Breast Cancer

Most women have some type of surgery to treat breast cancer. The type of surgery you need will depend on your diagnosis.

• Lumpectomy: A lumpectomy, also called breast-conserving surgery, allows your breast surgeon to remove a tumor and, in some cases, surrounding tissue and lymph nodes but leave most of the breast intact. You may have radiation therapy or another treatment after a lumpectomy.
• Mastectomy: During a mastectomy, your breast surgeon removes one or both breasts. In some cases, nearby lymph nodes are also removed. Nipple- and skin-sparing mastectomies leave the nipple or skin behind so you can have breast reconstruction surgery.
• Breast reconstruction: Breast reconstruction may be an option after a mastectomy or lumpectomy. Discussing your options for reconstruction with your breast surgeon before having surgery to treat the cancer helps you decide which type of surgery you may want or need.

Chemotherapy uses strong medicines to treat cancer, often combining several types. Most are given through a vein, though some are in pill form. For breast cancer, chemotherapy is commonly used after surgery to eliminate any remaining cancer cells and lower the risk of recurrence. Sometimes, it's given before surgery to shrink the cancer and make it easier to remove or control cancer in the lymph nodes. This approach can reduce the need for extensive surgery. In advanced cancer, chemotherapy can help manage symptoms like pain.

Hormone therapy treats certain breast cancers by blocking the hormones estrogen and progesterone, which fuel the cancer's growth. It's used for cancers that are estrogen or progesterone receptor-positive. By blocking these hormones, the cancer cells can shrink or die. Hormone therapy is often given after surgery to reduce the risk of the cancer returning, and it can also help control cancer that has spread. Treatments include medicines that block hormones, prevent estrogen production after menopause, or stop the ovaries from making hormones.

Immunotherapy uses medicine to help the immune system fight cancer by making it easier to find and destroy cancer cells. It may be an option for treating triple-negative breast cancer, a type that lacks receptors for estrogen, progesterone and HER2.

Targeted therapy uses medicines that attack specific chemicals in cancer cells, causing them to die. For breast cancer, the most common targeted therapy focuses on the HER2 protein, which some cancer cells produce in excess. These treatments target cancer cells without harming healthy ones. Other targeted therapies exist and can be tested for effectiveness. Targeted therapy can be used before surgery to shrink the cancer, after surgery to reduce recurrence, or when the cancer has spread to other parts of the body.

Radiation therapy uses high-energy rays to kill cancer cells. For women with early-stage cancers, radiation therapy occurs after surgery to destroy any cancer cells left behind after the procedure. With later-stage cancers, radiation therapy may be the only treatment, or it may be used to treat cancer that has spread to other parts of the body.

There are two types used for breast cancer:

• External beam radiation therapy (EBRT): EBRT delivers high-energy beams from a source outside your body. It’s the most common type of radiation therapy used for breast cancer.
• Internal radiation therapy: Also called brachytherapy, this treatment uses an implant placed in the body to deliver a consistent dose of radiation.