The type of breast cancer treatment depends on two groups of factors:
Factors related to the breast cancer itself like:
- grade (speed of cancer growth)
- type of cancer cells (histology)
- sensitivity to hormones: oestrogen and progesterone
- the presence of certain protein (receptor) on the cancer cell (Her-2 receptors)
- has it spread to lymph nodes under the armpit (axilla)
- has it spread to other parts of the body like bone, liver or lungs
Factors related to the person involved in breast cancer:
- fitness for treatment
- personal wishes: some patients may choose not to have all or part of the treatment
- previous history of breast cancer
For breast cancers which have not spread outside the breast and lymph nodes under the armpit:
Treatment usually starts with surgery to remove the breast cancer and sometimes the lymph nodes under the armpit. This is usually followed by a course of daily radiotherapy to eradicate any cancer cells which may have been left within the breast and reduces the risk of breast cancer recurrence. Those who have had a mastectomy may not need radiotherapy.
Patients with breast cancers sensitive to hormones will be offered endocrine therapy for five years (or sometimes ten years following discussion of the benefits and risks with the oncologists).
Patients with large and/or aggressive cancers may have chemotherapy after surgery. This is to kill any cancer cells which may have spread outside the breast before surgery and prevent secondary breast cancer in the future.
Sometimes, chemotherapy may be given before surgery to reduce the size of breast cancer, make surgery more successful in removing all cancer tissue and avoid mastectomy. Sometimes, it is given before surgery to reduce the risk of secondary cancer in the future.
For breast cancers which have already spread to other parts of the body at the time of diagnosis (secondary breast cancer):
Secondary breast cancer has other names like metastatic, advanced or stage-4 breast cancer.
Secondary breast cancer may happen many years after treating a breast cancer but sometimes can happen without any previous history of breast cancer.
The aim of the treatment is to achieve remission while maintaining patients’ quality of life for as long as possible. Treatment may result in complete resolution of disease but cancer may still return at some point in the future.
Oncologists may use chemotherapy, endocrine therapy, or targeted therapy to manage this cancer. Sometimes they advise patients to have radiotherapy or even surgery to achieve remission.
If you want to know more about each treatment modalities please click on the link below: