Early breast cancer is contained in the breast. Or, it has only spread to the lymph nodes in the underarm area. This term often describes stage I and stage II breast cancer.
In the U.S., most breast cancers are found at these early stages.
With treatment, people with early breast cancer usually have a very good prognosis.
However, survival depends on each person’s diagnosis and treatment.
For example, from 2008-2014 (most recent data available) :
With recent improvements in treatment, survival for women diagnosed today may be even higher.
Treatment for early breast cancer (including invasive ductal carcinoma and invasive lobular carcinoma) usually involves some combination of surgery, radiation therapy, chemotherapy, hormone therapy and/or HER2-targeted therapy.
Surgery is usually the first step in treating early breast cancer.
You may have a mastectomy (the entire breast is removed) or a lumpectomy (only the tumor and some surrounding tissue are removed).
With either type of surgery, some lymph nodes in the underarm area (axillary nodes) may be removed to find out whether the cancer has spread there.
Women who have a lumpectomy also have radiation therapy to the breast to get rid of any cancer cells that may remain. This lowers the chances of the cancer coming back (recurrence) .
Most women who have a mastectomy don’t need radiation therapy.
However, in some cases, radiation therapy is used after mastectomy to treat the chest wall, the axillary lymph nodes and the lymph nodes around the collarbone.
For a summary of research studies on mastectomy versus lumpectomy plus radiation therapy and overall survival in early breast cancer, visit the Breast Cancer Research Studies section.
For a summary of research studies on radiation therapy following mastectomy in women with invasive breast cancer, visit the Breast Cancer Research Studies section.
Most people have treatments after surgery to help prevent the breast cancer from coming back. It's not common to have surgery as the only treatment.
Some combination of chemotherapy, hormone therapy and/or HER2-targeted therapy almost always follows breast surgery.
These drug therapies travel throughout the body to help ensure the body is rid of cancer. They may be called systemic therapy or adjuvant therapy.
Some drug therapies are given by vein (through an IV) and some are pills.
Which treatments you will need after surgery depends on:
For women, whether you are pre- or postmenopausal can also play a role in your treatment options.
Women with lymph node-negative, hormone receptor-positive tumors larger than 0.5 cm should consider getting tumor profiling testing (such as OncotypeDX®) to see if chemotherapy is needed .
Learn more about factors that affect treatment options.
For a summary of research studies on chemotherapy and early breast cancer, visit the Breast Cancer Research Studies section.
For a summary of research studies on tamoxifen in women with hormone receptor-positive early breast cancer, visit the Breast Cancer Research Studies section.
For a summary of research studies on aromatase inhibitors in women with hormone receptor-positive early breast cancer, visit the Breast Cancer Research Studies section.
For a summary of studies on trastuzumab (Herceptin) and early breast cancer, visit the Breast Cancer Research Studies section.
For some women with large tumors, chemotherapy or hormone therapy may be used before surgery (called neoadjuvant or pre-operative therapy).
Neoadjuvant therapy can shrink a large tumor enough so a lumpectomy becomes an option instead of a mastectomy.
For those with HER2-positive breast cancer, trastuzumab (Herceptin) and pertuzumab (Perjeta) may be included in neoadjuvant chemotherapy.
For a summary of studies on neoadjuvant chemotherapy, visit the Breast Cancer Research Studies section.
For a summary of studies on neoadjuvant hormone therapy for women with estrogen receptor-positive breast cancer, visit the Breast Cancer Research Studies section.
Learn more about talking with your health care provider.
If you have been diagnosed with early breast cancer, Susan G. Komen® has a series of Questions to Ask Your Doctor cards that may be helpful. For example, we have a question card on breast cancer surgery and a question card on hormone therapy.
You can download and print these cards and take them with you to your next doctor appointment. There’s plenty of space to write down the answers to these questions, which you can refer to later.
You can also download other Questions to Ask Your Doctor cards on many different breast cancer topics. These cards are a nice tool for people recently diagnosed with breast cancer, who may be too overwhelmed to know where to begin to gather information.
Although the exact treatment for breast cancer varies from person to person, guidelines help ensure high-quality care. These guidelines are based on the latest research and agreement among experts.
The National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology (ASCO) are respected organizations that regularly review and update their guidelines.
In addition, the National Cancer Institute (NCI) has treatment overviews.
Talk with your health care providers about which treatment guidelines they use. Since there’s often a lag time between the latest research and guideline updates, most providers prefer to base their treatment on the latest research.
You play an active role in making treatment decisions by understanding your breast cancer diagnosis, your treatment options and possible side effects.
Together, you and your health care provider can choose treatments that fit your values and lifestyle.
In 2013, the Health and Medicine Division of the National Academy of Sciences (formerly the Institutes of Medicine) 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 recommended improvements to fix shortcomings that add cost and burden to cancer care. Susan G. Komen® was one of 13 organizations that sponsored this study.
The report identified key ways to improve quality of care:
Read the full report.
Breast Cancer 101 - Treatment for Stage I
Breast Cancer 101 - Treatment for Stage II
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