A diagnosis of node-positive breast cancer can be daunting, leaving patients with a sense of fear and the unknown. Node-positive breast cancer occurs when cancer cells have spread to nearby lymph nodes, indicating a more advanced stage of the disease. This diagnosis raises significant concerns making effective treatment vital for patient survival. We spoke to our expert Dr Sachin Trivedi, Director, Medical Oncology, HCG Cancer Center, Colaba, who explained that adjuvant chemotherapy, which is chemotherapy administered after surgery, plays a crucial role in improving patient outcomes.
What Is Node-Positive Breast Cancer?
"Node-positive breast cancer is a type of cancer where cancer has spread to nearby lymph nodes. This translates into a higher risk of recurrence and metastasis. For these patients, adjuvant chemotherapy (post-surgery chemotherapy) can be a crucial treatment that significantly improves outcomes," said Dr Trivedi.
According to the Canadian Medical Association Journal (CMAJ), nearly all women diagnosed with node-positive breast cancer need drug therapy alongside surgery and radiation. Even when it appears that the entire tumour has been successfully excised, many women experience a recurrence of cancer. They may die within 10 years if they rely solely on surgery and radiation without any drug treatment.
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The Mechanism of Adjuvant Chemotherapy
"After surgical intervention to remove the tumour, there is a possibility that microscopic cancer cells remain undetected in the body. These residual cells can lead to local recurrence or metastasis if left untreated," said Dr Trivedi. Adjuvant chemotherapy works by circulating through the bloodstream, targeting and attacking these elusive cancer cells, regardless of location.
"By doing so, it effectively reduces the likelihood of both local and distant recurrence. Numerous clinical trials have demonstrated that patients with node-positive breast cancer who receive adjuvant chemotherapy have a markedly lower risk of cancer recurrence compared to those who do not," he added.
Combination with Targeted Therapies
In addition to its direct benefits, adjuvant chemotherapy is frequently combined with targeted therapies to optimise treatment outcomes. One notable example is the treatment of HER2-positive breast cancer, a subtype characterised by the overexpression of the HER2 protein.
"Patients with this type of breast cancer may receive chemotherapy in conjunction with HER2-targeted therapies like trastuzumab (Herceptin). This combination not only enhances the effectiveness of the treatment but also contributes to improved survival rates and reduced recurrence,"added Dr Trivedi. Similarly, patients with Triple-Negative Breast Cancer (TNBC), who typically lack options, such as hormone therapy, greatly benefit from chemotherapy as their primary treatment modality.
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Managing Side Effects
"Despite the effectiveness of chemotherapy, it is essential to acknowledge the potential side effects that can accompany this treatment. Common side effects include fatigue, nausea, hair loss, and an increased risk of infections due to lowered white blood cell counts. While these side effects can be challenging, they are generally temporary and manageable," highlighted Dr Trivedi.
Advances in supportive care, including anti-nausea medications and strategies to combat fatigue, have significantly improved the quality of life for patients undergoing chemotherapy. The long-term benefits of reducing the risk of cancer recurrence and enhancing survival typically outweigh the temporary discomfort associated with treatment.
Bottomline
Dr Trivedi concluded, "While chemotherapy might come across as an aggressive treatment strategy, it is only employed when it is clear that the patient derives a long-term benefit from treatment. Ultimately, adjuvant chemotherapy stands as a life-saving strategy for many patients battling node-positive breast cancer, reinforcing its essential place in modern oncology."
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your own professional if you are dealing with any health issues to avoid complications.]