Major therapeutic measures in breast cancer

The breast cancer treatment is a difficult task not only because of the variety of methods used and the complexity of rational justification of the plan, in each case, but also no less because of the contradictory recommendations and assessments of the results. Perhaps, there is another disease, in which there were so many opinions and diametrically opposite opinions about the effectiveness of a treatment method *. Difficulties are caused, first, individual deviations and differences within numerous pathogenic forms of tumors in patients of different age and physiological periods and, secondly, the complexity of the multivariate analysis.
Therapeutic measures in breast cancer can be divided into two groups: 1) local-regional aimed at the removal or destruction of the primary tumor and metastases in regional lymphatic nodes (surgery, radiation therapy, regional infusion); 2) the total of: a) influencing the metabolic-endocrine processes at different levels with the aim of creating unfavourable conditions for tumors (hormonotherapy by operations on endocrine organs with subsequent introduction of hormonal preparations);
b) aimed at destruction or damage circulating in the blood and lymph cancer cells and their complexes, as well as existing in distant organs metastases (mono - or polychemotherapy);
C) contributing to the restoration or maintenance of tissue and humoral immune defense mechanisms (immunotherapy). Finally, in recent years emerges another medical direction, based on the activation of nonspecific reactance of an organism with the help of adaptogens, medicinal agents stimulating the development of connective tissue at the site of the tumor and its metastases, reticuloendothelial, PropertyName system and others (Lazarev N. Century, 1965).
Integrated and combined use the whole Arsenal of local and systemic effects is the basis of rational therapy of breast cancer, since the tumor is already in the initial phase of development is disseminated process. This approach does not mean a simple summation of all methods of treatment at any stage of the cancer. On the contrary, before clinicians task is not only to establish a rational sequence of remedial measures and their augmentation, but also to protect the body from side and stress influence applied surgical, radiation, and drugs. Such rational plan is drawn up jointly by several specialists (surgeon, radiologist, endocrinologist, therapist and, in some cases, anesthesiologist),and in principle should be implemented in one medical institution, possessing experience and proper equipment for all stages of treatment. This explains the widespread desire to concentration of patients with breast cancer in the profiled institutions and the creation of powerful special centres for both organizational and clinical aspects of the problem. Such centers already operate in Moscow, Leningrad and some capitals of the Union republics.

* According to the estimates of A. I. of Gunatilaka (1978), for primary breast cancer can be used 64 141 option remedial measures.