How Do I Choose What Breast Cancer Treatment to Have?

Breast Cancer Treatment Options

Being diagnosed with breast cancer can be a very scary time. Once diagnosed, your cancer care team will discuss treatment options with you. Your treatment plan is tailored to you and based on many factors, including the stage of cancer, your age, general health and personal preferences, genetic testing, in addition to the presence of other medical issues. It’s important to be educated about these choices in order to make the best decision for you. There are two types of treatment for breast cancer:  local therapy and systematic therapy. Each treatment option comes with its own risks and benefits, so you’ll want to weigh your options carefully. 

Local Therapy for Breast Cancer

Local therapies treat the tumor, without affecting the rest of the body. Types of local therapy include breast cancer surgery and radiation therapy. 

Surgery for Breast Cancer

Surgery involves the removal of the entire tumor from the breast. There are two types of surgery to remove breast cancer:

• Lumpectomy. A lumpectomy, or breast-conserving surgery, removes the tumor and a small area of healthy tissue around the tumor. Most of the breast remains, allowing the breast to look as close to pre-surgery as possible. This is generally an option for women who have early or non-invasive breast cancer. 
  
  
• Mastectomy. A mastectomy is a surgery to remove the entire breast, along with other nearby tissue.  There are several types of mastectomies, based on how the surgery is done and how much additional tissue is removed. This is an option for women who are unable to have radiation therapy or those who have genetic factors that increase the chance of second cancer, among others.

Radiation Therapy for Breast Cancer

Some women with breast cancer will need radiation therapy, in addition to other treatments. Radiation uses high-energy X-rays to kill cancer cells. The need for radiation depends on the type of surgery you had and whether or not cancer has spread to the lymph nodes or other parts of the body. Unfortunately, not all breast cancer patients are eligible for radiation therapy. Radiation is not an option if you already have had radiation to that area of the body, have certain autoimmune diseases, such as scleroderma or systemic lupus or if you are pregnant.

Systemic Therapy for Breast Cancer

Systemic therapies are treatments that use drugs to fight breast cancer. They reach cancer cells anywhere in the body, not just one area.

Chemotherapy for Breast Cancer

Chemotherapy treats a woman’s entire body for breast cancer, not just her breast. Chemotherapy drugs can be used to kill cancer cells that have spread to other parts of the body. They might also be given before or after surgery to lower the chance of a reoccurrence. 

There are situations when chemotherapy is recommended:

• Before surgery. Chemotherapy before breast cancer surgery is administered to shrink the tumor so it can be removed with less extensive surgery. 
  
• After surgery. Chemotherapy used after breast cancer surgery focuses on killing any cancerous cells left behind from surgery or those that can't be seen.
  
• Advanced breast cancer. Chemotherapy can be used as the main treatment for women whose breast cancer has spread outside the breast area (metastatic).  It is used to slow or shrink the growth of tumors.

Hormone Therapy for Breast Cancer

Some types of breast cancer are affected by hormones, i.e. the cancer cells need estrogen or progesterone to grow. Hormone therapies for breast cancer are recommended for women with hormone receptor-positive (ER-positive or PR-positive) breast cancers. These therapies slow or stop the growth of hormone-receptor-positive tumors by preventing the cancer cells from getting these hormones.

Targeted Therapy for Breast Cancer

Targeted therapy drugs are designed to block the growth of breast cancer cells. Instead of working against all rapidly dividing cells as chemo drugs do, these therapies work by targeting specific changes in cancer cells that make them different from normal cells. Sometimes, targeted therapies help other types of breast cancer treatment work more effectively.

Many women will get more than one type of treatment for their cancer. Your Mercy care team will discuss all available options and provide the best course of treatment for your specific breast cancer.