Treatment

TREATMENT OPTIONS BY STAGE

Ductal Carcinoma In Situ (DCIS)

• Breast-conserving surgery with or without radiation therapy or hormone therapy.
• Total mastectomy with or without hormone therapy.

Lobular Carcinoma In Situ (LCIS)

• Biopsy to diagnose the LCIS followed by regular examinations and regular mammograms to find any changes as early as possible. This is referred to as observation.
• Tamoxifen to reduce the risk of developing breast cancer.
• Bilateral prophylactic mastectomy (surgical removal of both breasts to help prevent breast cancer). This treatment choice is sometimes used in women who have a high risk of getting breast cancer. Most surgeons believe that this is a more aggressive treatment than is needed.

Stage I, Stage II, Stage IIIA, and Operable Stage IIIC Breast Cancer

• Breast-conserving surgery to remove only the cancer and some surrounding breast tissue, followed by lymph node dissection and radiation therapy.
• Modified radical mastectomy with or without breast reconstruction surgery.
• A clinical trial evaluating sentinel lymph node biopsy followed by surgery.

Adjuvant therapy (treatment given after surgery to increase the chances of a cure) may include the following:

• Radiation therapy to the lymph nodes near the breast and to the chest wall after a modified radical mastectomy.
• Systemic chemotherapy with or without hormone therapy.
• Hormone therapy.
• A clinical trial of trastuzumab (Herceptin) combined with systemic chemotherapy.

Stage IIIB and Inoperable Stage IIIC Breast Cancer

• Systemic chemotherapy.
• Systemic chemotherapy followed by surgery (breast-conserving surgery or total mastectomy), with lymph node dissection followed by radiation therapy. Additional systemic therapy (chemotherapy, hormone therapy, or both) may be given.
• Clinical trials testing new anticancer drugs, new drug combinations, and new ways of giving treatment.

Stage IV and Metastatic Breast Cancer

• Hormone therapy and/or systemic chemotherapy with or without trastuzumab (Herceptin).
• Radiation therapy and/or surgery for relief of pain and other symptoms.
• Bisphosphonate drugs to reduce bone disease and pain when cancer has spread to the bone.

Reference:

National Cancer Institute, USA.