The kind of treatment you receive will depend on your cancer’s characteristics — its size; aggressiveness; whether or not it is invasive and how far it has spread; whether it has receptors for hormones; whether or not the cancer cells have too much HER2 on their surface, etc. Your doctor will order several tests to help build a profile of your cancer, which will help determine the best course of treatment. Also, your doctor and you will consider your medical history in considering treatment options.
The five main types of treatments are:
Surgery (Lumpectomy or Mastectomy)
A lumpectomy involves the surgical removal of the tumor, as well as some of the surrounding tissue. A mastectomy involves the surgical removal of the breast, as well as some of the surrounding tissue and nearby lymph nodes. What and how much tissue is removed during surgery will depend largely on your cancer’s characteristics.
In certain cases, a dye will be used during the surgery to help locate the lymph node closest to the tumor. This lymph node also will be removed and tested to see whether or not there are any cancer cells present. This procedure is called a sentinel node biopsy.
In other instances, several lymph nodes under the armpit (the axillary area) are also removed during the initial surgery. The axillary lymph nodes are then tested by a pathologist to determine if the cancer has spread there. This procedure, called an axillary lymph node dissection, is usually reserved for those cancers that the doctor believes are more likely to have spread or invaded nearby tissue.
Radiation therapy uses high-energy radiation to kill breast cancer cells and shrink breast tumors. There are two types of radiation therapy: external and internal.
External radiation therapy involves applying radiation (such as high-energy x-rays) from a machine located outside of the body. Internal radiation therapy entails putting radiation-producing materials (radioisotopes) into the area where the breast cancer cells have been found. Radioisotopes are placed via thin plastic tubes into the breast cancer site.
Chemotherapy (also called “chemo”) involves drugs that systemically treat breast cancer cells throughout the body. The chemotherapy drugs either are injected intravenously or taken orally.
Hormone therapy is reserved for specific types of cancer, such as breast cancer, that are influenced by the presence of hormones (e.g., estrogen or progesterone).
Anti-estrogen therapy is only effective on cancers that are estrogen-positive (ER-positive), meaning that there are estrogen receptors present on many of the cancer cells. Ways to achieve anti-estrogen therapy can involve administration of drugs like Tamoxifen that block the action of estrogen, or by the surgical removal of organs, like the ovaries, that produce estrogen.
Biological (also called biologic) therapy uses materials made by the human body or made by cells grown in a laboratory to fight cancer. An example of biological therapy used to treat breast cancer is the medication, Herceptin (generic name, trastuzumab), which is a monoclonal (a special, pure type of) antibody. Herceptin blocks the HER-2/neu receptor on the surface of certain types of breast cancer cells from binding to epidermal growth factor (EGF), a molecule that otherwise could stimulate the multiplication of the cancer cells.