Personalizing Your Invasive Breast Cancer Treatment (STAGE I-IIIa)

Invasive breast cancer treatment is not “one size fits all”— what is best for one woman is often not right for another. You should take an active role in learning as much as possible about your breast cancer diagnosis and your available treatment options, including the success rates and side effects of each option, before making a decision about what is best for you.

As a first step, your doctor will likely recommend surgery to remove the tumor and any other cancerous tissue surrounding it. The next step is to determine the risk that your breast cancer will return. This assessment, along with your age and medical history, will be used to help you and your doctor choose the most appropriate treatment for you. It is also important to consider such personal concerns as your work/life priorities, fertility issues, and tolerance for risk. Recommended therapies may include:

• Chemotherapy
• Radiation Therapy
• Hormonal Therapy

Chemotherapy

Chemotherapy Benefits
Chemotherapy uses powerful drugs to kill cancer cells that remain in your body after surgery. You may receive chemotherapy in a clinic, at your doctor’s office, or at home, depending on your treatment regimen. Chemotherapy attacks undetected cancer cells, too small to be identified, in an effort to keep your cancer from returning.
Chemotherapy Risks
The side effects of chemotherapy can be serious, since the treatment targets all rapidly dividing cells in your body, including healthy cells along with cancer cells. The side effects of chemotherapy depend on the type of drugs you take and the duration of your treatment, and many will go away when treatment ends. They include:

Fatigue Hair loss   Nausea Vomiting Anemia Diarrhea

Heart problems Menopausal symptoms Fertility issues Infections Memory loss Neuropathy

Radiation Therapy

Radiation Therapy Benefits
Radiation therapy is a highly effective and relatively safe way to destroy cancer cells that may still remain in your breast after surgery. In radiation therapy, a special kind of high-energy beam is delivered to the cancer cells either externally by a machine or internally by implanted pellets or seeds. If you have a lumpectomy, you will almost certainly be recommended radiation therapy. If you have a mastectomy, you may also receive radiation, depending on the size of your tumor or the extent of your cancer.
If you are pregnant, or unable to commit to a daily treatment schedule for several weeks, you are not a candidate for radiation therapy.
Radiation Therapy Risks
Radiation treatment is painless when administered, but can result in side effects that typically go away within several weeks of ending treatment. Some of the most common side effects are:

• Fatigue
• Lowered white blood cell counts
• Swelling and inflammation
• Skin sensitivity and discoloration
• Armpit and/or chest discomfort

Hormonal Therapy

Hormonal Therapy Benefits
If you have hormone receptor-positive (either ER+ or PR+) breast cancer, hormonal therapy may be recommended after surgery to lower the risk of your breast cancer from returning or spreading to a new site. Hormonal treatments are designed to block or lower the levels of the hormones in your body that stimulate the growth of your breast cancer. The therapy may involve taking a drug orally, such as tamoxifen or an aromatase inhibitor, for five years.
Hormonal Therapy Risks
Hormonal treatments can lead to side effects similar to menopause as well as:

• Hot flashes or flushes
• Aches and pains in the muscles and joints
• Nausea
• Weakening of the bones (aromatase inhibitors)
• Blood clots
• Fatigue
• Fertility issues
• Increased risk of uterine cancer

Genomic Testing with Oncotype DX -- Take Charge of your Cancer Journey

If you have been diagnosed with early-stage invasive breast cancer, the Oncotype DX breast cancer test may be appropriate for you. Oncotype DX is a genomic breast cancer test that looks at the activity of certain genes in your tumor and provides personalized information that is not available from any other test or measure.

• If you have early-stage invasive breast cancer, the Oncotype DX test is the only genomic test shown to predict the likelihood that you will benefit from adjuvant chemotherapy, while also determining the chance that your breast cancer will return. 
• If you have DCIS, the Oncotype DX test can help to determine the risk of your cancer returning locally – a key factor in deciding your treatment after surgery. 

Along with the information in your pathology report and other factors, your Oncotype DX test results can help you and your doctor select the best treatment path for you.