy
Biologically Targeted Therapy
Radiation Therapy
Surgery
Important Safety Information
Indication
FASLODEX is a medication that has been
approved for use in postmenopausal women with hormone receptor-positive
metastatic breast cancer that has progressed following therapy
with a hormonal treatment like tamoxifen.
FASLODEX is not indicated for treatment of early stages
of breast cancer.
The stages of breast cancer
A breast is made up of lobules, ducts, fatty tissue, blood
vessels, and lymph vessels. The lobules are glands that
make milk; the ducts are tubes that link the lobules to
the nipple. The fatty tissue surrounds the lobules and ducts.
Lymph vessels carry lymph to lymph nodes in the underarm,
above the collarbone, and in the chest. There are also lymph
nodes throughout the body.
Your doctor will look at a number of factors, including
the size of the tumor, the role of lymph nodes, and how
far the cancer has spread, to determine the stage of your
breast cancer. There are early stages (0, I, and II) of
breast cancer and advanced stages (III and IV) of breast
cancer.
Early stages of breast cancer
Stage 0
Cancer cells are present in either the lining of a lobule
or a duct, but they have not spread to the surrounding fatty
tissue.
Stage I
Cancer has spread from the lobules or ducts to nearby tissue
in the breast, and tumor is 2 cm (3/4 inches) or less in
diameter; the lymph nodes are not involved.
Stage II
Cancer has spread from the lobules or ducts to nearby tissue
in the breast, and tumor is about 2 to 5 cm (3/4 to 2 inches)
in diameter; sometimes the lymph nodes may be involved.
Advanced stages of breast cancer
Stage III
May include locally advanced cancer; tumor may be larger
than 5 cm (2 inches) across, and cancer may or may not have
spread to lymph nodes or other tissues near the breast.
Stage IV
Known as metastatic; cancer has spread from the breast and
lymph nodes under the arm to other parts of the body, such
as bone, liver, lung, or brain.
The recurrence of breast cancer-the return of cancer after
remission of the disease-can occur at the site of the first
tumor, in the lymph nodes adjacent to the cancerous breast,
or in other parts of your body.
Breast cancer recurrence
Local recurrence is when breast cancer
returns to the breast (after lumpectomy), and/or the chest
area and scar (after mastectomy), but no other area of the
body.
Regional recurrence is when breast cancer
returns to one or more of the axillary lymph nodes, and/or
to the lymph nodes in the center of the chest and elsewhere
near the chest. Regional recurrence can also include a combination
of a local recurrence and a recurrence in the chest-area
lymph nodes.
Distant (systemic) recurrence is when
breast cancer has traveled (or metastasized) to one or more
locations outside of the breast or chest area. This is known
as advanced or metastatic breast cancer.
Impact of hormones on breast cancer
Hormones are produced by organs or cells
in your body. Hormones, such as estrogen, affect bodily
processes. Normal breast cells have receptors for estrogen
and progesterone. Some, but not all, breast cancer tumors
also have these receptors and need these hormones to grow.
Such tumors are called estrogen and/or progesterone receptor
positive, or hormone receptor positive. Breast cancer tumors
are estrogen and progesterone receptor positive in 63 percent
of postmenopausal women. Lab tests of your cancer biopsy
give your medical team this information. Receptors are very
small parts of a cell. If estrogen is present, it will attach
to an estrogen receptor and may make the tumor grow larger.
Estrogen does not cause breast cancer,
though it may promote the growth of tumors.
Treatment options
Today, women with advanced breast cancer
have several treatment options available to them. Generally,
these treatments are aimed at lengthening life, while considering
quality and fullness of life. A medical team can help make
the appropriate decisions about treatment and follow-up
care, based on the medical condition and the lifestyle women
want to lead. You need to determine what treatment options
will work for you by weighing the risks and benefits with
your physician.
Some therapies that are available for
women with locally advanced or metastatic breast cancer
include
HORMONAL THERAPY: A woman
may have already received hormonal therapy after surgery
at her initial diagnosis. Hormonal therapy can be used to
reduce the growth, spread, and recurrence of breast cancer.
If the cancer is found to be of the type that may be sensitive
to estrogen, hormonal therapy may be able to keep estrogen
from helping the cancer cells to grow and divide. The presence
of estrogen receptors (a message-carrying protein that may
stimulate tumor growth) in the cancerous tumor is the best
way to predict a woman's response to hormonal therapy. Your
doctor can do a test to determine the estrogen receptor
status of your tumor. Click here to learn more about your
estrogen receptor status.
There are several hormonal treatment options
available for postmenopausal women with advanced or metastatic
breast cancer that can be tailored to the lifestyle a woman
wants to lead. Hormonal therapies are currently available
in pill form or as a monthly intramuscular injection into
the buttock. Ask your physician about these therapies.
FASLODEX is a hormonal
treatment for hormone receptor-positive metastatic breast
cancer in postmenopausal women with disease progression
following antiestrogen therapy (eg, tamoxifen). Click here
to see How
FASLODEX Works.
CHEMOTHERAPY: Chemotherapy may be used
if it is believed the breast cancer will not respond to
hormonal therapy. Chemotherapy is the use of drugs that
target and destroy rapidly dividing cells, including cancer
cells. It is frequently used in metastatic breast cancer
and used in locally advanced breast cancer to shrink the
tumor and make it operable.
BIOLOGICALLY TARGETED THERAPY:
This term covers a range of new options that are to be added
to the family of cancer treatments. These therapies target
specific features of cancer cells to fight cancer. Since
these therapies are specific, they are intended to have
less effect on normal cells, which may reduce the chance
of side effects like those caused by current cancer treatments.
Types of treatment include monoclonal antibodies, which
bind to proteins on the cancer cell surface to slow down
cancer cell growth; angiogenesis inhibitors, which are intended
to prevent the growth of new blood vessels and so cutoff
the supply of oxygen and nutrients to cancer cells; and
signal transduction inhibitors, which block the signals
inside the cancer cell that promote the cells to divide
and in turn cause the cancer to grow.
Most of these approaches are still experimental
and would be offered as part of a clinical trial.
RADIATION THERAPY: Radiation
therapy uses penetrating beams of high-energy waves or streams
of particles to kill and hinder the growth of cancer cells.
In metastatic disease, radiation is most commonly used to
treat symptoms in breast cancer that has spread to the bone.
SURGERY: Surgery permits
both diagnostic tissue removal and may help with control
of cancer. In some cases, a physician may recommend surgery
to remove tissue from the breast or lymph node.
Important Safety Information
Only postmenopausal women should take
FASLODEX. Do not take FASLODEX if you are pregnant and do
not become pregnant while taking FASLODEX, because it may
harm your unborn child. (See WARNINGS and CONTRAINDICATIONS
sections of Full Prescribing Information).
Because FASLODEX is administered intramuscularly,
it should not be used in patients with certain blood disorders
or in patients receiving anticoagulants (sometimes called
blood thinners, for example, warfarin).
In clinical studies, the most commonly
reported side effects were nausea, vomiting, constipation,
diarrhea, abdominal pain, headache, back pain, hot flashes,
sore throat and injection site reactions with mild, transient
pain and inflammation.
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