What are the treatment options?

How is it decided what further treatment is needed?

The tissue removed from your breast is analysed and the information is used to access your risk of recurrence. This information is used to structure a future programme of localised (area where cancer was removed) or system (full body) treatment.

This explanation shows how the information gathered is combined.

1. The lump or cancerous area is removed and the lab analyses the cancer to find out its grade, hormonal status, size, and determines whether its margins are clear.

2. The lymph nodes are checked to see whether they are free of the disease. The number of lymph nodes involved is noted. All this information is reported to your doctor on a histology report.

3. Taking into account all of the factors above, it is decided whether you will benefit from additional therapy and if so whether chemotherapy or hormone therapy, or both is the most appropriate way to treat your body for any possible active cancer cells.

4. Radiation therapy may be used to reduce the possibility of any local recurrence by destroying any possible active cells in the breast area.

Treatment Stage 0

Stage zero is a non-invasive carcinoma in situ.

A very small number of women at stage zero may require only breast conservation surgery (lumpectomy) but many may need radiation therapy as well.

Sometimes a total mastectomy may be required, and in these cases radiation will probably not be needed. Chemotherapy is not required for stage zero breast cancer but hormone therapy may be used after a lumpectomy to reduce the risk of new cancers forming.

Treatment Stage I

Tumour is less than 2cm

In stage I, the cancer is invasive but has not spread beyond the breast.

With stage I cancer, you may need to have a mastectomy or a lumpectomy. In either case, some lymph nodes will be removed from your armpit to determine whether the cancer has spread.

Following surgery, you may receive radiation therapy if you had a lumpectomy and either chemotherapy or hormone therapy or both to help ensure that you have got rid of all the cancer.

The condition of your lymph nodes and the type of tumour you have will determine which treatments you will need.

Treatment Stage II

Tumour size is 2 – 5cm

For stage II, either a mastectomy or breast conserving surgery is recommended. With either procedure, some of the lymph nodes will be removed from the armpit to determine whether the cancer has spread there.

Radiation will be necessary if you have not had a mastectomy but may also be necessary after some mastectomies, and either chemotherapy, hormone therapy or both almost always follow surgery to help ensure that the body is completely free of cancer. Which treatments a woman will need after surgery depends on the status of the lymph nodes and the characteristics of the tumour.

Treatment Stage III

Usually over 5cm (50mm) with lymph node involvement

For a stage III a mastectomy is usually recommended with radiation after surgery.

Underarm lymph nodes will be removed and radiation may be recommended for internal mammary lymph nodes and those near the collarbone.

Chemotherapy is almost always recommended and hormone therapy is common if the cancer was hormone sensitive. Breast conserving surgery can be done for some stage III cancers if chemotherapy is given before surgery to shrink the tumour.

Treatment Stage IV (Metastatic or secondary cancer)

In stage IV, the cancer has metastasised or spread to other organs in the body and cannot be completely cured. Treatment of metastatic breast cancer varies but mostly focuses on lengthening and maintaining the quality of a woman’s life.

Surgery may be required to remove tumours in the breast or other organs and hormone therapy is often recommended.

Some women may need chemotherapy and Herceptin may be prescribed for patients who are HER2 positive.

What are the treatment options?

About Breast Cancer