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Breast Cancer Treatment

Breast Cancer Treatment

Breast cancer treatments include various methods determined by taking into account the patient's cancer type, stage and individual health condition.
Breast Cancer Treatment

The huge increase in life-saving treatment developments against breast cancer in recent years is hopeful and exciting. Today, instead of one or two treatment options, there are many treatment options that can combat each type of breast cancer. Surgery, then perhaps radiotherapy (radiation therapy), hormonal therapy and/or chemotherapy treatment options are available.

Breast cancer treatments include various methods determined by taking into account the patient's cancer type, stage and individual health condition. These methods may include surgical interventions, radiotherapy, chemotherapy, hormone therapy and targeted therapies.

Breast Cancer Treatment at Liv Hospital


Liv Hospital is a healthcare institution that specializes in breast cancer treatment and adopts a multidisciplinary approach. Experienced oncologists, surgeons, and radiotherapists come together to create personalized treatment plans tailored to patients' individual situations. Various treatment methods such as surgical interventions, radiotherapy, chemotherapy and hormone therapy are determined according to the stage and characteristics of the patient's cancer. In addition to offering its patients the latest treatment options using modern medical technology, Liv Hospital also provides comprehensive healthcare services in areas such as psychological support and rehabilitation services.

After breast cancer diagnosis, your doctor will make a treatment plan specific to your current situation with you, based on the results of your pathology report. Your treatment plan will consist of one or more specific treatments aimed at targeting cancer cells in different ways and reducing the risk of breast cancer recurring in the future. You and your doctor will make treatment decisions regarding your unique situation, taking into account your overall medical condition and personal decision-making style. You may need to reconsider your decisions from time to time. The medical team caring for you will help you in this regard.

Why are there many different types of breast cancer treatments?


Successful breast cancer treatment means getting rid of cancer or keeping it under control for a long time. However, because breast cancer consists of many different types of cancer cells, getting rid of these cells may require different types of treatments.

Your treatment plan may include a combination of the following types of treatments:
• Surgery
• Radiotherapy (radiation therapy)
• Comotherapy
• Hormonal therapy (anti-estrogen therapy)
• Targeted therapies (biological treatments)

Organizing your individual treatment to treat breast cancer requires careful planning. The ideal treatment plan is created against all elements within the cell that can cause cancer to develop, grow and spread to other parts of the body.

Why is Every Cancer Different from Each Other?


Cells are the building blocks of every living creature, whether human, animal or plant. A cell is instructed what to do by genes located in the center of the cell. These genes are made of DNA. DNA may change or become damaged over time. While some changes in DNA are harmless, others can lead to disease. Cancer cells begin to form when changes in DNA tell cells to multiply faster and behave differently than they should. As these cancer cells begin to multiply and form a tumor, they begin to change and become much more different from each other.

As a cancer grows, new and different types of breast cancer cells form within the same cancer. This mixture of different cells begins to become much more complex over time. Although every cancer cell is related to the same original “parent” cell, not all cells that cause cancer are the same. The fact that a cancer consists of different types of cells is called "tumor heterogeneity".

Over time, when the breast cancer tumor grows to a centimeter in size, this mass consists of millions of cells that are very different from each other. Each cancer has its own genetic identity (fingerprint) derived from the DNA in its cells. That is, two people with breast cancer who are the same age, height, weight, and race but have similar medical histories almost always have two very different cancers. The only thing cancers have in common is that they start from a single breast tissue cell.

Are Different Cancer Cells Treated Differently?

Cancer cells being different (tumor heterogeneity) is why your pathology report, blood and other test results can be so complex, and why there are so many different treatments for breast cancer. Because cancer cells can be very different from each other, a treatment that may kill one cell may not be effective on another.

The best overall treatment requires making the most of each specialty. Surgery, radiotherapy, chemotherapy, hormonal therapy, and targeted biologic therapies all work differently on their own and may be more effective when administered together.

More than a hundred drugs have been approved to treat cancer, and many more are in development. Some treatments are very specific, designed to specifically target just one gene or protein in cancer cells. Although this targeted therapy works very well, it is only part of the overall battle against cancer. Other treatments are needed to fight other targets in cancer cells. Each treatment plays its part in the effort to get rid of cancer once and for all. This is also the answer to why some treatments work best when given in combination with other treatments or before or after other treatments.

Differences in cancer cells are why two people with breast cancer may receive completely different treatments. You may encounter other patients in the waiting room before the examination or treatment. In these cases, it is quite common for diagnosis and treatment stories to be shared. Please remember that each cancer may have a different structure and a different treatment plan. When talking to another person, it is difficult to know how their situation is similar or different from yours. For this reason, it would not be right to comment on your own treatment based on the treatment given to someone else. The treatment that works for him may be different from the treatment that works for you.

What is Tumor Resistance?


It is possible for a tumor to develop resistance to treatment over time. This is when cancer cells find the solution to survive treatment. This occurs when various treatments kill the cells they know how to kill, but fail to do so against every cancer cell. Cells that escape the lethal effects of previous treatments are called cancer-resistant cells. These survive previous treatment and continue to grow. This situation also shows how disease recurrence can occur.

To get rid of these resistant cells, you need new forms of treatment that work differently than the treatments you have received before. Sometimes a second course of treatment can destroy all residual cancer cells. However, in these cases, additional treatment courses are required.

What kind of surgical options are available for breast cancer treatment?


Surgery is often the first line of attack against breast cancer. Decisions about surgery depend on many factors. You and your doctor will determine the type of surgery that is best for you based on the stage of the cancer, the biological characteristics of the cancer, and what you think is acceptable for your long-term peace of mind.

Surgical options can be summarized as follows:

It is also known as breast-conserving surgery. Only some healthy tissue is removed from the tumor and its surroundings.

It is the removal of all breast tissue. The breast tissue can be removed along with the skin and nipple, or in some cases, the skin and nipple can be preserved without removal. In cases where the skin and nipple are protected, a prosthesis must be placed in place of the breast tissue.

Lymph node removal:
It is also called armpit lymph node removal. If biopsy shows that breast cancer has spread to the armpit lymph, it can be performed during lumpectomy and mastectomy. Some people undergo "sentinel lymph node removal", which requires less intervention.

Breast reconstruction:
It is the reconstruction of the breast after mastectomy and sometimes lumpectomy. Reconstruction can be done during surgery to remove the cancer, or it can be done months or years later. Some patients may not prefer reconstruction or may prefer a bra prosthesis instead.

Preventive (prophylactic) mastectomy:
It is the removal of breast tissue for protective purposes in order to reduce the risk in people with a high risk of breast cancer.

Removing the protective ovaries:
It is a preventive surgery performed to reduce the amount of estrogen in the body. Ovaries are surgically removed for protective purposes. It is intended to make it harder for estrogen to stimulate the development of breast cancer.

What preparations need to be made when surgery is decided?


CV: Your medical history will be questioned when planning the surgery with your doctor. It is important to know your background to stay safe during surgery. You should not hide any information, even if you think it is unimportant or you are embarrassed to say it. Say everything. No matter what type of surgery you are going to have, you should inform your doctor about the following:

• Past history of reactions to any procedure or medication (including allergies).
• Any prescription or non-prescription medication you are currently using or have recently stopped taking
• Any vitamins or herbal supplements you use

Your doctor will tell you to stop taking any aspirin and similar medications (ibuprofen, diclofenac, etc.) at least one week before the surgery. Some medications you use may negatively affect your body's ability to withstand the stress of surgery and recover afterward.

Preoperative examinations: Examinations are required a few days before surgery to make sure your body can handle the planned surgery and anesthesia. Although not all patients need to be performed, the most frequently performed tests are as follows:

• Plain chest X-ray and ECG (shows that there is no problem with your lungs and heart)
• Blood tests (evaluates blood cells, liver and kidney function, and your risk of bleeding and infection)
• Urine test (evaluates kidney function and presence of infection)
• Other tests (tests to confirm the presence of infectious disease, radiological examinations if necessary)
• Consultations (obtained from necessary clinics in the presence of diabetes, high blood pressure, heart disease or other conditions that may affect the surgery)

Surgery and menstrual period: It is still doubtful whether the coincidence of the surgery date and menstrual date will affect the surgical success. Although there are no serious drawbacks to breast surgery, you can talk to your doctor about this issue.

Fasting before surgery: Do not eat or drink anything after midnight the day before the surgery. This precaution will prevent the food in the full stomach from escaping into your lungs through vomiting during anesthesia. It is rare for vomit to get into the lungs, but it can cause serious problems. Therefore, it is important not to eat or drink anything after midnight. If you are constantly taking medication due to any chronic disease, your doctor or anesthesiologist will tell you when and how to take your medications before surgery (for example, when you wake up in the morning, swallow your medications with a little water). You can also ask your doctor about this situation.

What is done when you come to the hospital for surgery?


Companion: It would be good to have a companion with you on the day of surgery. Your companion will be able to assist you both during hospitalization and in the post-operative period and will be able to communicate with your doctor and medical staff. When you are discharged home, your companion will be able to help you return home. Having a companion for outpatient surgery or outpatient clinic procedures will also help you in the process of returning home after the procedure. Even if you are a very strong and independent person, find someone who will be there for you regardless of what type of surgery or procedure will be performed. Even the hospital admission process can be overwhelming. It may be difficult to return home the same day. Medications given during surgery or the procedure are not completely eliminated from your body, making it difficult for you to get around on your own.

Informed consent: When you are hospitalized before the surgery or when you apply for an outpatient procedure, you will be asked to sign a consent form regarding the surgery/procedure. This means that you accept the surgery/procedure, fully understand what will be done, and accept the risks of the surgery/procedure. Request the consent form long enough before any anesthesia or surgery that may cause you to feel weak so that you have enough time to read and understand it.

The informed consent form is designed to confirm:

• Your doctor has told you exactly what he plans to do
• You are aware of alternative treatment options
• You understand the surgery plan and its associated risks

No matter how much you respect your doctor, read the form carefully. Make sure that the consent form you sign is only for the procedure you have previously discussed with your doctor and decided on.

Anesthesia (narcosis): Before the surgery, you will probably meet with your anesthesiologist to discuss your medical history, possible allergies, and the anesthesia you will receive during the surgery. Since some breast surgeries, such as lumpectomy or biopsy, take a short time, limited anesthesia with sedatives or shallow anesthesia with a mask may be preferred. Long procedures such as mastectomy, armpit lymph removal and breast reconstruction require deep general anesthesia.

After you are admitted to the hospital, the nurse will place an intravenous line in your arm, preferably on the side that will not undergo surgery. Your clothes will be removed and you will be put on special disposable surgical clothes and pressure socks on your legs. When it is time to enter the operating room, you will be taken down to your bed (rarely on a special stretcher). When you arrive at the operating room door, after your identity information is confirmed, a sedative will be administered through the vein in your arm. You will feel more comfortable after being sedated. Even if you continue to communicate with your doctor and other operating room personnel, you may not remember them later.

After you are placed on the operating table, what you see may seem very interesting and different, especially if you have not had surgery before. You will see people you have never seen before, and hear some noises and conversations related to surgery and equipment preparations. Your surgeon and other operating room staff will say hello and give you last-minute reassurance before you go to sleep. If you are cold, do not hesitate to ask to be covered. Most of the devices you see around you are for the surgical team to monitor you more carefully during surgery. A blood pressure cuff is worn on your arm for monitoring, an electrocardiograph monitors your heart rate, and a finger clip measures your blood oxygen levels.

If you are planned to receive general anesthesia; You will be given oxygen through a mask and a drug will be given slowly through the vein in your arm to put you to sleep. Other medications and fluids during the surgery will also be given through this intravenous line. In cases where a single vascular access is not sufficient or is blocked, a second vascular access can be opened. After the initial sleep state, a breathing tube will be placed in your throat to ventilate your lungs, and the anesthesia will continue with the contribution of the gases given from there. During the surgery, all your vital functions (heart rate, blood pressure, oxygen density, etc.) will be closely monitored and it will be constantly evaluated that your systems are working normally. In surgeries that may last a long time (more than a few hours), active pressure stockings with pumps are worn to prevent the risk of clotting. The hair in the surgery area, if any, is shaved. Just before the surgery begins, the surgical area is cleaned with antiseptic solutions and areas outside the surgery area are covered with sterile covers.

What is done after the surgery?


Recovery (recovery) room: If you had surgery under general anesthesia, after being woken up, you will be taken to the recovery room where other patients who underwent surgery are also located. The staff in the recovery room checks your vital signs (blood pressure, heart rate, oxygen rate) and waits until you are fully awake and stable. If you are in pain, now is the time to tell it. The recovery room staff will administer the painkillers prescribed by your doctor. You may feel cold after the surgery. This is a normal process of recovering from anesthesia. You may want an extra blanket.

Hospital stay: Since surgeries that do not remove armpit lymph (lumpectomy, removal of a mass from the breast, biopsy) are usually performed on a daily basis, you can be sent home on the same day. Mastectomy and lumpectomy with armpit lymphoma are larger surgeries and require hospitalization.

Post-operative walking: Getting up and walking after surgery will speed up your recovery and prevent unwanted side effects that may develop due to surgery. Therefore, in accordance with your doctor's instructions, your nurse will get you up and walking a few hours after you are taken to your room. The next morning, your arm exercises will begin to prevent stiffness. You will be able to return to your normal activities a few days after lumpectomy and a week after mastectomy.

Oral food intake after surgery: Depending on the duration and area of the surgery you have had, oral liquid and soft food intake usually begins 2-4 hours after breast surgery. If there is no problem, the next meal can be started with normal food.

When is the postoperative pathology result available?

Your pathology report will usually be ready within 3-7 days, taking into account the extent of the surgery you have had and sometimes additional staining that may be done. This waiting period may be very stressful for you. Your doctor will call you and notify you when your report arrives. If the waiting period exceeds one week, you can call your doctor and inquire about the status of your pathology report. Reports of pathology studies requiring additional staining and examinations may arrive piecemeal at different times.

After your pathology report arrives, you can talk to your doctor about what to do next or what treatments you should receive. In addition, your doctor will discuss your situation with the other department doctors at the Tumor Council, together with your post-operative pathology report, and convey the council's recommendation to you.

Are there risks of breast surgery?


The techniques used in breast cancer surgery have changed dramatically in recent years. But any type of surgery, from a simple skin biopsy to open-heart surgery, carries some risks. Below are some risks and complications that may be encountered during breast surgery:

Wound inflammation (infection): May occur after surgery and is usually treated with antibiotics. Rarely, drainage/evacuation may be required.

Wound site problems: Not common. Accumulation of blood in the wound is called hematoma, and accumulation of fluid is called seroma. Although both sometimes regress spontaneously, they are usually treated with surgical drainage/drainage.

Excessive bleeding: This may occur during or after surgery. It is rare. If larger surgeries such as bilateral mastectomy or reconstruction are planned, it is useful to reserve blood.

Respiratory and heart problems: May be encountered in cases where general anesthesia is applied. It is a reaction to anesthesia. It very rarely has serious consequences.

Lymphedema: Swelling in the arm due to problems in the drainage of lymph fluid in the arm. Removal of all armpit lymph and radiotherapy increases this risk.

Are there some rumors about breast cancer surgery?


There are indeed many false rumors about breast cancer surgery. While coping with this disease can be difficult even without these rumors, it is important to prevent such false rumors from obstructing the best treatment option available. Below are some of these false rumors:

Surgery causes cancer to open and spread: False. When surgery is performed, the result is cancer. If subsequent examinations reveal that there is cancer in other parts of the body, the patient immediately thinks that the surgery during the surgery has spread the cancer cells around and that they have spread to other parts of the body.

However, the reason for this spread may be one of the following situations:

• Before surgery, the cancer has already spread to other parts of the body.
• A new cancer has developed.
• There are cancer cells remaining after surgery.
• Cancer cells may have gotten into an open vein while the surgeon was removing the tumor.

Adjuvant treatments such as radiotherapy, chemotherapy, hormonal therapy, or targeted therapies can help destroy cancer cells left behind after surgery.

Mastectomy combined with lumpectomy is safer than radiotherapy (radiation therapy): Not necessarily true. Lumpectomy + radiotherapy has been found to be as effective as mastectomy when a tumor in one breast is smaller than 4 cm and is removed with intact margins during surgery.

If you have a strong family history of breast cancer, lumpectomy + radiotherapy is not suitable for you: False. Having breast cancer in your family does not automatically make your cancer more threatening than other patients. It doesn't mean that breast-conserving surgery won't be an option for you. You and your doctor will decide which type of surgery is more suitable for you, based on factors such as the stage of the cancer, its biological characteristics, and how susceptible you are to the tumor recurring or a new tumor starting in the breast.

If your armpit lymph nodes are removed, your arm will be swollen for the rest of your life: False. Lymph node surgery can cause unwanted side effects such as persistent discomfort, numbness, and swelling, called lymphedema. This condition occurs in only 5-10% of cases. If all the lymph nodes under the armpit are removed and radiotherapy (radiation therapy) is added to the surgery area, as well as chemotherapy, the risk of lymphedema can reach 25%. Physical therapy, along with proper use and treatment of the affected arm, can help treat lymphedema and reduce its severity.

How can one deal with the fear of surgery?


It is perfectly normal to feel uneasy about your surgery, especially if you have not had surgery before or spent much time in the hospital. Talk about your fears with your doctor, nurse, or a counselor recommended by your doctor.

Many people are concerned about what they do not understand or do not know. The more you ask your doctor about your fears, the more he or she can make the necessary explanations to reassure you. Knowing what a patient is particularly afraid of can help the doctor find solutions.

For example; If you say that you are afraid of having an intravenous access with a needle in your arm, your doctor may give you a sedative to relax you, numb your arm with a local anesthetic, or even have a nurse with you for support. If you tell us what scares you, there can usually be a formula that can help you. In short-term procedures, even telling the patient that the procedure will be completed in a very short time can be comforting for the patient. If patients are curious, they can benefit from complementary/holistic techniques such as hypnosis, massage and yoga.

What should be considered when deciding on mastectomy or lumpectomy?


Under normal circumstances, people with breast cancer have the opportunity to choose between removal of the entire breast (mastectomy) or breast-conserving surgery (lumpectomy) + radiotherapy (radiation therapy). Lumpectomy + radiotherapy is as effective as mastectomy in people with a tumor in only one breast and smaller than 4 cm. It is essential that it has solid edges (there should be no cancer cells in the tissue surrounding the tumor).

Although most patients prefer lumpectomy because it is a more limited surgery, deciding between lumpectomy and mastectomy depends on how you feel about some issues. These:

• Do you want your breast protected? If you want your breast to be preserved and not removed completely, you can choose lumpectomy.
• How much do you want your breast to maintain its current shape? The cosmetic results of lumpectomy are good in most patients. In rare cases, a large area of the breast may need to be removed, and as a result, the breast may remain smaller than the other or become deformed. If a very large area of your breast needs to be removed and it is important for you that your two breasts are compatible with each other, you should discuss with your doctor which surgery is most suitable for you.
• How afraid are you of breast cancer recurring? You may choose a mastectomy because removing your entire breast will help you worry less about the possibility of the cancer returning.

Some factors other than the above factors may also be effective in this decision. The hospital where you applied for surgery and your doctor there may prefer and recommend mastectomy, depending on the available facilities. The patient's sociocultural situation may also affect the decision. If the patient's place of residence is far from the hospital and healthcare facilities are limited, mastectomy may be preferred as the follow-up phase may be troublesome. Older physicians may sometimes be more conservative towards new developments and may prefer mastectomies with an older history based on their experience. Cosmetic concerns may be less in elderly patients and they may prefer mastectomy.

What are the advantages and disadvantages of lumpectomy?


The main advantage of lumpectomy is that most of the look and feel of your breast is preserved. It is a simpler surgery, has a shorter recovery time and is easier than a mastectomy.

Lumpectomy has several possible disadvantages:

• After lumpectomy, radiotherapy (radiation therapy) is probably required 5 days a week for 5-7 weeks to ensure that there is no cancer left in the breast.
• Radiotherapy may affect the timing of postoperative breast reconstruction and possibly affect reconstruction options.
• The risk of regional cancer recurrence in the breast after lumpectomy is slightly higher than after mastectomy. However, regional cancer recurrences can be successfully treated with mastectomy.
• If there is a recurrence of cancer in the same breast after lumpectomy, the breast cannot safely tolerate additional radiotherapy. This is true for both a recurrence of cancer in the same breast and a new cancer. If you have a second cancer in the same breast, your doctor will usually recommend a mastectomy.
• One or more additional surgeries may be required after the initial lumpectomy. During lumpectomy, the surgeon removes the tumor and some healthy tissue (edge) from its surroundings that does not contain cancer cells. While examining this tissue, if the pathologist sees cancer cells in these edges that are thought to be healthy, more tissue must be removed again to obtain a solid cancer-free edge. Ideally, this is done at the time of lumpectomy. However, it may take a week for the pathology report to be available. In some cases where the Pathologist is in the operating room during the surgery, edge strength (the method of cutting the tissue by freezing) can also be checked during the surgery. However, the evaluation made with this method is not as sensitive as routine evaluation and may give false negative results.

What are the advantages and disadvantages of mastectomy?


For some patients, removing the entire breast provides greater peace of mind (anything that could pose a danger is removed). Depending on the pathology report, radiotherapy may still be required.

Some possible disadvantages of mastectomy include:

• Mastectomy is a larger surgery than lumpectomy, the surgery takes longer, there are more post-surgical side effects (complications) and the recovery time is longer.
• Mastectomy means permanent loss of your breast.
• After mastectomy, additional surgeries will be required for breast reconstruction.

Your breasts are an important part of your personality, and it's only natural that you want to protect them. However, when deciding, regardless of your age or appearance, it is important that you make the choice that will not endanger your general health and give you a chance for full recovery.

What is radiotherapy (radiation therapy) used for?


Radiotherapy (radiation therapy/ray) is the most targeted and highly effective way to destroy cancer cells that may remain in your breast after surgery. Radiotherapy is a regional treatment and is effective only in the area where the radiation is given (chemotherapy is a systemic treatment, effective throughout the body). Although many people fear it, radiotherapy is a method that is quite easy to bear and its side effects are limited to the area treated. Your treatment will be performed by Radiation Oncology Specialists who specialize in radiation therapy.

What is Chemotherapy (Drug Treatment) Used for?


Chemotherapy aims to weaken and destroy cancer cells, both in the original area and those that have spread to other parts of the body, by using drugs. Chemotherapy is a systemic treatment that affects the entire body through the blood. There are many chemotherapy drugs available, and in most cases, a combination of two or more drugs is used for chemotherapy of breast cancer. The selection of drugs to be used is usually made according to the patient's pathology report and the biological characteristics of the tumor. Chemotherapy administered after surgery is called adjuvant chemotherapy. Chemotherapy is used to treat the following conditions:

• To destroy cancer cells that may be left behind after surgery in early-stage breast cancer and reduce the risk of cancer coming back.
• Destroying cancer cells as much as possible in advanced breast cancer

In some cases, chemotherapy is given before surgery to shrink the cancer. This is called neoadjuvant (new adjuvant therapy) chemotherapy.

Medical Oncology Specialists who will apply your chemotherapy treatment will enlighten you about the drugs to be chosen for chemotherapy, the duration of chemotherapy, possible side effects and things to pay attention to during chemotherapy.

Why is Hormonal Therapy Used?


In order for hormonal therapy to be applied, hormone receptors must be present in the patient's cancer cells. This is called “hormone positive.” The hormones that are checked for the presence of receptors are female sex hormones called estrogen and progesterone. In order to give hormonal treatment, it is sufficient for even one of these receptors to be positive. Hormonal therapy drugs are not effective in hormone-receptor negative breast cancers.

Hormonal therapy drugs can be effective in hormone-receptor positive breast cancers in two ways:

• By reducing the amount of estrogen hormone in the body
• By preventing the effect of estrogen on breast cancer cells

Most of the estrogen in a woman's body is produced in the ovaries. Estrogen causes hormone-receptor breast cancer cells to grow. Therefore, reducing the amount of estrogen or preventing its effect may reduce the risk of cancer coming back (recurrence) after surgery in early-stage hormone-receptor positive breast cancers. Hormonal therapy medications may also be used to help shrink or slow the growth of a tumor in advanced or metastasized hormone-receptor positive breast cancers.

Whether the patient is in menopause or not is important when choosing the drugs to be used in hormonal therapy. In some cases, ovaries may be surgically removed to treat hormone-receptor positive breast cancers or as a preventive measure in women with a very high risk of breast cancer. The functions of the ovaries can also be stopped temporarily by using medication.

It is important to know that hormonal therapy is not hormone replacement therapy (HRT) used after menopause. HYT is not used for cancer treatment. HYT is used by some women to treat side effects such as hot flashes and sweating attacks that occur after menopause. HYT is used to increase blood estrogen levels, which decrease after menopause. HYT contains estrogen and may sometimes contain progesterone and other hormones. Hormonal therapy is the complete opposite of HYT; it blocks or reduces the amount of estrogen in the body.

Why are Targeted (Biological) Therapies Applied?


Targeted cancer therapies are treatments that target cell-specific properties, such as a protein found within cancer cells that causes them to proliferate rapidly or abnormally. Unlike chemotherapy, targeted therapies are less likely to damage healthy cells. Some targeted therapies are antibodies (defense proteins) and act in a similar way to antibodies naturally made by our immune system in our bodies. These types of targeted treatments are sometimes called immune system-targeted therapies.

Pregnant women should not receive targeted treatments. The limited number of studies conducted on this subject suggest that targeted therapies are not safe during pregnancy.

What kind of treatment is applied at Liv Hospital?


People who apply to our hospital for breast cancer treatment are first given a physical examination by General Surgery Specialists who specialize in breast diseases, and all parameters related to existing breast cancer are evaluated. First of all, it will be decided whether to prepare for surgery or do chemotherapy before surgery. In this process, the opinions of Medical Oncology Specialists will also be taken. First of all, patients for whom surgery is decided are directed to the Anesthesiology (Narcosis) department for surgery preparations, and those for whom chemotherapy is decided are directed to the Medical Oncology department for this purpose.

In patients who have decided to undergo surgery, the doctor and patient decide together by discussing which surgery to choose. Depending on the type of surgery decided, if necessary, consultation with the Plastic Surgery department is made and the treatment process is included.

Following the surgery, after the patient's pathology report is issued, postoperative treatment is determined and planned by discussing it at the Tumor Council, which is held every week at Liv Hospital with the participation of many clinics. In line with the pathology report and the recommendations of the Tumor Council, the patient is directed to the relevant departments for chemotherapy, radiotherapy, hormonal therapy and targeted treatments.

Patients are invited for follow-up examinations and examinations at intervals recommended by the General Surgery Specialist.

Which Physicians and Clinics are Collaborated with?


Medical Oncology, Radiation Oncology, Nuclear Medicine and Radiology Specialists work in collaboration with General Surgery Specialists who specialize in breast diseases.