Breast Cancer Treatment Options

Surgery

For some people, surgery is a first-line treatment with the goal of removing the cancer. Performing a lymph node biopsy at the same time can help stage the cancer.

Lumpectomy

A lumpectomy, or “breast-sparing surgery,” involves removing the tumor and a margin of healthy tissue around it. The surgeon might also remove the sentinel lymph nodes under your arm. A lumpectomy may be an option if you have ductal carcinoma in situ or early stage breast cancer.

A lumpectomy is also possible for people with larger tumors who undergo neoadjuvant treatment and have a good response or a “complete response,” which means that all the cancer is gone.

Total mastectomy

A total mastectomy, also known as a “simple mastectomy,” is a procedure in which the surgeon removes the whole breast. It usually also includes removing sentinel lymph nodes. In a modified radical mastectomy, the surgeon removes the whole breast and most of the lymph nodes under your arm.

A mastectomy may be a better option than a lumpectomy if:

• the tumor is large in relation to breast size
• you have multiple tumors
• you won’t be able to have radiation therapy
• you have a BRCA mutation and opt for it as part of your treatment plan for risk reduction in the future

Breast reconstruction

In some cases, it’s possible to preserve some skin, the nipple, and the areola for reconstruction. Breast reconstruction, if you choose it, can take place at the same time as mastectomy or later.

There are different types of reconstruction surgeries. The surgeon can use an implant or tissue from another part of your body.

Radiation therapy

Radiation therapy targets high doses of radiation directly to cancer sites. According to the American Cancer SocietyTrusted Source, external beam radiation is the most common typeTrusted Source of radiation for people who have breast cancer.

Radiation therapy can be used after surgery to destroy any cancer cells that may have been left behind, which lowers the chance of recurrence.

If cancer has spread beyond the breasts, radiation therapy can help destroy tumors, slow tumor growth, or ease symptoms in other parts of the body.

Chemotherapy

Chemotherapy is a systemic therapy, which means it can destroy cancer cells anywhere in the body. Chemotherapy can help:

• Before surgery (neoadjuvant chemotherapy): to shrink large tumors and allow for less extensive surgery (e.g., a lumpectomy rather than a mastectomy)
• After surgery (adjuvant chemotherapy): to treat people who have inflammatory breast cancer or triple-negative breast cancer, to kill cancer cells left behind, and to lower the chances of cancer recurrence
• As the main treatment: to treat cancer that has spread to distant sites (metastatic breast cancer)

It’s worth noting that some people may receive both neoadjuvant and adjuvant therapy, depending on the type of cancer they have and the extent of tumor remaining after surgery.

There are many different chemotherapy drugs for breast cancer treatment. Most of the time, you’ll need a combination of two or more different drugs.

Hormone therapy

Some types of breast cancer test positive for estrogen receptors or progesterone receptorsTrusted Source. These cancers use hormones to grow and spread. The goal of hormone therapy, also called “endocrine therapy,” is to starve the cancer of these fuels.

Some therapies block the production of these hormones and others interfere with the effect the hormones have on cancer cells. An oncologist will make a recommendation based on factors such as your other treatments and menopausal status.

About 65% of all breast cancers are hormone receptor (HR)-positive. If your breast cancer is hormone receptor (HR)-negativeTrusted Source, hormone therapy won’t be effective.

Targeted therapy

Certain drugs target specific proteins or other characteristics of cancer cells that help them grow and spread. Targeted therapies can:

• stop cancer cells from reproducing
• lower the risk of recurrence
• treat advanced breast cancer that’s no longer responding to other treatments

HER2-positive breast cancers are treated with anti-HER2-positive drugs, such as trastuzumab (Enhertu) or pertuzumab (Perjeta). These drugs are given alongside chemotherapy (either neoadjuvant, adjuvant, or both) and play a significant role in managing HER2-positive cancers as well as early stage breast cancers and cancers that have metastasized.