Treatments by breast cancer stage
Treatment for breast cancer will usually be determined by how advanced the cancer is, which doctors assess using a process called staging.
There are four stages, 1 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, general health, age, and whether you have had breast cancer before.
Stage 1 treatment options
This is a very early stage of the disease. The cancer has not spread beyond the breast at all, so you have a number of good treatments to choose from. Almost all (99%) women diagnosed with stage 1 breast cancer live for more than five years, says Cancer Research UK. This does not mean that these women will only live five years. Doctors just measure success rates for cancer treatment by seeing how women are faring five years after treatment. Women usually do well with a combination of treatments. Here are the basic options:
- Surgery is standard. Since the tumour is still small, you may have a lumpectomy. With this procedure, just the tumour and some of the surrounding tissue are removed. Some women have a mastectomy and the whole breast is removed. In both cases, the surgeon is likely to take out one or more of the lymph nodes. After a mastectomy, you might choose to have breast reconstruction surgery. Surgery treats the diseased area known about. The other treatments of radiotherapy, chemotherapy and/or hormone therapy are considered "adjuvant" (added) treatments for occult (or hidden) disease. They are used to reduce the risk of breast cancer recurrence
- Radiotherapy is standard after a lumpectomy. It can kill off any cancer cells that were missed. Women with stage 1 cancer who have a mastectomy do not usually need radiotherapy.
- Chemotherapy is treatment with drugs that attack cancer cells. It is often used after surgery to reduce the risk of the cancer coming back. Women who have had larger tumours are more likely to need it
- Hormone therapy is sometimes used after surgery in women who have hormone receptor-positive cancer - tumours whose growth seems dependant on oestrogen. In these women, drugs can prevent the tumour from getting the hormone it needs to grow. These drugs include tamoxifen and newer aromatase inhibitors such as anastrozole, exemestane and letrozole. Women who have not reached the menopause may consider having their ovaries removed to stop them from making hormones that help cancer grow. Again, women with larger tumours are more likely to need hormone therapy.
- Biological therapy is a new approach. Around 15% to 25% of women with breast cancer have too much of a protein known as HER2 which makes the cancer spread quickly, says Cancer Research UK. Trastuzumab is a new drug that is used to treat women with metastatic breast cancer that is HER2 positive. It stops this protein from making the cancer grow and makes chemotherapy more effective. It is most often used in combination with chemotherapy.