If your biopsy indicates that you have cancer, you will be scheduled to see a surgeon and/or a medical oncologist. Physicians at Levine Cancer Institute have experience and expertise in helping you select the appropriate treatment for your breast cancer. Together with your medical team, you will discuss risks and benefits of treatment and develop a plan to get rid of the breast cancer, to reduce the chance of the breast cancer coming back in the breast, and reduce the chance of the cancer traveling to another part of the body.
The type of treatment that will be recommended will depend on the size and location of the tumor, the results of the special tests done on the cancer cells (ER, PR, HER-2), and the stage or extent of the disease. CAT scans and a bone scan may be ordered to see if the cancer has spread to another part of the body. Your physician will also consider your overall state of health, your age, as well as your feelings about the treatment options.
Treatment for breast cancer is either local or systemic. Local treatment is used to control the cancer in the breast. Surgery and radiation therapy are considered local treatments. Systemic treatments are used to control or destroy cancer cells throughout the body. Chemotherapy and hormone therapy are types of systemic treatments. It might be recommended that you receive just one type of treatment, or a combination, depending on your specific needs. Chemotherapy or hormone therapy may be given before surgery to shrink the tumor, or after surgery to reduce the chances of the cancer coming back.
- Lumpectomy, also called partial mastectomy, removes the cancerous part of the breast and an area of normal tissue around the cancer. The goal of this surgery is to remove the cancer and preserve the normal appearance of the breast. Lymph nodes under your arm may also be removed at the time of this surgery through a second incision. The decision to remove lymph nodes depends on your initial biopsy report and the physician’s evaluation of all your information. This surgery is usually followed by radiation therapy to treat the remaining breast tissue. Most women with early-stage disease can have this surgery.
- Mastectomy, or removal of the entire breast, is another surgical option. Today a mastectomy does not usually remove muscle and may be followed by delayed or immediate reconstruction, depending on your situation. You will need to discuss this with your surgeon. Breast reconstruction is done by a plastic surgeon. Some women who have a mastectomy will still need radiation therapy.
- Chemotherapy is the use of chemicals to kill cancer cells. It can be given orally, but most chemotherapy is given intravenously, or in the vein. There are many chemotherapy drugs used for breast cancer that are used in various combinations. Sometimes chemotherapy is given before surgery, neoadjuvant, or after surgery, adjuvant. In metastatic breast cancer, the goal of chemotherapy is to control the cancer for as long as possible while considering a person’s quality of life.
- Hormone therapy may be used if your breast cancer is hormone receptor positive. Blocking estrogen from working, or lowering estrogen levels, can help stop breast cancer from growing or returning.
- Targeted therapy is made to attack only cancer cells and does not effect normal cells. Trastuzumab (Herceptin) is an example of a targeted drug for those breast cancers that test positive for overexpression of HER-2.
- Radiation therapy is the use of high energy rays (photons and electrons) to destroy cancer cells. It is used to kill any cells that may have been left behind in the breast after surgery. For some, it is also used to treat lymph nodes areas around the breast. Radiation treatments are usually delivered Monday through Friday for six to seven weeks.
Levine Cancer Institute has a strong focus on clinical trials to try to improve current treatments for breast cancer. A clinical trial is done when physicians have reason to believe that a new treatment may be better than what we currently have as standard of care. If deemed appropriate by your healthcare team, you will be asked and encouraged to take part in a clinical trial to advance the fight against cancer.
To have the best chance of finding breast cancer at an early stage, follow these three steps:
- Get a mammogram: The American Cancer Society recommends having a yearly mammogram starting at age 40 and continue as long as you are in good health.
- Examine your breasts every month starting in your 20s. Know how your breasts normally look and feel and report any changes to your health care provider.
- Have your breasts examined by hour health care provider at least every three years starting in your 20s, and once every year if you are 40 or older.