When breast cancer is detected at an early stage of development, a number of effective treatment options are available. A woman and her physician will choose the treatment that is right for her, based on the location and extent of the cancer, her age and preferences, and the risks and benefits of each treatment. The basic treatment choices for breast cancer are surgery, radiation, chemotherapy, and hormonal therapy. Local treatments such as breast surgery and radiation therapy are focused on the breast itself to remove or destroy the cancer cells confined to the breast. Systemic treatments such as chemotherapy and hormonal therapy aim to destroy the cancer cells that may have spread throughout the body.
Breast cancer cells can be estrogen receptor positive or estrogen receptor negative. Estrogen receptor positive cells are those that have a protein to which the hormone estrogen will bind. Cancer cells that are ER+ need estrogen to grow, and may stop growing when treated with hormones that block estrogen from binding.
Estrogen receptor negative refers to cells that do not have a protein to which the hormone estrogen will bind. Cancer cells that are ER- do not need estrogen to grow, and usually do not stop growing when treated with hormones that block estrogen from binding.
Surgery has an important role in breast cancer treatment. Most women have the option to choose between breast-conserving surgery (lumpectomy, plus radiation) or removal of the breast (mastectomy). Clinical trials have proven that both options provide the same long-term survival rates for most types of early stage breast cancer.
Lumpectomy removes a small tumor and a margin of normal tissue around the tumor. The surgeon also removes some of the lymph nodes under the arm to find out if the cancer has spread. Lumpectomy is followed by radiation therapy to destroy any remaining cancer cells is the standard care.
Modified radical mastectomy is surgery to remove the entire breast, some of the lymph nodes under the arm, and the lining over the chest muscles. It may be appropriate when the breast tumor is large or if cancer is found in more than one part of the breast.
Radical mastectomy involves removal of the breast, chest muscles, and all lymph nodes under the arm. It was the standard treatment many years ago, but it is used now only when a tumor has spread to the chest muscles.
Radiation therapy uses high-energy x-rays to destroy cancer cells. It is usually used after lumpectomy to destroy any cancer cells that still may remain in the breast after surgery. It is sometimes used to shrink tumors before surgery.
Chemotherapy uses drugs, usually a combination of drugs, that travel through the body to slow the growth of cancer cells or to kill them.
Hormonal therapy prevents cancer cells from getting the hormones they need to grow. If a breast tumor relies on the body’s natural hormones to grow, it is described as estrogen receptor-positive or progesterone-positive. This means that any cancer cells that remain after surgery may continue to grow when these hormones are present in the body. Hormonal therapy can reduce the amount of the body’s natural hormones or block the hormones from reaching any remaining cancer cells.
Women who have received treatment for breast cancer may be at risk of developing lymphedema, a condition in which excess fluid collects in tissue and causes swelling, according to the National Cancer Institute. Lymphedema may occur in the arm or leg after lymph vessels or lymph nodes in the underarm or groin are removed or treated with radiation. For more information on this condition, visit the National Cancer Institute or American Cancer Society.
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