A variety of factors will influence the decisions you and your health care provider make about your treatment. These include: your overall health, your age and medical history; the type and stage of your breast cancer; the available treatments (and their side effects); and your goal and preferences for treatment. When making decisions about treatment, be sure to discuss all of these topics with your doctor.
Types of Treatment
The best treatment of breast cancer often requires more than one type of treatment and can include surgery, radiation therapy, chemotherapy, and antihormonal therapy. Newer therapies are being studied that are tailored to molecular characteristics of breast tumors. These treatments are called targeted or biologic therapies.
Surgery and radiation therapy are local treatments. That means they can get rid of the cancer in your breast and the nearby area, but they cannot kill cancer cells that have spread to other parts of your body. Chemotherapy and antihormonal therapy are systemic treatments. That means they can reach cancer cells anywhere in your body. Here is some general information about treatment.
Surgery
The first treatment for breast cancer is often surgery to take out the cancer. The surgery may be one of the following:
Lumpectomy (also known as excisional biopsy) - Is a breast-conserving surgical procedure that involves removal of the cancer and some surrounding breast tissueLumpectomy
Simple or total mastectomy - Is removal of the entire breast containing cancer
Modified radical mastectomy - Is removal of the entire breast along with underarm lymph nodes
You may also have surgery to reconstruct (rebuild) your breast. For more information, see Surgery for Breast Cancer.
Radiation Therapy
Radiation is used to kill any tiny cancer cells invisible to the naked eye that may have been left behind after surgery. It may also be used to help control symptoms if cancer spreads. For more information, see Radiation Therapy for Breast Cancer.
Chemotherapy
Chemotherapy uses anticancer drugs to kill cancer cells. There are many different kinds of chemotherapy drugs. Often they are used in combinations called regimens. For more information, see Chemotherapy for Breast Cancer Treatment.
Antihormonal Therapy
In some breast cancers, the hormone estrogen makes the cells grow. These are called estrogen-receptor-positive tumors. Antihormonal therapy prevents estrogen from stimulating tumor growth. This therapy usually involves taking drugs. There are several different kinds. For more information, see Antihormonal Therapy for Breast Cancer.
Biologic Therapy (targeted therapy)
Over the past few years, researchers discovered that breast tumors that express a protein called HER2 are more likely to be aggressive. That observation led to development of a drug called Herceptin® (trastuzumab) to block the HER2 protein. This type of therapy is known as targeted therapy because the drug is targeted to a biologic characteristic of the tumor. Trastuzumab, in combination with chemotherapy, reduces the risk of recurrence and prolongs life in women with HER2-positive breast cancer. As our understanding of the biology of breast cancer deepens, newer biologic treatments will become available.
Treatment by Stage
The treatment of breast cancer is based in large part on the stage of the cancer. If you do not know the stage of your cancer, ask your doctor. If you do know, choose the appropriate stage below to learn more.
Treatment of Carcinoma In Situ
Treatment of Stage I Breast Cancer
Treatment of Stage II Breast Cancer
Treatment of Stage III Breast Cancer
Treatment of Inflammatory Breast Cancer
Treatment of Stage IV Breast Cancer
Treatment of Recurrent Breast Cancer
Side Effects of Treatment
Most treatments for breast cancer have side effects. They can range from mild to serious. Among the more common are fatigue, mouth sores, nausea and vomiting, hair loss, and something called "chemo brain," in which you feel as if you're more forgetful and hazy.
It is hard to predict who will get side effects and whether the side effects will be mild, moderate, or severe in intensity. Ask your health care provider about what you might expect from your treatment, but be aware that you may not develop side effects, and that if you do, they may turn out to be mild and manageable. Also, ask your health care provider about pretreatment for potential side effects.
Today your doctor can give you medication before chemotherapy to prevent or modify certain side effects, such as fatigue and nausea. One side effect—called lymphedema—can happen if lymph nodes in your armpit (called axillary lymph nodes) are removed during surgery. With this condition, you get swelling and pain in your arm and stiffness in your shoulder. But there are ways to prevent it and to treat it. For more information, see Lymphedema After Breast Cancer Surgery.
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