There are a variety of treatments for breast cancer. Most people need a combination of two or more.
Treatment
is available at every stage of breast cancer. After diagnosis, your
doctor will determine the stage of your cancer. He or she will then
determine the best treatment options based on your stage and other
factors, such as age, family history, genetic mutation status, and
personal medical history. Treatments for early stage breast cancer may
not treat advanced stage breast cancer effectively.
Breast cancer stages range from 0 to 4. Different factors determine your stage, including:
- the size of the tumor
- the number of lymph nodes affected
- whether the cancer has spread to other parts of your body
Doctors use different tests to stage breast cancer. Imaging tests include CT scan, MRI, ultrasound, X-ray, and PET scan.
These can help the doctor narrow down the location of the cancer,
calculate tumor size, and determine whether the cancer has spread to
other parts of the body. If an imaging test shows a mass in another part
of the body, your doctor can perform a biopsy to see whether the mass
is malignant or benign. A physical exam and blood test can also help
with staging.
If precancerous or cancer cells are confined to the milk ducts, it’s called noninvasive breast cancer or ductal carcinoma in situ (DCIS). Stage 0 breast cancer can spread beyond the ducts. Early treatment can stop you from developing invasive breast cancer.
Surgery
In a lumpectomy, the surgeon removes the cancerous cells and spares the rest of the breast. It’s a viable option when DCIS is confined to one area of the breast. A lumpectomy may be performed as an outpatient procedure. This means you can go home shortly after the surgery and won’t need to stay in a hospital overnight.A mastectomy is the surgical removal of the breast. It’s recommended when DCIS is found throughout the breast. Surgery to reconstruct the breast can begin at the time of the mastectomy or at a later date.
Radiation therapy
Radiation is a type of targeted therapy. It’s usually recommended after lumpectomy for stage 0 breast cancers. High-energy X-rays are used to destroy cancer cells and prevent them from spreading. This treatment can lower the risk of recurrence. Radiation therapy is typically administered 5 days per week over the course of 5 to 7 weeks.Hormone treatment
Your doctor may recommend a hormone treatment if you’ve had a lumpectomy or single mastectomy for estrogen receptor-positive (ER+) or progesterone receptor-positive (PR+) breast cancer. Oral hormone treatments, such as tamoxifen, are generally prescribed to lower your risk of developing invasive breast cancer. You might receive trastuzumab (Herceptin) therapy if your breast cancer tests positive for the human growth factor HER-2.Hormone treatment may not be prescribed for women who have had a double mastectomy for stage 0 breast cancer.
Stage 1A breast cancer means the primary tumor is 2 centimeters or less and the lymph nodes are not affected. In stage 1B, cancer is found in axillary lymph nodes and there is no tumor in the breast or the tumor is smaller than 2 centimeters. Both 1A and 1B are considered early stage invasive breast cancers. Surgery and one or more other therapies may be recommended.
Surgery
Lumpectomy and mastectomy are both options for stage 1 breast cancer. The decision is based on:- the size and location of the primary tumor
- personal preference
- other factors such as genetic predisposition
Radiation therapy
Radiation therapy is often recommended after surgery for stage 1 breast cancer. It may not be necessary for women older than 70 years, especially if hormone therapy is possible.Hormone therapy
Doctors may recommend hormone therapy for hormone receptor-positive breast cancers, regardless of tumor size.Chemotherapy
Breast cancer that is negative for ER, PR, and HER2 is called triple-negative breast cancer (TNBC). Chemotherapy is almost always needed for these cases because there is no targeted treatment for TNBC. Herceptin, a targeted therapy, is often given along with chemotherapy for HER2+ breast cancers.However, chemo isn’t always needed for early stage breast cancer, especially if it can be treated with hormone therapy.
Breast Cancer Treatment Options by Stage
There are a variety of treatments for breast cancer. Most people need a combination of two or more.
Treatment
is available at every stage of breast cancer. After diagnosis, your
doctor will determine the stage of your cancer. He or she will then
determine the best treatment options based on your stage and other
factors, such as age, family history, genetic mutation status, and
personal medical history. Treatments for early stage breast cancer may
not treat advanced stage breast cancer effectively.
Breast cancer stages range from 0 to 4. Different factors determine your stage, including:
- the size of the tumor
- the number of lymph nodes affected
- whether the cancer has spread to other parts of your body
Doctors use different tests to stage breast cancer. Imaging tests include CT scan, MRI, ultrasound, X-ray, and PET scan.
These can help the doctor narrow down the location of the cancer,
calculate tumor size, and determine whether the cancer has spread to
other parts of the body. If an imaging test shows a mass in another part
of the body, your doctor can perform a biopsy to see whether the mass
is malignant or benign. A physical exam and blood test can also help
with staging.
If precancerous or cancer cells are confined to the milk ducts, it’s called noninvasive breast cancer or ductal carcinoma in situ (DCIS). Stage 0 breast cancer can spread beyond the ducts. Early treatment can stop you from developing invasive breast cancer.
Surgery
In a lumpectomy, the surgeon removes the cancerous cells and spares the rest of the breast. It’s a viable option when DCIS is confined to one area of the breast. A lumpectomy may be performed as an outpatient procedure. This means you can go home shortly after the surgery and won’t need to stay in a hospital overnight.A mastectomy is the surgical removal of the breast. It’s recommended when DCIS is found throughout the breast. Surgery to reconstruct the breast can begin at the time of the mastectomy or at a later date.
Radiation therapy
Radiation is a type of targeted therapy. It’s usually recommended after lumpectomy for stage 0 breast cancers. High-energy X-rays are used to destroy cancer cells and prevent them from spreading. This treatment can lower the risk of recurrence. Radiation therapy is typically administered 5 days per week over the course of 5 to 7 weeks.Hormone treatment
Your doctor may recommend a hormone treatment if you’ve had a lumpectomy or single mastectomy for estrogen receptor-positive (ER+) or progesterone receptor-positive (PR+) breast cancer. Oral hormone treatments, such as tamoxifen, are generally prescribed to lower your risk of developing invasive breast cancer. You might receive trastuzumab (Herceptin) therapy if your breast cancer tests positive for the human growth factor HER-2.Hormone treatment may not be prescribed for women who have had a double mastectomy for stage 0 breast cancer.
Stage 1A breast cancer means the primary tumor is 2 centimeters or less and the lymph nodes are not affected. In stage 1B, cancer is found in axillary lymph nodes and there is no tumor in the breast or the tumor is smaller than 2 centimeters. Both 1A and 1B are considered early stage invasive breast cancers. Surgery and one or more other therapies may be recommended.
Surgery
Lumpectomy and mastectomy are both options for stage 1 breast cancer. The decision is based on:- the size and location of the primary tumor
- personal preference
- other factors such as genetic predisposition
Radiation therapy
Radiation therapy is often recommended after surgery for stage 1 breast cancer. It may not be necessary for women older than 70 years, especially if hormone therapy is possible.Hormone therapy
Doctors may recommend hormone therapy for hormone receptor-positive breast cancers, regardless of tumor size.Chemotherapy
Breast cancer that is negative for ER, PR, and HER2 is called triple-negative breast cancer (TNBC). Chemotherapy is almost always needed for these cases because there is no targeted treatment for TNBC. Herceptin, a targeted therapy, is often given along with chemotherapy for HER2+ breast cancers.However, chemo isn’t always needed for early stage breast cancer, especially if it can be treated with hormone therapy.
In stage 2A the tumor is smaller than 2 centimeters and has spread to 1 to 3 nearby lymph nodes. Or, it’s between 2 and 5 centimeters and hasn’t spread to lymph nodes.
Stage 2B means the tumor is between 2 and 5 centimeters and has spread to 1 to 3 nearby lymph nodes. Or it’s larger than 5 centimeters and hasn’t spread to any lymph nodes.
You’ll probably need a combination of surgery, radiation, chemotherapy, and hormone treatment.
Surgery
Lumpectomy and mastectomy may both be options depending on the size and location of the tumor. A modified radical mastectomy is a removal of the breast, including chest muscles. If you choose reconstruction, the process may begin at the same time or after cancer treatment is complete.Radiation therapy
Radiation therapy targets any remaining cancer cells in the chest and lymph nodes.Chemotherapy
Chemotherapy is a systemic therapy to kill cancer cells throughout the body. These powerful drugs are delivered intravenously (into a vein) over the course of many weeks or months. There are a variety of chemotherapy drugs used to treat breast cancer, including:- docetaxel (Taxotere)
- doxorubicin (Adriamycin)
- cyclophosphamide (Cytoxan)
Hormone treatment
After all other treatment is complete, you may benefit from continued treatment for ER+ or PR+ breast cancers. Oral medications such as tamoxifen or aromatase inhibitors may be prescribed for five or more years.3A: Stage 3A breast cancer means that the cancer has spread to 4 to 9 axillary (armpit) lymph nodes or has enlarged the internal mammary lymph nodes. The primary tumor may be any size. It can also mean the tumor is bigger than 5 centimeters and small groups of cancer cells are found in the lymph nodes. Finally, stage 3A can also include tumors greater than 5 centimeters with involvement of 1 to 3 axillary lymph nodes or any breastbone nodes.
3B: Stage 3B means a breast tumor has invaded the chest wall or skin and may or may not have invaded up to 9 lymph nodes. Stage 3C means cancer is found in 10 or more axillary lymph nodes, lymph nodes near the collarbone, or internal mammary nodes.
Symptoms of inflammatory breast cancer (IBC) are different from other types of breast cancer. Diagnosis may be delayed since there is usually no breast lump. By definition, IBC is diagnosed at stage 3B or above.
Treatment
Treatments for stage 3 breast cancers are similar to those for stage 2. If you have a large primary tumor, your doctor may recommend chemotherapy to shrink it before surgery. Radiation therapy will probably be needed before reconstruction can begin. Hormone therapy and other targeted therapies will be prescribed if needed.Stage 4 indicates that breast cancer has metastasized (spread to a distant part of the body). Breast cancer most often spreads to the lungs, brain, liver, or bones. Metastatic breast cancer can’t be cured, but it can be treated with aggressive systemic therapy. Because the cancer involves different parts of the body, you may need multiple therapies to stop tumor growth and ease symptoms.
Treatment
Depending on how advanced your breast cancer is, you’ll probably have chemotherapy, radiation therapy, and hormone therapy (if you have a hormone receptor-positive cancer). Another option is targeted therapy, which targets the protein that allows cancer cells to grow.If the cancer spreads to the lymph nodes, you may notice swelling or enlargement of your nodes. Surgery, chemotherapy, and radiation can be used to treat cancer that spreads to the lymph nodes.
The number and location of tumors determine your surgical options. Surgery isn’t the first line of defense with advanced breast cancer, but your doctor may recommend surgery to treat spinal cord compression, broken bones, and single masses caused by metastasis. This helps relieve pain and other symptoms.
Other drugs used to treat advanced stage breast cancer include antidepressants, anticonvulsants, steroids, and local anesthetics.
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