There are several effective types of breast cancer treatment, including radiation therapy, chemotherapy, hormone therapy, and surgery. The stage and type of breast cancer a person has usually determines the treatment they receive.
The further breast cancer progresses, the greater the combination of therapies a person needs. These therapies may include surgery, chemotherapy, hormone therapy, and radiation therapy.
Doctors treat breast cancer in males the same way they do in females. However, males are more likely to have a mastectomy, as they have less breast tissue to begin with.
This article will discuss different breast cancer treatments, depending on the stage and type. It will also talk about the cost of breast cancer treatment.
Some drug therapies to treat breast cancer include:
- Chemotherapy: This is a cancer treatment that uses drugs that stop the growth of cancer cells. A person can receive chemotherapy drugs orally or via injection into the vein or muscle.
- Radiation therapy: This uses high energy X-rays to kill cancer cells. External radiation therapy uses a machine to send radiation to the affected area of the body. Internal radiation therapy uses a radioactive substance in needles, catheters, or wires that a healthcare professional places into, or near, the cancer.
- Hormone therapy: Some cancer cells use hormones to grow. Hormone therapy removes hormones or blocks their action. This stops the cancer cells from growing.
- Targeted therapy: This uses drugs and other substances that identify and attack cancer cells. They cause less harm to healthy cells than other options. Targeted therapy includes monoclonal antibodies, cyclin-dependent kinase inhibitors, tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors, and PARP inhibitors.
- Immunotherapy: This is a type of biologic therapy that uses a person’s own immune system. Substances that the body or a laboratory creates boost and restore a person’s natural defenses.
A surgeon may recommend the following surgical procedures:
- Lumpectomy: During a lumpectomy, a surgeon removes cancer tissue and leaves a small amount of healthy tissue behind.
- Mastectomy: A mastectomy is a procedure wherein the surgeon removes the entire breast.
- Modified radical mastectomy: This is a procedure to remove the entire breast, many lymph nodes under the arm, the lining of the chest muscles, and, in some cases, the chest wall muscles.
In some cases, a person can choose to undergo breast reconstruction surgery. This is a procedure during which a surgeon inserts breast implants or recreates a breast using tissue from other parts of the body.
Breast reconstruction surgery can occur at the same time as the surgery to remove the cancer. However, if a person requires radiation therapy, they should wait until after the radiation therapy is complete.
Surgeons can also perform nipple and areola reconstruction surgery approximately 3 or 4 months after the initial surgery.
There are two different types of stage 0 breast cancer: ductal carcinoma in situ (DCIS) and Paget’s disease of the nipple.
DCIS occurs when cancer cells develop in the lining of the breast duct. If the cancer cells are in the skin cells of the nipple and, in some cases, the areola, a doctor will diagnose Paget’s disease of the nipple.
It is possible for a person to have both DCIS and Paget’s disease of the nipple at the same time. If this happens, a doctor will diagnose breast carcinoma in situ.
Treatment options for stage 0 cancer include:
- Lumpectomy: While performing a lumpectomy, a surgeon will also remove part of the sentinel lymph node (SLN) for a biopsy. A doctor may then follow up with radiation treatment to remove any remaining cancer cells and help prevent cancer from recurring.
- Mastectomy: If someone has a mastectomy, they may not need radiation therapy afterward. If a person has large areas of DCIS, a surgeon may perform a mastectomy and remove the SLN for a biopsy.
- Hormone therapy after surgery: If the cancer cells have receptors that respond to the hormones estrogen or progesterone, there are several treatments that could lower the risk of cancer recurring. Females who have transitioned to menopause will take an aromatase inhibitor, and all others will take tamoxifen.
People with stage 1 breast cancer will usually undergo surgery first and then receive radiation therapy. If the cancer is at stage 2 or 3, a doctor will prescribe some drug therapies before surgery.
If a person starts any therapy before surgery, doctors call it neoadjuvant therapy. Any therapy that comes after surgery is called adjuvant therapy.
Some factors affect what treatment a person receives. These include:
- hormone receptors on the cancer cells
- HER2 proteins on the cancer cells
- cancer progression
Drug therapies before and after surgery include:
- targeted therapy that targets HER2 proteins (Herceptin and Perjeta)
- hormone therapy (tamoxifen and aromatase inhibitors)
A healthcare professional may recommend a combination of the above treatments.
Stage 1 breast cancer
When a person has stage 1 breast cancer, treatment will usually consist of surgery followed by radiation therapy. Sometimes, if a person undergoes a mastectomy, they may receive a breast reconstruction at the same time.
The American Cancer Society notes that females over 70 years of age may not need radiation therapy after mastectomy, providing none of the lymph nodes had cancer, the tumor was smaller than 2 centimeters (cm) in length, and the cancer was estrogen receptor-positive or progesterone receptor-positive.
Stage 2 breast cancer
In stage 2 breast cancer, the cancer cells have spread to nearby lymph nodes.
Similarly to stage 1, treatment usually begins with either a lumpectomy or mastectomy. Doctors typically suggest radiation therapy after surgery. However, if a person needs chemotherapy afterward, the radiation treatment will wait until the person completes chemotherapy.
Sometimes, a person may start hormone therapy and chemotherapy before surgery, especially if the tumor is particularly large and is also growing in the lymph nodes.
A healthcare professional may also suggest:
- HER2 targeted drugs
- hormone therapy
Stage 3 breast cancer
A person has stage 3 breast cancer when a tumor is larger than 5 cm in length and is growing in either the muscles over and under the breast. There may also be a considerable number of cancer cells in the lymph nodes.
At this stage, secondary tumors could start growing in other areas of the body. When this happens, doctors call the cancer metastatic.
Most people will begin treatment to reduce the size of the tumor before surgery. If the tumor shrinks, the surgeon may only need to perform a lumpectomy.
Drugs that can shrink HER2-positive tumors include Herceptin and Perjeta. If these drugs do not work, a doctor will recommend a mastectomy rather than a lumpectomy.
After surgery, a person will likely receive radiation therapy. People who had HER2-positive tumors may continue with Herceptin and possibly Perjeta for 1 year after surgery. Treatment varies depending on how well the tumor responds to therapies before and after surgery.
Doctors sometimes refer to stage 4 breast cancer as metastatic cancer. This means that the cancer has spread beyond the breast and lymph nodes and that secondary tumors are growing in other areas of the body. These areas usually include the bones, liver, lungs, and other organs that receive and process a lot of blood.
At this stage, drugs are the main therapy options. However, a surgeon may remove tumors to prevent complications from developing as quickly.
The main drugs that treat stage 4 breast cancer include:
- hormone therapy
- targeted drugs (HER2-positive breast cancer)
- a combination of the above
A person may receive radiation therapy or regional chemotherapy to treat secondary tumors in other parts of the body. The goal is to slow down and prevent further complications while also easing symptoms.
Triple-negative breast cancer makes up 10–20% of breast cancers. This type of breast cancer does not respond to hormone therapy or therapies that treat cancer cells with HER2 proteins. Because of this, triple-negative breast cancer has fewer treatment options.
Treatment options include:
- radiation therapy
Triple-negative breast cancer tends to affect people who are younger than 50 years old, and it is more prevalent in Black and Hispanic females. It is also more aggressive than other types of breast cancer.
According to the
The CDC adds that the total medical cost of breast cancer care in the United States is $16.5 billion, and this accounts for 13% of all cancer treatment costs.
The cost an individual might pay for breast cancer depends on their health insurance coverage.
Lower cost treatment
The CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP) helps provide lower cost or free breast cancer screening options.
The Breast and Cervical Cancer Prevention and Treatment Act
A person can find a screening program
The type of treatment a person receives for breast cancer depends on the type of cancer they have and how severe it is.
People with breast cancer at stages 0–2 usually need surgery and radiation therapy.
At stages 3–4, a person may need a combination of therapies. Some of these therapies may focus more on drug treatment than on surgery.
Triple-negative breast cancer has fewer treatment options, as the cancer cells do not respond to hormone and HER2 targeted therapies.