How Breast Cancer Is Treated

Understanding the different options

Woman with breast cancer wondering how long recovery will take
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When you've been diagnosed with breast cancer, you have a lot of treatment decisions ahead of you. Breast cancer treatments have improved greatly over time and you have more options than ever, but learning about them all can be daunting. Your doctor can help guide you through the treatments that are the best choices for your specific case of breast cancer, but doing your own research will help you understand the choices and make informed, empowered decisions.

Surgeries and Standard Medical Approaches

Some breast cancer treatments are local, aimed at the tumor (or tumors) and removing them from your body. Others are systemic, meaning their goal is to chase down and destroy stray cancer cells throughout your body.

Local breast cancer treatments include:

  • Surgery
  • Radiation

Systemic treatments include:

  • Chemotherapy
  • Targeted therapies
  • Hormone therapy
  • Adjuvant therapy

The combination of these treatments you'll get depends on the type and stage of your particular cancer.

Breast Cancer Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

Surgery

The earlier the stage of breast cancer, the more likely surgery is performed and may be curative.

  • Lumpectomy: Often referred to as breast-conserving surgery, lumpectomy involves removing the cancerous tumor and a surrounding margin of tissue. It's most common with early-stage breast cancer. Due to the risk of leaving behind some cancerous cells, lumpectomy is typically followed by radiation.
  • Mastectomy: A mastectomy involves removing the entire breast. If both breasts are removed, it's called a bilateral or double mastectomy. Sometimes, other tissues, such as the muscle that lies behind the breast, are removed, as well. Radiation is not as common following mastectomy as it is after lumpectomy.
  • Breast Reconstruction. This isn't technically a part of cancer treatment, but breast reconstruction is an important part of the treatment process and can be a big help with emotional recovery. Reconstruction is often done immediately after lumpectomy or mastectomy, but it may be performed later on, especially in cases where radiation therapy follows lumpectomy or mastectomy.
  • Sentinel Lymph Node Biopsy: Sentinel lymph node biopsy is a surgical procedure that's performed to see whether cancer has spread into the lymphatic system. It may be done during breast cancer surgery or on its own.
  • Axillary Lymph Node Dissection: The axillary nodes in your armpit are the first place to which breast cancer usually spreads. If a sentinel node biopsy finds cancer in the lymph nodes, they're most often removed as part of a mastectomy but can be performed separately.
  • Re-excision: This procedure is only done if surgical margins weren't clear following a lumpectomy. It's an outpatient surgery.

Radiation Therapy

Radiation therapy, also called radiotherapy, involves ionizing radiation to destroy cancer cells. It's used in very specific instances:

  • After a lumpectomy, to kill any remaining cancer cells and prevent a recurrence
  • After a mastectomy, when the tumor is larger than 5 centimeters or if cancer has spread to the axillary lymph nodes
  • In stage 4 breast cancer, when cancer has spread to other organs

Several radiation-therapy techniques are in use, including whole-breast and partial-breast radiation. Each type has specific uses and indications.

Chemotherapy

Chemotherapy is a systemic treatment that involves the use of drugs to kill cancer cells or stop them from growing. Some chemo drugs are oral (pills that you take) while others are infusions (delivered into your veins). The specific drug(s) you'll get depend on the stage and characteristics of your tumor.

Not everyone with breast cancer will need chemotherapy. Your doctor may recommend chemotherapy:

  • For advanced breast cancer: If breast cancer has spread to other areas of the body, surgery is no longer an option. Chemotherapy, often in combination with targeted therapy, is typically the preferred treatment.
  • After surgery for some early-stage breast cancer: When there's a high risk of recurrence or metastasis, chemotherapy may help reduce the risk. This is called "adjuvant" therapy, which means that it follows the primary treatment.
  • Before surgery to shrink large tumors: This can help surgery be more successful, decrease the chance of recurrence, and sometimes allow for a lumpectomy instead of a mastectomy. This is called neoadjuvant therapy, as it comes before the primary treatment.

Neoadjuvant therapy is often used for:

  • Inflammatory breast cancer
  • HER2-positive breast cancer
  • Triple-negative breast cancer
  • High-grade tumors
  • Large tumors
  • Cancers that have spread to the lymph nodes

A drawback of chemotherapy is that it targets any rapidly growing cells, which leads it to damage non-cancerous cells. That's responsible for many of the side effects linked to this form of treatment.

Targeted Therapies

Targeted therapies are a newer form of breast cancer treatment. They can be used alone or along with other therapies.

While chemotherapy targets all rapidly growing cells, targeted therapies do what their name suggests—directly target cancer cells or specific processes that contribute to the growth of cancer cells. That means target therapy often has fewer side effects than chemo.

  • Targeted therapies are available for people with:
  • Estrogen receptor-positive breast cancer
  • HER2-positive breast cancer
  • Triple-negative breast cancer
  • Women with the BRCA gene mutations

Hormone Therapy

Hormone therapy either blocks your body's ability to produce hormones or interferes with how hormones work. It's used to slow or stop the growth of hormone-sensitive tumors.

Typically, hormone therapy follows primary treatments and continues for five years. The specific drugs depend on whether you're pre-menopausal or post-menopausal.

Over-the-Counter (OTC) Therapies

While there are no over-the-counter treatments for breast cancer, your doctor may recommend some for help with pain and other symptoms, or to manage treatment side effects.

No matter how common or harmless they may seem, be sure your doctor knows about any and all OTC medications and supplements you're taking. Some may interfere with your treatments or interact negatively with cancer medications.

Lifestyle and Home Remedies

Lifestyle changes may have a positive impact on your risk of recurrence and overall health. Recommended changes include:

The Internet is full of home remedies for diseases, and breast cancer is no exception. Remember that these treatments are unproven and may even be harmful. Be sure to talk to your doctor about anything you're considering and don't opt for unproven "treatments" as replacements for the proven ones your oncologist recommends.

Complementary Alternative Medicine

As with home remedies, you should be careful with complementary or alternative treatments that aren't scientifically proven, especially if they're recommended as replacements for standard treatments that are proven to save lives.

However, some complementary approaches may be beneficial alongside cancer treatments, especially for helping you cope with symptoms, treatment side effects, and the emotional impact of it all. Medical science is learning more about Eastern treatments such as acupuncture, yoga, and meditation, and treatment protocols that integrate these into cancer care are becoming more common.

A Word From Verywell

The treatment choices may seem overwhelming, but your doctor can help you figure out which ones are most appropriate for you. Having all those choices mean that your treatment regimen can be tailored specifically for you, and that increases your chance of a good outcome.

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