> Treatment Options for Different Stages of Breast Cancer
Treatment for non-invasive breast cancer
Treatment for ductal carcinoma in situ (DCIS), a non-invasive breast cancer, involves surgery and possibly radiation therapy and/or tamoxifen.
Treatment for invasive breast cancer
Treatment for invasive breast cancer usually involves some combination of surgery, radiation therapy, chemotherapy, hormone therapy and/or targeted therapy. The order of the therapies and the specific treatments depend on the cancer stage and the characteristics of the tumor.
Treatment by stage of breast cancer
These sections describe the recommended treatments for different types of non-invasive and invasive breast cancer.
Your breast cancer treatment plan
Your breast cancer treatment plan is based on both medical and personal choices. It is tailored to:
- Your specific type of breast cancer (the biology of the tumor)
- The stage of the breast cancer
- Other medical issues
- Your personal preferences
Because of the differences between tumors and between people, your treatment plan may differ from another person’s, even though you both have breast cancer. Each treatment option has risks and benefits to consider with your own values and lifestyle.
Treatment for breast cancer can be thought of in two areas: local therapy and systemic therapy.
Local therapy removes the cancer from a limited (local) area, such as the breast, chest wall and lymph nodes in the underarm area (axillary nodes). It also helps to ensure the cancer does not recur (come back) to that area. It usually involves surgery, with or without radiation therapy to the breast area.
Systemic therapy (adjuvant therapy)
Systemic therapy aims to get rid of cancer cells that may have spread from the breast to other parts of the body. This usually means drug therapy, which travels throughout the body to get rid of cancer cells that may have spread from the breast to other parts of the body. Systemic therapy includes chemotherapy, hormone therapy and targeted therapy. Because systemic therapy is an adjunct to (or in addition to) breast surgery, these treatments are often called adjuvant therapy.
Learn about factors that affect treatment options.
Learn about financial issues related to treatment.
How does your age affect your treatment plan?
No matter your age, your treatment plan depends on many factors, such as the type of breast cancer you have and the characteristics of the tumor. Your overall health and other health conditions you may have also play a role in your treatment plan. For example, if you have heart disease, some medications can cause more harm than good. All of these things help tailor your treatment plan.
Younger women with breast cancer have special concerns about early menopause and loss of fertility due to treatment. Learn about these issues for young women with breast cancer.
Although the exact treatment for breast cancer varies from person to person, treatment guidelines help ensure quality care. These guidelines are based on the latest research and the consensus of experts. The American Society of Clinical Oncology (ASCO) and National Comprehensive Care Network (NCCN) are two respected organizations that regularly update and post their guidelines online.
You should ask your health care providers what treatment guidelines they use as the basis of their practice. Since there is often a time lag between the latest research and updates of guidelines, most medical oncologists prefer to base their treatment on the latest research that ultimately drives these guidelines.
In September 2013, the Institute of Medicine (IOM) released a set of recommendations (below) on improving cancer care in the U.S. The report Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis recommends improvements to fix shortcomings that add cost and burden to cancer care. In the U.S., there are about 14 million cancer survivors and more than 1.6 million new cases are diagnosed each year. By 2022, the IOM projects that there will be 18 million cancer survivors and, by 2030, cancer incidence is expected to rise to 2.3 million new diagnoses per year. Therefore, the IOM convened a committee of experts to examine the quality of cancer care in the U.S. and made recommendations for improvement. The committee concluded that the cancer care delivery system is in crisis due to a growing demand for cancer care, increasing complexity of treatment, a shrinking workforce and rising costs. Changes across the board are urgently needed to improve the quality of cancer care.
Susan G. Komen® endorses these recommendations as they have special significance in the breast cancer field. “Issues of accessibility, quality treatments and survivorship are especially complex for breast cancer patients, who may be treated for many years,” said Chandini Portteus, Komen’s Chief Mission Officer.
The report identified key ways to improve quality of care:
- Ensure that cancer patients are engaged and understand their diagnosis so they can make informed treatment decisions with their health care providers
- Develop a trained and coordinated workforce of cancer professionals
- Focus on evidence-based care, using information technology to provide better information about the potential benefits of treatments
- Focus on quality measurements
- Provide accessible and affordable care for all
The study was chaired by a Susan G. Komen Scholar Patricia Ganz, M.D., with participation by Komen’s Chief Scientific Advisor, George Sledge, M.D. Komen was one of 13 organizations sponsoring the study. Read the full report at www.nas.edu and www.iom.edu.