Breast cancer diagnosis: the follow-up examinations

Whoever has been diagnosed with breast cancer often has the feeling that her (or his) life is collapsing. In a conversation, a surgeon often immediately tells what is going on. But then there is a whole follow-up process that is just as exciting. Whether the cancer has spread further is of great importance.

The preliminary diagnosis for breast cancer and further investigation

Breast cancer is diagnosed after biopsies are taken from the breast and / or lymph nodes in the armpit. As the pathologist who investigated and found malignant cells, the first diagnosis was made. That is then breast cancer. For the rest of the treatment it is of great importance to know whether metastases can be found further down the body. This is done again on the basis of a number of further investigations. These are:
  1. Thorax photo
  2. Liver ultrasound
  3. Bone scan

Thorax photo

With a chest x-ray an x-ray of the upper body is made. Someone may just wear a shirt if there are no metal things in it. The photo must be inhaled deeply and then the breath must be held. At that moment a photo is made. Then another photo is made of the lungs in another position. In most hospitals, people do not immediately hear the results of that photo. That is very unpleasant, because it means being in tension again. It often takes another week or two in most regional hospitals for the aforementioned examinations to be completed and there is certainty about the rest of the body. In specialized cancer hospitals, this can often be much quicker and the patient has the result the same day.

Liver ultrasound

With a liver ultrasound, a large area of ​​the abdomen is mapped with an ultrasound device. On the bare abdomen, everything from just above the pubic area to below the breasts is mapped with an ultrasound and with the help of gel and images are made that are stored digitally. The person who makes these recordings can actually see immediately whether metastases can be seen in the liver. However, he or she may not usually say that, but you can always try. After taking the pictures, a radiologist still looks at the pictures to see if there are any things that are unclear that require further investigation. For a liver echo someone needs to be sober and so nothing can be drunk and eaten since the previous day. Eating and drinking can cause a disturbed image.

Bone scan

With a bone scan, radioactive material is injected into the body. This is due to a drip in the arm. After tightening the material, the patient must spend a few hours elsewhere and drink plenty of water to ensure that the radioactive substances penetrate the body properly. In the meantime, someone may also just eat and drink. After the training period, the person in question is placed on a long couch. A movable scan then crosses the body to see if metastases (metastases) are found anywhere in the bone tissue. This investigation takes approximately 20 to 30 minutes. You do not lie in a tube, but there is just space on both sides. It is therefore different from an MRI scan in which people often become claustrophobic.

Metastases or no metastases in breast cancer

For the treatment of breast cancer it is very important to know whether or not metastases have been found in the liver, lungs and bones. Treatment is tailored to that.

Types of cancer treatments

The types of treatments that someone must undergo depend on:
  • The type of cancer
  • The stage the cancer is in (including whether there are metastases)
  • The age of the patient
  • The general condition of the patient
Therefore, the treatment of someone with breast cancer can also vary from person to person.

Purpose of treatment

The purpose of the treatments is subdivided into:
  • Curative treatment
  • Adjuvant treatment
  • Neoadjuvant treatment
  • Palliative treatment

Curative treatment

The purpose of curative treatment is to cure the patient.

Adjuvant treatment

An adjuvant or additional treatment is given after a curative treatment. This can be, for example, chemotherapy or radiotherapy after surgery.

Neoadjuvant treatment

A neoadjuvant treatment can be given before someone undergoes surgery. This can be in the form of radiation or chemotherapy before the operation so that the tumor becomes smaller and the operation less drastic.

Palliative treatment

If the cancer is no longer curable, palliative treatment is given. This is intended to inhibit the disease or reduce the symptoms or both.

Combination therapy

Nowadays, multiple treatment methods are often used for cancer to reduce or cure the disease. This can be a combination of:
  1. Surgery
  2. Radiotherapy (radiation)
  3. Chemotherapy (treatment of cancer with cell division inhibiting drugs)
  4. Immunotherapy (these drugs activate your own immune system)
  5. Hormone therapy (treatment of cancer with hormones)
  6. Hyperthermia (treatment of cancer with heat)
  7. Stem cell therapy (new stem cells are administered after a high dose of chemotherapy)

Combination therapy for breast cancer

Breast cancer usually requires surgery first. This can be a breast-conserving operation, but also an operation where the breast is completely amputated. Incidentally, breast-conserving surgery may be involved in the first instance, but later on the examination of the removed tissue shows that the cuts were not clean and that the breast must still be amputated as a whole. This can be a fairly traumatic experience for the woman in question. Moreover, she still has to undergo surgery, which quickly follows the previous one.
Often the lymph nodes are also removed or part thereof. The insights per hospital do, incidentally, differ and it is good to delve into that as a patient. Removing the lymph nodes can cause lymphedema and the use of the arm can also be considerably reduced. Moreover, due to the lack of lymph nodes, the body is less able to arm itself against infections.
Breast-conserving surgery always involves breast radiation. When the lymph nodes are removed, radiation always follows. These irradiations last for 7 weeks and the patient in question must then be irradiated 5 times a week. Fatigue and burnt skin often occur due to radiation.
Depending on the nature of the cancer and the age of the woman in question, chemotherapy must also be treated relatively often thereafter. In addition, the woman receives a portion of chemo once every three weeks that is led into the body by an infusion. This goes very slowly because this liquid has to be absorbed into a body that is already full of liquid and therefore takes 2.5 to 4 hours. The woman is treated for this on an outpatient basis and can then go home as usual. The chemo can make someone feel sick. On the day itself, most people are doing well (also because of the preventive medication that is given), but in the days that follow many people feel very bad. It is not until the third week that most chemo patients with breast cancer get a little better again, but then they know that they have to follow a course a week later.

Personal blog about breast cancer

In my personal blog about breast cancer I describe all stages of research and treatment of my own breast cancer and I give tips and advice. The blog can be found at: I have breast cancer

Video: How do you screen breast cancer ? Health Questions (April 2020).

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