What to Know About Your Treatment Choices for Breast Cancer

Researchers are continually finding ways to treat breast cancer. Women diagnosed with it now have more hope for survival than ever before. The choices that you have for treatment depend on these factors:

• Type, size, and location of the tumor in your breast
• Results of lab tests, such as hormone receptor tests
• Extent of the disease, called the stage
• Your health, age, menopause status, and size of your breasts
• Your personal needs and preferences

Many women want to learn all they can about their disease and treatment choices so that they can make confident decisions about their care. If you are one of them, you're likely to have many questions. For instance, most women want to know how they will look after treatment. And they want to know whether they'll have to change their normal activities. Your doctor is the best person to answer your questions. You can talk with your doctor about these issues:

• Your treatment choices
• How successful treatment is expected to be
• What the risks and potential side effects are
• How much treatment is likely to cost

Types of Treatment for Breast Cancer

Local treatments remove, destroy, or control the cancer cells in one certain area. Surgery and radiation are local treatments.

Systemic treatments destroy or control cancer cells all through the body. Chemotherapy and hormone therapy are systemic treatments.

You may have one type of treatment or a combination. Different types of treatments have different goals. Here are some of the types and goals of treatment for breast cancer.

• Surgery. The goal of surgery is to remove the tumor from your breast. Surgery is the most common way to treat breast cancer. Sometimes only the tumor is removed, and the breast is left intact. Sometimes the entire breast is removed. Your doctor may also use surgery to see if the cancer has spread to the lymph nodes under your arm. Knowing if the cancer has spread can help you and your doctor make important decisions about other types of treatment you may need. After a breast is removed, surgery may also be used to reconstruct a breast with either your own tissue or an implant. The surgeries to remove the tumor and lymph nodes, and reconstruct the breast, may be done as one operation or separately.
• Radiation therapy. The goal of radiation is to kill cancer cells using X-rays and other types of radiation. This treatment can be used to shrink a tumor before surgery. Or it may be used after surgery to kill cancer cells that may remain in the breast or chest area. Radiation may also be used to treat tumors in other areas of the body.
• Chemotherapy. This treatment uses medicines to kill cancer cells all through the body. It may be used to shrink a tumor before surgery. Or it may be used to kill any cancer cells that remain after local treatments. Chemotherapy may also treat tumors that have developed in other places in the body. Breast cancer that has spread is usually treated with chemotherapy, either by itself or with hormone therapy.
• Hormone therapy. This treatment stops the growth of cancer cells that rely on hormones. It can be delivered in two ways. One way to take it is with drugs, such as tamoxifen. Another way is by removing the organs that make hormones, in this case, the ovaries. Hormone therapy may be used after surgery to decrease the chance of breast cancer returning or a new cancer developing. It can also be used to treat cancer that has spread, either alone or with chemotherapy.
• Targeted therapy. This is a newer type of treatment. These types of medicines are designed to recognize a specific molecular change in a cancer cell that drives the growth and spread of a tumor. Once they zero in on their molecular target, these medications either destroy or slow the growth of cancer cells. And, they avoid normal, healthy cells, so they tend to have fewer and less severe side effects than conventional treatments. For some types of breast cancer, the drug Herceptin (trastuzumab) may be used. It targets the protein HER-2 or erb B2.

Your doctor may recommend a combination of two or more of these types of treatment. Most treatment plans last at least six months. You probably won't feel like yourself for up to a year following your diagnosis. If you're going to have reconstructive surgery, your recovery may take longer.