Treatment is based on many factors, including:
- Type and stage of the cancer
- Whether the cancer is sensitive to certain hormones
- Whether the cancer overproduces (overexpresses) the HER2/neu gene
Cancer treatments may include:
- Chemotherapy, which uses medicines to kill cancer cells.
- Radiation therapy, which is used to destroy cancerous tissue.
- Surgery to remove cancerous tissue: A lumpectomy removes the breast lump; mastectomy removes all or part of the breast and possibly nearby structures.
- Targeted therapy uses medicine to attack the gene changes in cancer cells. Hormone therapy is an example of targeted therapy. It blocks certain hormones that fuel cancer growth.
Cancer treatment can be local or systemic:
- Local treatments involve only the area of disease. Radiation and surgery are forms of local treatment. They are most effective when the cancer has not spread outside the breast.
- Systemic treatments affect the entire body. Chemotherapy and hormonal therapy are types of systemic treatment.
Most women receive a combination of treatments. For women with stage I, II, or III breast cancer, the main goal is to treat the cancer and prevent it from returning (curing). For women with stage IV cancer, the goal is to improve symptoms and help them live longer. In most cases, stage IV breast cancer cannot be cured.
- Stage 0 and ductal carcinoma -- Lumpectomy plus radiation or mastectomy is the standard treatment.
- Stage I and II -- Lumpectomy plus radiation or mastectomy with lymph node removal is the standard treatment. Chemotherapy, hormonal therapy, and other targeted therapy may also be used after surgery.
- Stage III -- Treatment involves surgery, possibly followed by chemotherapy, hormone therapy, and other targeted therapy.
- Stage IV -- Treatment may involve surgery, radiation, chemotherapy, hormone therapy, other targeted therapy, or a combination of these treatments.
After treatment, some women continue to take medicines for a time. All women continue to have blood tests, mammograms, and other tests after treatment.
Women who have had a mastectomy may have reconstructive breast surgery. This will be done either at the time of mastectomy or later.