Your doctor will discuss your breast cancer treatment options with you. These recommendations will take a number of considerations into account, including the kind of cancer you have, whether the cancer cells respond to hormones, the stage of the cancer's growth, its location, your overall health and your personal preferences.
The most common course of treatment for breast cancer is surgery followed by additional treatment, such as chemotherapy, hormone therapy or radiation.
As you and your family, together with your doctor, make complex treatment decisions, you may feel overwhelmed by all the choices available and decisions that need to be made. Many newly-diagnosed women find it helpful to talk to other women who have faced similar decisions. The most common and effective treatments for breast cancer include:
- Chemotherapy
- Radiation therapy
- Surgery
- Targeted therapy: Certain drugs that attack specific abnormalities within cancer cells
- Hormone therapy: Used to treat breast cancers that are responsive to hormones, this therapy can be used after surgery to decrease the chance of your cancer returning. If the cancer has already spread, hormone therapy may shrink and help control it.
Three basic types of breast cancer surgeries include:
- Diagnostic
- Therapeutic
- Reconstructive
Lumpectomy
During a lumpectomy, the surgeon removes the tumor and a small margin of healthy tissue surround it. This procedure is typically reserved for smaller tumors that are easily separated from the surrounding tissue.
Mastectomy
A mastectomy is surgery which removes all of your breast tissue. There are two types of mastectomy. A "simple" mastectomy means the surgeon removes the lobules, ducts, fatty tissue and skin, including the nipple and areola. A "radical" mastectomy means the underlying muscle of the chest wall is removed, along with surrounding lymph nodes in the underarm.
Sentinel node biopsy
Breast cancer that has spread to the lymph nodes may spread to other areas of the body. In a sentinel node biopsy, the lymph node nearest your breast tumor (which receives the lymph drainage from your cancer) is removed and tested for breast cancel cells. If no cancer is found, the chance of finding cancer in any of the remaining lymph nodes is small and no other nodes need to be removed.
Axillary lymph node dissection
If cancer is found in the sentinel node, your surgeon may remove additional lymph nodes in your underarm.
Breast reconstruction surgery
Some women choose to have breast reconstruction surgery. Discuss your preferences and options with your surgeon. These may include reconstruction with a synthetic breast implant or reconstruction using your own tissue. These operations can be performed at the time of your mastectomy or at a later date, so you may want a referral to speak with a plastic surgeon before your breast cancer surgery.
Other possible treatment options include:
Clinical trials: Clinical trials represent the cutting edge of cancer research and are used to test new and promising cancer treatments. However, being unproven, these treatments may or may not be superior to current therapies. Speak with your doctor about available clinical trials to see if one may be right for you.
Alternative therapies: No alternative medicines have been discovered which help treat breast cancer. But complementary and alternative therapies may help you manage the most common side effects of cancer treatment, especially fatigue. These therapies include gentle exercise, stress management and other relaxation strategies.
If routine exams or tests ever suggest the possibility of a recurrence of your cancer, imaging tests such as X-ray, computed tomography (CT or CAT scan), positron emission tomography (PET scan), magnetic resonance imaging (MRI scan), bone scan and/or biopsy may be ordered.
If your cancer does recur, your treatment will depend on the location of the cancer and what treatments you've had previously. Options may include surgery, radiation therapy, hormone therapy, chemotherapy, drug therapy or some combination of these.