What Are My Treatment Options?
Treatment and side effects
After a breast cancer diagnosis, you and your doctors will put together a treatment plan specific to your situation, based on your pathology report and other tests. Your treatment plan will be made up of one or more specific treatments that are intended to target the cancer cells in different ways and reduce the risk of future breast cancer recurrence. Based on your type and stage of cancer, your plan may include a combination of surgery, chemotherapy, radiation, hormonal therapy and targeted therapies. Your physician will also recommend a follow-up regimen including exams and tests to monitor for recurrence.
Surgery, often the first option for treatment, involves the removal of tumors, breast tissue and/or lymph nodes from the body. A lumpectomy involves the removal of the tumor and a small amount of surrounding tissue. A mastectomy is the removal of all breast tissue. As a part of surgery, a potential consideration for patients is breast reconstruction surgery to rebuild the removed tissue. A potential side effect of some surgeries, including those with an axillary dissection, is lymphedema, which is the build-up of lymph fluid in the fatty tissues just under your skin.1 Symptoms may include:
- Swelling in the breast, chest, shoulder, arm, or hand
- Skin changing texture, feeling tight or hard, or looking red
- New aching, tingling, or other discomfort in the area
- Less movement or flexibility in nearby joints, such as your shoulder, hand, or wrist
Be sure to talk to your doctor about symptoms you may experience after any type of surgery, even if the symptoms go away on their own.
Chemotherapy is a systemic therapy that uses medicine to destroy cancer cells throughout the body by interfering with cell growth and division. In this process, a combination of medicines will be used to destroy rapidly dividing cells in your body, including both cancer and healthy cells.
There are two kinds of chemotherapy based on when the chemotherapy is administered —neo-adjuvant (pre-surgery) and adjuvant chemotherapy. Neo-adjuvant chemotherapy can help shrink the tumor before surgery. Adjuvant chemotherapy is administered after surgery.
There are a variety of different types of chemotherapy drugs, which are often given in combination with each other or in succession to maximize the chemotherapy benefit. Side effects from chemotherapy are common because the treatment affects all rapidly dividing cells—not just the abnormal cancer cells. Cells that are most commonly affected are those of the bone marrow, digestive tract, reproductive system and hair follicles. That’s why hair loss and nausea are common side effects of chemotherapy. While all patients experience different symptoms, some may experience uncomfortable side effects as a result of the medicines targeting otherwise healthy cells.
Radiation therapy is the use of a high-energy beam to damage any cancer cells that may remain following surgery. Patients who undergo radiation may experience lymphedema, skin irritation, chest pain, armpit discomfort and fatigue.
Hormonal therapy medicines work against hormone-receptor-positive (ER/PR+) breast cancers by blocking the effects of estrogen on cancerous cells and lowering the overall amount of estrogen in your body. There are three types of hormonal therapy medicines, aromatase inhibitors, selective estrogen receptor modulators (SERMs), and estrogen receptor downregulators (ERDs). Hormonal treatments can lead to side effects similar to menopause, including:
- Hot flashes or flushes
- Aches and pains in the muscles and joints
- Weakening of the bones (aromatase inhibitors)
- Blood clots
- Fertility issues
- Increased risk of uterine cancer
It is important to weigh the possible side effects and the benefits of each medicine.
Targeted cancer therapies focus on blocking specific cancer cell characteristics, such as blocking the growth of new blood vessels or certain proteins or blocking the ability to receive chemical signals telling the cancer to grow. Targeted treatments, such as Herceptin®, Tykerb®, and Avastin®, are less likely to harm healthy cells in the body because they are focused on characteristics specific to cancer cells.
Visit Breastcancer.org to learn more about the different types of breast cancer and tests for screening and diagnosis.
Build Your Treatment Plan
Empower yourself with information and discuss your treatment regimen with your healthcare team as you tackle this disease. No two diagnoses and treatment regimens look exactly the same, which is why learning all you can about your options and talking to your health care team are critical. Gather personalized information about your type of cancer by answering a few simple questions in the My Breast Cancer Coach questionnaire. You'll receive a customized report to help you better understand your cancer and treatment options to discuss with your doctor.
1. Lymphedema: What Every Woman with Breast Cancer Should Know