Treatments by breast cancer stage

Breast cancer is a complicated disease. Every woman's case is distinct. Your experience may be very different from those of friends or relatives who also have or have had breast cancer. So there is no single "best" treatment. Only you and your doctors can work out the best approach for you. No matter what treatment you have, you will need regular check-ups to make sure that you are staying healthy.

Doctors evaluate a woman's breast cancer in part by determining how large the tumour is and how far it has spread. This is called staging. It is just a way of summarising your current condition. There are five basic stages, 0 to 4, and a number of sub-stages.

Staging does not tell the whole story. Other factors can affect your prognosis, such as the type of cancer, the speed with which the cancer is growing, your general health, your age, whether you have had breast cancer before and whether female hormones affect the cancer's growth.

If you know the stage of the disease you are at, you can use this quick guide to see what kinds of treatments might help.

Stage 0 treatment options

When needed, treatment for stage 0 breast cancer is very successful. This very early stage of the disease is not always actually cancer. Instead, it is often a precancerous condition. Treatment is not always needed and close observation may be enough. Treatments differ depending on what kind of stage 0 cancer you have. Ductal carcinoma in situ (DCIS) or intraductal carcinoma is one type. With this condition, abnormal cells appear in the ducts of the breast. Sometimes these cells become cancerous. That is why it is important to get treatment immediately. Here is a list of the typical treatments:

•  Surgery is standard. For smaller tumours, you might have a lumpectomy, in which only the abnormal cells and some of the tissue are removed. Some women choose a mastectomy where the entire breast is removed. After a mastectomy, you might choose to have breast reconstruction surgery.
•  Radiation therapy is standard treatment after a lumpectomy. Radiation therapy attacks any abnormal cells that might have been missed and reduces the risk of another cancer.
•  Hormone therapy with tamoxifen after surgery may also help prevent cancer from developing in the same or opposite breast.

Lobular carcinoma in situ (LCIS) is the other type of stage 0 cancer. LCIS develops when abnormal cells appear in the lobes of the breast. Most women do not need treatment immediately. However, LCIS raises the risk of getting cancer. So it is important to have frequent check-ups with your doctor. Here are some treatment options:

•  Hormone therapy with tamoxifen to lower the risk of developing cancer.
•  Bilateral mastectomy - the removal of both breasts - is another option. Some women choose this approach because they are worried about getting cancer. They might have certain risk factors, such as a strong family history of breast cancer. After surgery, you might choose to have breast reconstruction surgery. However, experts think that a bilateral mastectomy is a more extreme approach than most women need.