There are several ways to treat breast cancer, depending on the type of breast cancer you have, your tumor’s location, size, characteristics, subtype, etc. The primary treatment options include surgery, chemotherapy, radiation therapy and hormonal therapy. The order in which these treatments will happen is also dependent on the type, size and location of your tumor.
Surgery for breast cancer
There are several surgical procedures doctors use to treat breast cancer, including:
- Lumpectomy – During a lumpectomy, a surgeon removes the cancerous tissue and some of the healthy breast tissue surrounding it. The surgeon may also remove lymph nodes under the arm (axillary lymph nodes) to examine for signs of cancer.
- Mastectomy – Mastectomy is removal of breast tissue. There are several types of mastectomy, including a partial mastectomy, total mastectomy and modified radical mastectomy.
- Breast reconstruction – During breast cancer surgery, doctors may also perform breast reconstruction surgery. This surgery helps restore a more normal look and feel of the breast. Breast reconstruction can be done at a later time as well.
In most cases, doctors will perform a lymph node dissection in addition to the breast procedures. This is to find out whether cancer has spread to the lymph nodes and, if it has, to remove that cancer so it won’t spread to other areas of the body.
Chemotherapy
Chemotherapy is a type of treatment sometimes used to treat breast cancer. It involves injecting anti-cancer agents into the veins or having you swallow chemotherapy medications. Regardless of how doctors administer chemotherapy, the goal is the same – for the drug to travel throughout the body to damage cancer cells and keep them from dividing.
Sometimes, doctors give more than one type of chemotherapy drug at the same time. Your doctor will work with you to find the chemotherapy treatments that are best for you. The decision will depend in part on the type of cancer cells you have, how they are behaving, and you’re your general health is like. For example, your doctor will avoid giving you chemotherapy agents that might make a pre-existing condition worse. Also, doctors may use certain chemotherapy medications for tumors that are hormone-receptor positive.
Radiation therapy
Radiation therapy for breast cancer helps kill breast cancer cells that may be left in the body after surgery. The specialist directs radiation at the affected area of the breast and in the chest, underarm, or collarbone area. This treatment helps reduce the risk of recurrence.
There are several ways to give radiation therapy, including:
Hormone therapy
If breast cancer tests positive for hormone receptors, most doctors will recommend hormonal therapy as a treatment. Sometimes, doctors give hormonal therapy for advanced invasive ductal carcinoma prior to surgery to help shrink the cancer cells. But in most cases, hormone therapy occurs after chemotherapy or radiation therapy.
When cancer cells are hormone-receptor positive, estrogen and/or progesterone have the ability to attach to the hormone receptors, which tells the cancer cells to divide and grow. This means the hormone-receptor positive cells are being urged by the natural hormones to grow, creating more and more cancer cells. By removing the hormones or blocking the cells from hormones, cancer cells are less likely to survive and multiply.
Hormone therapy works by reducing hormones in the blood stream. The two most common hormone therapy drugs are selective estrogen-receptor response modulators (SERMs), such as tamoxifen, and aromatase inhibitors, like Arimidex or Aromasin. Doctors may also recommend estrogen-receptor downregulators (ERDs) or shutting down or removing the ovaries using medication or surgery.
HER2-targeted therapies
Sometimes, breast cancer is HER2 positive, which means the cancer cells make too much of a protein called HER2 and have too many HER2 receptors on the surface of the cells. Having too many receptors allows breast cancer cells to pick up growth signals, which causes them to grow too fast and multiply too aggressively. HER2-targeted therapy helps slow or stop the growth of cancer cells by blocking the HER2 receptors.