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전이성 유방암 치료

전이성 유방암 치료 유형

수술 유형
(유방 절제술 또는 유방 절제술)

림프절 제거의 유형
(감시 림프절 또는 겨드랑이 림프절 절제술)

방사선 요법의 유형 및 양

화학 요법의 유형 및 양

표적 치료의 유형 및 양

환자와 담당의는 진료에 대한 접근 방식에 대해 합의해야 합니다. 치료를 받기 위해 얼마나 적극적인지 의사에게 알려 주세요.
예를 들어, 의사는 심각한 부작용이 있을 수 있는 매우 적극적인 치료를 권장할 수 있지만, 환자가 적은 부작용을 원한다면 덜 공격적인 치료를 할 수 있습니다.
통증이 있다면 통증 조절을 가장 첫번째로 고려해야 할 것입니다. 자신의 감정과 결정을 존중하는 치료 계획을 개발할 때 의사와의 솔직하고 명확한 의사 소통이 중요합니다.

삶의 질, 통증 조절, 가능한 한 공격적이든 치료에 관해서는 의사에게 무엇이 중요한지 정확히 알려주세요. 각 치료 선택의 위험과 이점에 대해 이야기하세요. 의사의 권고를 듣고 함께 계획을 세워야 합니다.
치료 선택에 대해 마음이 바뀔 수도 있습니다. 기분에 따라, 치료가 일상생활에 어떤 영향을 미치는지, 가족 문제 및 재정적 문제에 따라 치료 계획을 변경하고 싶을 수 있습니다. 치료 계획은 언제든지 의사와 상의하여 바꿀 수 있습니다.

05_img_002

다음과 같은 경우에 전이성 유방암에도 수술이 권장됩니다.

전이성 재발인 경우

유방암이 신체의 다른 부위로 퍼진 경우, 수술은 암세포를 완전히 제거하지 않기 때문에 좋은 치료법이 아닐 수도 있습니다. 암이 여러 곳으로 퍼져 있는 경우 특히 그렇습니다. 그러나 간혹 뼈가 부러지거나 암세포 폐색을 막거나 통증 및 기타 증상을 완화하기 위해 수술이나 방사선 요법(또는 두 가지 모두)을 추천하는 경우도 있습니다.

최초 진단 시 전이성 유방암인 경우

유방암에 대한 최초의 진단이 전이성인 경우, 유방 종양 제거 수술이 귀하의 특정 상황에 대한 좋은 선택이 될지 의사에게 물어볼 수 있습니다.

간 전이를 제거하기 위한 수술

현재 간에서 전이성 유방암을 제거하기 위한 수술을 받은 여성이 수술을 받지 않은 여성보다 더 나은 결과를 얻는지 여부는 알 수 없습니다. 간 전이가 있는 경우, 의사에게 독특한 상황에서의 수술 이점과 위험에 대해 문의하는 것이 좋습니다.

냉동 절제술

냉동 수술은 일반적 수술에 좋은 후보자가 아닌 여성에게 국소 전이성 유방암 종양을 치료할 수 있는 옵션일 수 있습니다. 이미징(초음파, CT 스캔 또는 MRI)에 따라 특수한 냉동 프로브(카테터 유형)를 피부와 종양에 삽입하여 치료합니다.

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화학 요법은 가능한 한 암세포를 파괴하거나 손상시켜 전이성 유방암을 치료하는 데 사용됩니다. 화학 치료제 전신에 영향을 주기 때문에 다음과 같은 경우 화학 요법이 일반적으로 권장됩니다.

다른 형태의 치료에도 불구하고 암이 증가하고 있는 경우

간이나 폐와 같은 기관에 상당한 양의 암이 있는 경우

암이 빨리 자라고 있는 경우

각 환자의 화학 치료 계획은 다를 수 있지만, 전이성 유방암 치료를 위해 화학 요법을 사용할 때 일반적인 가이드라인이 있습니다.

일반적으로 대부분의 화학 요법 약품은 부작용이 문제가 되거나 약이 효과가 없어질 때까지 사용할 수 있습니다.

일부 화학 요법 약품은 병용 시 유방암 종양에 효과적입니다. 연구 결과 병합 요법이 일부 전이성 유방암의 전반적인 예후를 향상시키는 것으로 나타났으므로 의사가 여러 가지 약을 병용하도록 권장 할 수 있습니다.

전에 화학 요법을 받은 적이 있다면 의사는 전이성 질환 치료를 위해 한 번에 하나의 화학 치료제만을 사용할 것을 권장할 수 있습니다. 이 방법을 사용하면 가능한 부작용을 최소화하면서 편익을 얻습니다.

05_img_006

전이성 유방암으로 진단 받고 증상이 나타나면, 다음과 같은 이유로 방사선을 권할 수 있습니다.

특정 지역의 암 관리

종양의 침범으로 인한 피부의 출혈이나 출혈을 줄입니다.

통증 완화

호흡을 개선하기 위해 막힌 기도를 열어 줍니다.

골 파괴의 위험을 낮춥니다.

조여진 신경에 대한 압력을 줄입니다.

전이성 유방암을 치료하기 위한 방사선량 및 일정은 다음과 같은 여러 요인에 따라 달라집니다.

통증의 정도 또는 기능 상실 정도

이전 방사선량

암의 크기

다른 치료법에 대한 일정

암의 위치

전에 화학 요법을 한 적이 있는데 암이 돌아 왔거나 반응이 없으면 의사는 다른 약을 병용할 것을 권장합니다.

05_img_004

호르몬 치료제는 두 가지 방법으로 호르몬 수용체 양성 유방암을 치료합니다.

신체의 호르몬 에스트로겐 양을 줄임으로써

몸에서 에스트로겐 작용을 차단함으로써

호르몬 요법은 에스트로겐을 표적으로 하기 때문에 항에스트로겐 요법으로도 알려져 있습니다.
암이 한 호르몬 요법 약에 반응을 멈추는 경우, 의사는 일반적으로 다른 호르몬 요법 약을 권할 것입니다. 몇 개월 또는 몇 년 동안의 기간이 지나면 호르몬 치료를 받는 동안 암이 진행될 수 있는데, 이 경우 의사는 화학 요법을 권장할 수 있습니다. 화학 요법을 시작할 때 호르몬 치료를 중단하거나 호르몬 요법을 계속할 수 있습니다. 또한 암의 유형에 적합한 경우 표적 치료법도 추천할 수 있습니다.

05_img_005

표적치료제는 정상 세포와는 다른 암세포의 특정 부위(표적)에 작용하도록 고안된 약물로 기존의 화학항암제와는 달리 정상세포에 영향을 거의 주지 않아 부작용이 심하지 않습니다. 표적치료제 단독으로 사용되기 보다는 주로 치료의 효과를 높이기 위해 항암화학요법, 방사선요법과 병행하여 시행됩니다.

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DR CATHERINE CASTILLO

Neurologist

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