Breast Cancer Treatment Options

The section provides an overview on the variety of treatment options available to women with breast cancer. Most women who have been diagnosed with breast cancer will undergo some type of treatment for the disease. A woman’s most favorable course of treatment will depend on a number of factors including the size and location of the breast tumor, the stage of the cancer, and results of laboratory tests (such as hormone receptor tests). Before undergoing treatment, women are encouraged to learn about the different treatment options available and to discuss all possible alternatives with their physician or cancer treatment team. It is always a wise decision to obtain a second opinion before beginning breast cancer treatment.

Breast cancer treatment depends on a variety of factors including:

• the size of the breast tumor
• location of the tumor
• the stage of the cancer
• results of laboratory tests (such as hormone receptor or gene analysis).

The majority of women with breast cancer will undergo surgery as part of their cancer treatment. The standard types of breast surgery include: lumpectomy and mastectomy.  In addition to surgery, some women will receive adjuvant (additional) treatment to stop cancer growth, spread, or recurrence. Types of adjuvant therapies include: chemotherapy, radiation therapy, and drug treatments. Occasionally women may be treated with chemotherapy, radiation, or drugs without having breast surgery.

The remainder of this article provides brief descriptions of various breast cancer treatments available to women. To learn more about a topic, simply click on the underlined words within the different sections.

Lumpectomy

Lumpectomy refers to the surgical removal of a cancerous lump (or tumor) in the breast along with a small margin of the surrounding normal breast tissue. This type of surgery is attractive to many women because it allows them to maintain most of their breast after surgery. Lumpectomy is often performed on Stage 0, Stage I, or Stage II breast cancers with or without lymph node removal.  Occasionally, patients with Stage III breast cancer may undergo lumpectomy if the tumor can be cut free with one incision. When lumpectomy is combined with at least six weeks of radiation therapy, it is called breast-conserving therapy.

Mastectomy

Mastectomy is the surgical removal of the affected breast. Types of mastectomy include simple, modified radical, and radical. Mastectomy may or may not include the removal of some or all of the underarm lymph nodes.  Although mastectomy involves the physical alteration of the breast, immediate or delayed breast reconstruction is possible in most cases. Mastectomy is common treatment for women with Stage 0, Stage I, Stage II, or Stage III breast cancers.  Surgeons may occasionally perform radical mastectomy on Stage IV patients to provide symptom relief.

Lymph node removal

Axillary node dissection refers to the surgical removal of some or all of the lymph nodes under a woman’s arm. Axillary node dissections are usually performed on women who undergo mastectomy to determine whether the cancer has spread past the breast.  Sentinel node biopsy is a procedure in which only the sentinel lymph node is removed to evaluate breast cancer metastasis (spread). Lymphedema (chronic swelling of the arm) is a potentially dangerous side effect of lymph node removal.

Chemotherapy

Chemotherapy is treatment with anticancer drugs and is normally administered intravenously (through the vein) or orally in the form of pills or liquid. Chemotherapy may be used alone or in conjunction with lumpectomy or mastectomy to treat breast cancer patients. Chemotherapy is a systemic form of treatment; it flows through the bloodstream, affecting the entire body. Its purpose is to interfere with the DNA synthesis of cancer cells. . Physicians will determine the appropriate combination of drugs used for chemotherapy based on the patient's cancer characteristics and individual medical profile.

Radiation

Radiation therapy uses high-energy rays to stop breast cancer cells from growing and dividing. Ionizing radiation deposits energy in the area being treated that injures cancer cells by damaging genetic material and inhibiting growth. Although radiation damages both cancer cells and normal cells, normal cells are usually able to repair themselves and function properly after radiation.

Drug Therapy

A variety of drugs may be used with or without breast surgery to treat breast cancer. The most common breast cancer drug, tamoxifen, works by competing with estrogen to bind to estrogen receptors in breast cancer cells. By blocking estrogen in the breast, tamoxifen helps slow the growth and reproduction of breast cancer cells.

A variety of drugs may be used with or without breast surgery to treat breast cancer. They include:

• Tamoxifen: effective only in breast cancer that are dependent on estrogen
• Herceptin: used to treat breast cancer patients who have an excess of the HER2 gene
• Ellence: used in conjunction with chemotherapy (cyclophosphamide and fluorouracil) to treat early stage breast cancer
• Taxol: used to treat early and advanced stages of breast cancer
• Docetaxel: used in conjunction with chemotherapy to treat advanced breast cancer
• Aromasin: used in post-menopausal breast cancer patients with advanced breast cancer
• Arimidex: used in advanced (metastatic) breast cancer patients who have not responded well to treatment with the drug, tamoxifen

The above drugs are only a few used to treat breast cancer. Click here to read about others. The type of drugs used to treat breast cancer will vary depending on the patient's individual medical situation.

Updated: October 18, 2009

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