Breast Cancer (cont.)
Treatment choices by stage
Your treatment options depend on the stage of your disease and these factors:
- The size of the tumor in relation to the size of your breast
- The results of lab tests (such as whether the breast cancer cells need hormones to grow)
- Whether you have gone through menopause
- Your general health
Below are brief descriptions of common treatments for each stage. Other treatments may be appropriate for some women. Clinical trials can be an option at all stages of breast cancer.
Stage 0
Stage 0 breast cancer refers to lobular carcinoma in situ (LCIS) or ductal carcinoma in situ (DCIS):
- LCIS: Most women with LCIS do not have treatment. Instead, the doctor may suggest regular checkups to watch for signs of breast cancer.
Some women take tamoxifen to reduce the risk of developing breast cancer. Others may take part in studies of promising new preventive treatments.
Having LCIS in one breast increases the risk of cancer for both breasts. A very small number of women with LCIS try to prevent cancer with surgery to remove both breasts. This is a bilateral prophylactic mastectomy. The surgeon usually does not remove the underarm lymph nodes.
- DCIS: Most women with DCIS have breast-sparing surgery followed by radiation therapy. Some women choose to have a total mastectomy. Underarm lymph nodes are not usually removed. Women with DCIS may receive tamoxifen to reduce the risk of developing invasive breast cancer.
Stages I, II, IIIA, and operable IIIC
Women with Stage I, II, IIIA, and operable (can treat with surgery) IIIC breast cancer may have a combination of treatments. Some may have breast-sparing surgery followed by radiation therapy to the breast. This choice is common for women with Stage I or II breast cancer. Others decide to have a mastectomy.
With either approach, women (especially those with Stage II or IIIA breast cancer) often have lymph nodes under the arm removed. The doctor may suggest radiation therapy after mastectomy if cancer cells are found in 1 to 3 lymph nodes under the arm, or if the tumor in the breast is large. If cancer cells are found in more than 3 lymph nodes under the arm, the doctor usually will suggest radiation therapy after mastectomy.
The choice between breast-sparing surgery (followed by radiation therapy) and mastectomy depends on many factors:
- The size, location, and stage of the tumor
- The size of the woman's breast
- Certain features of the cancer
- How the woman feels about saving her breast
- How the woman feels about radiation therapy
- The woman's ability to travel to a radiation treatment center
Some women have chemotherapy before surgery. This is neoadjuvant therapy
(treatment before the main treatment). Chemotherapy before surgery may shrink a
large tumor so that breast-sparing surgery is possible. Women with large Stage
II or IIIA breast tumors often choose this treatment.
After surgery, many women receive adjuvant therapy. Adjuvant therapy is
treatment given after the main treatment to increase the chances of a cure.
Radiation treatment can kill cancer cells in and near the breast. Women also may
have systemic treatment such as chemotherapy, hormone therapy, or both. This
treatment can destroy cancer cells that remain anywhere in the body. It can
prevent the cancer from coming back in the breast or elsewhere.
Stages IIIB and inoperable IIIC
Women with Stage IIIB (including inflammatory breast cancer) or inoperable Stage IIIC breast cancer usually have chemotherapy. (Inoperable cancer means it cannot be treated with surgery.)
If the chemotherapy shrinks the tumor, the doctor then may suggest further treatment:
- Mastectomy: The surgeon removes the breast. In most cases, the lymph nodes under the arm are removed. After surgery, a woman may receive radiation therapy to the chest and underarm area.
- Breast-sparing surgery: The surgeon removes the cancer but not the breast. In most cases, the lymph nodes under the arm are removed. After surgery, a woman may receive radiation therapy to the breast and underarm area.
- Radiation therapy instead of surgery: Some women have radiation therapy but no surgery. The doctor also may recommend more chemotherapy, hormone therapy, or both. This therapy may help prevent the disease from coming back in the breast or elsewhere.
Stage IV
In most cases, women with Stage IV breast cancer have hormone therapy,
chemotherapy, or both. Some also may have biological therapy. Radiation may be
used to control tumors in certain parts of the body. These treatments are not
likely to cure the disease, but they may help a woman live longer.
Many women have supportive care along with anticancer treatments. Anticancer
treatments are given to slow the progress of the disease. Supportive care helps
manage pain, other symptoms, or side effects (such as nausea). It does not aim
to extend a woman's life. Supportive care can help a woman feel better
physically and emotionally. Some women with advanced cancer decide to have only
supportive care.
Recurrent breast cancer
Recurrent cancer is cancer that has come back after it could not be detected.
Treatment for the recurrent disease depends mainly on the location and extent of
the cancer. Another main factor is the type of treatment the woman had before.
If breast cancer comes back only in the breast after breast-sparing surgery,
the woman may have a mastectomy. Chances are good that the disease will not come
back again.
If breast cancer recurs in other parts of the body, treatment may involve
chemotherapy, hormone therapy, or biological therapy. Radiation therapy may help
control cancer that recurs in the chest muscles or in certain other areas of the
body.
Treatment can seldom cure cancer that recurs outside the breast. Supportive
care is often an important part of the treatment plan. Many patients have
supportive care to ease their symptoms and anticancer treatments to slow the
progress of the disease. Some receive only supportive care to improve their
quality of life.
Next: What about breast cancer reconstruction? »
- cyclophosphamide, Cytoxan - Explains the medication cyclophosphamide (Cytoxan), a drug used for the treatment of several types of cancers and often in combination with other drugs to treat breast cancer, leukemia and ovarian cancer.
- CA 125 - Read about CA 125, the blood test for ovarian cancer. This test however, will also be increased with benign conditions such as endometriosis, uterine fibroids, pelvic inflammatory disease, and others.
- Lupus - Get information on lupus (SLE) disease treatment, signs, diagnosis, types of symptoms (butterfly, discoid rash), causes, pregnancy flares, prevention and statistics.
Latest Medical News
Cancer RSS