Many women with breast cancer want to take an active part in making decisions about their medical care. It is natural to want to learn all you can about your disease and treatment choices. Knowing more about breast cancer helps many women cope.
Your doctor may refer you to a specialist, or you may ask for a referral. Specialists who treat breast cancer include surgeons, medical oncologists, and radiation oncologists. You also may be referred to a plastic surgeon.
Treatment options include surgery, radiation therapy, chemotherapy, hormone therapy, and biological therapy. These options are described below. Many women receive more than one type of treatment.
The choice of treatment depends mainly on the stage of the disease. Treatment options by stage are described below. You and your doctor can work together to develop a treatment plan that reflects your medical needs and personal values.
Cancer treatment is either local or systemic.
Surgery and radiation therapy are local treatments. They remove or destroy cancer in the breast. When breast cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas.
Chemotherapy, hormone therapy, and biological therapy are systemic treatments. They enter the bloodstream and destroy or control cancer throughout the body. Some women with breast cancer have systemic therapy to shrink the tumor before surgery or radiation. Others have systemic therapy after surgery and/or radiation to prevent the cancer from coming back. Systemic treatments also are used for cancer that has spread.
New treatment options
"We've come to realize that breast cancer isn't just one disease," says Clifford Hudis, M.D., chief of the breast-cancer medicine service at Memorial Sloan-Kettering Cancer Center. "We're separating tumors into subsets based on their genetic and molecular traits, and as a result, we're offering women more targeted, effective treatments."
That's been made easier thanks to two new diagnostic tests, the Oncotype DX and MammaPrint. These allow doctors to look at the status of genes in the tumor tissue to determine who will need chemotherapy in addition to surgery and radiation--and to predict a tumor's likelihood of recurrence. For example, only 15 to 20 percent of women with early stage estrogen-fueled tumors actually need chemo, but until now it hasn't been easy to tell who does and who doesn't.
Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects depend mainly on the type and extent of the treatment. Side effects may not be the same for each woman, and they may change from one treatment session to the next.
Before treatment starts, your health care team will explain possible side effects and suggest ways to help you manage them.
At any stage of disease, supportive care is available to control pain and other symptoms, to relieve the side effects of treatment, and to ease emotional concerns. Information about such care is available on NCI's Web site at http://www.cancer.gov/cancertopics/coping and from Information Specialists at 1-800-4-CANCER or LiveHelp.