Based on which criteria is the treatment chosen?
The treatment is chosen according to the pre-established guidelines in previously elaborated protocols so that the treatments that are administered are optimal and appropriate for each precise situation in the evolution of the disease.
What types of treatments are there?
There is local treatment that would be the one in which surgery or radiotherapy is used and that is used to perform a treatment on a specific area, on a specific tumor.. There is also the systemic treatment that is based on the administration of certain drugs such as chemotherapy, hormonal treatment or immunological treatments and have different aspects, one would be what we call neoadjuvant in that the idea is to reduce the size of the tumor to make it more accessible to surgery; another would be the adjuvant systemic treatment, which is the one that would be carried out after the surgery with the intention of avoiding the regrowth of the disease; and finally there would be systemic treatment of the disease when it has already spread and is in the metastasis phase.
In what cases should surgery be resorted to and what is surgical treatment like?
In general, surgery should always be done. And it must be done with a healing purpose except in those cases in which the process already debuts in the form of a breast tumor and with metastasis. The current trend is more and more pronounced in terms of trying to reduce the size of the tumor and doing what we call a conservative surgery. We do a chemotherapy prior to surgery so that the tumor is smaller to do what we call conservative surgery in which the breast is preserved. The tendency is to flee more and more from the great mastectomies and from the major surgeries related to this process. It also flees from the large ganglion emptyings that were done in the past and every time more surgeries are performed looking for what we call the sentinel node in which by injecting a substance into the primary tumor we know which are the ganglia to which the tumor drains and only those ganglia are resected. Then they are analyzed in the laboratory and in this way we know if there is invasion or not and then the surgery can be much more limited and therefore much less burdensome for the patient.