By Dr. Kathleen Ruddy
Early cancer detection means more options in terms of treatment and a better chance of survival. Simply finding a tumor is the first step in a long process that involves a great deal of discovery and discussion.
How does the doctor measure the tumor?
Tumors in your breast are typically measured in centimeters and assigned a T rating. The smaller the tumor size, the smaller the T rating. For example, a T-1 tumor is less than 2 centimeters. A T-3 tumor is greater than 5 centimeters. When your doctor performs surgery on the tumor, the most accurate measurement is taken. Until the surgery is performed, your doctors must estimate the tumor size based on results from mammograms, ultrasounds and MRIs.
What other factors go into evaluating treatment options?
The tumor size does play a role in which treatment options are available, but there are other important factors that you and your doctor must consider. The first factor is whether the tumor affects nearby lymph nodes; the results are either positive for cancer cells affecting other lymph nodes or negative if no nodes are affected. If the tumor size is greater than 4 centimeters, your doctor orders a scan to see if the cancerous cells have spread to other organs in your body. If the cancerous cells are affecting other organs, the cancer has metastasized.
To help visualize the size of the tumor, imagine a T-1 tumor to be between the sizes of a black peppercorn and a black-eyed pea, a T-2 tumor between the sizes of a cranberry and walnut and a T-3 at about the size of a lime.
What are the treatment options?
While your treatment plan is specifically tailored to your needs, there are some aspects of treatment that remain constant. If the tumor is small and has a T-1 rating, a lumpectomy is likely to be advised. This procedure allows your breast to remain intact. Radiation therapy is advisable after a lumpectomy.
If your tumor is larger, the doctor may suggest that you undergo a mastectomy, which removes the entire breast. Typically, radiation therapy is not necessary once a mastectomy is complete. However, if the cancer has spread to the surrounding lymph nodes, radiation therapy is advisable.
If the tumor is too large to remove surgically, the doctor may advise radiation therapy in hopes of shrinking the tumor and then performing surgery.
If the tumor has metastasized, there is likely no amount of surgery or radiation therapy that can completely destroy the cancer cells. There are drugs that can slow or possibly halt the division of cancer cells and allow you to continue living a normal life for at least a few more years.
How can tumors be detected early?
Your doctor should perform a clinical breast exam once every three years. When you reach the age of 40, your doctor should perform this exam annually. Once you are over age 40, you should have an annual mammogram. If breast cancer runs in your family, you should start scheduling annual mammograms at age 30.
Early detection is advantageous because a simple lumpectomy is far less invasive than months of radiation therapy and reconstructive surgeries to restore the shape of your breast. Getting regular breast examinations and mammograms is the key to maintaining breast health.
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