Treatments For Stage 2 Breast Cancer
The following are treatment options for ductal carcinoma and lobular carcinoma. Doctors consider stage 2A to be early stage breast cancer. Stage 2B is considered to be locally advanced breast cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.
Everolimus And Hormone Therapy
Everolimus is an mTOR inhibitor. mTOR inhibitors are a class of drugs that may increase the benefit of hormone therapy.
Everolimus is FDA-approved for the treatment of hormone receptor-positive, HER2-negative metastatic breast cancers in postmenopausal women. The combination of everolimus and the aromatase inhibitor exemestane can slow the growth of such cancers better than exemestane alone .
Everolimus is a pill.
Some possible side effects include mouth ulcers, infections, rash, fatigue, diarrhea and decreased appetite.
In rare cases, it can cause lung inflammation, which can cause death. Tell your health care provider right away if you have shortness of breath or other breathing problems while taking this drug.
Adapted from select sources .
Systemic Treatments For Stage 1 Breast Cancer
Systemic treatments, often termed add-on or adjuvant treatments, treat breast cancer throughout your body and not just at the site of the tumor.
These treatments help destroy cancer cells that have spread beyond your breast but are still too small to be spotted. They include the therapies outlined below.
Doctors may recommend chemotherapy, also called chemo, after surgery to help destroy any undetected cancer cells. Chemotherapy may also lower your risk of the cancer coming back at a later stage.
Chemotherapy may be recommended for a smaller tumor if:
- Any cancer cells were found in the lymph nodes.
- You score high on a gene test such as Oncotype DX, which shows whether chemotherapy could help treat your breast cancer and if its likely to come back after surgery.
- The cancer cells are progesterone receptor- and estrogen receptor-negative.
- The breast cancer cells are positive for human epidermal growth factor receptor 2 various therapies can target these receptors.
Hormone therapy can be used to help slow down the growth of cancer cells in people with estrogen receptor-positive or progesterone receptor-positive cancer cells. Hormone therapy works by blocking hormone receptors on the cancer cells or by lowering the amount of estrogen produced in your body.
Its important to ask your doctor about the potential side effects of hormone therapy before you begin this treatment, so can you know what to expect.
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How Is Breast Cancer Recurrence Managed Or Treated
Your treatment depends on the type of cancer recurrence, as well as past treatments. If cancer develops in a reconstructed breast, your surgeon may want to remove the breast implant or skin flap.
Treatments for local and regional breast cancer recurrence may include:
- Mastectomy: Your surgeon removes the affected breast and sometimes lymph nodes.
- Chemotherapy:Chemotherapy circulates in blood, killing cancer cells.
- Hormone therapy:Tamoxifen and other hormone therapies treat cancers that thrive on estrogen .
- Immunotherapy:Immunotherapy engages your bodys immune system to fight cancer.
- Radiation therapy: High-energy X-ray beams damage and destroy cancer cells.
- Targeted therapy: Treatments target specific cancer cell genes or proteins.
Stage 2 Cancer Treatment Options
In general, stage 2 cancers tend to be treated locally with surgery and/or radiation. At times, chemotherapy or other drug therapies may also be a part of stage 2 cancer treatment. Below, find stage 2 cancer treatment options for the five most common cancers.
Stage 2 breast cancer treatment: Stage 2 breast cancer tends to be most commonly treated with surgerya lumpectomy or mastectomyand radiation treatment afterward. During the surgery, doctors check the nearby lymph nodes for cancer, too. Most patients also have medication as part of their treatment plan: either chemotherapy, breast cancer targeted therapy, hormone therapy or a combination.
Stage 2 lung cancer treatment: Stage 2 lung cancer is typically treated with surgery. Some people may also have chemotherapy after surgery. For patients who cant have surgery, radiation may be a treatment option.
Stage 2 prostate cancer treatment: For stage 2 prostate cancer, treatment depends on the patients symptoms, age and overall health. If the patient is older and isnt experiencing symptoms, doctors may simply keep an eye on how the tumor is doing and treat it if theres any drastic change. However, stage 2 cancers are more likely to spread without treatment than stage 1 cancers. Treatment options may include surgery, surgery followed by radiation, radiation only, or radiation with hormone therapy.
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What Are The Symptoms Of Breast Cancer Recurrence
You may experience different signs of breast cancer recurrence depending on where the cancer forms.
Local breast cancer recurrence may cause:
- Breast lump or bumps on or under the chest.
- Nipple changes, such as flattening or nipple discharge.
- Swollen skin or skin that pulls near the lumpectomy site.
- Thickening on or near the surgical scar.
- Unusually firm breast tissue.
Personal Genetic Testing For Inherited Gene Mutations
The National Comprehensive Cancer Network recommends everyone diagnosed with metastatic breast cancer get genetic testing for BRCA1 and BRCA2 inherited gene mutations . If you have a mutation in one of these genes, a PARP inhibitor may be included in your treatment plan.
Learn more about genetic testing.
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What Are Risk Factors For Breast Cancer Recurrence
Anyone with a breast cancer diagnosis can have a recurrence. Your risk of cancer recurrence depends on several factors:
- Age: Women who develop breast cancer before age 35 are more likely to get breast cancer again.
- Cancer stage: Cancer stage at the time of diagnosis correlates with the risk of the cancer being able to recur. Several factors determine cancer stage: tumor size, cancer grade and cancer spread to lymph nodes or other parts of the body. Cancer grade indicates how unusual cancer cells look in comparison to healthy cells.
- Cancer type: Aggressive cancers like inflammatory breast cancer and triple-negative breast cancer are harder to treat. Theyre more likely to come back and spread.
What Are The Types Of Breast Cancer Recurrence
If you develop cancer in the opposite, untreated breast , you receive a new breast cancer diagnosis. This isnt the same as breast cancer recurrence.
When breast cancer returns, it may be:
- Local: Cancer returns in the same breast or chest area as the original tumor.
- Regional: Cancer comes back near the original tumor, in lymph nodes in the armpit or collarbone area.
- Distant: Breast cancer spreads away from the original tumor to the lungs, bones, brain or other parts of the body. This is metastatic cancer, often referred to as stage 4 breast cancer.
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Can You Die From Stage Two Breast Cancer
A breast cancer diagnosis is a lot to take in not only on the patient but friends and family, and one common question that arises is can you die from stage two breast cancer?
There is no definite answer to this question as individuals respond differently to medications. And though estimates have been done to project ones survival rate, it is important to remain positive as you go through the treatment.
After the treatment, some people regain full health and enjoy many years, while others may experience a recurrence in the growth of cancer which affects the survival rate.
The good thing about detecting breast cancer at an early stage is the likelihood to get better is higher as the cancerous cells have not affected other parts of the body which may make it hard for the body to recover fully.
Is Early Menopause A Risk Of Chemotherapy For Breast Cancer
Yes. If you have not gone through menopause, chemotherapy may stop your ovaries from producing estrogen. You may go into early menopause. If you want to have children in the future, discuss the risks of infertility with your healthcare provider.
Some womens ovaries begin working again after chemotherapy treatment. Women who want to bear children in the future may also choose fertility preservation before starting chemotherapy.
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What Does Triple Negative Mean In Terms Of Breast Cancer
Normal breast cells have receptors that respond to hormones such as estrogen and progesterone, which allows them to grow and regress in response to the hormone level. Hormone receptors may or may not be present in breast cancer. About two-thirds of breast cancers are positive and contain these receptors like normal breast cells do. These are less aggressive cancers that are less likely to need chemo and are often treated with hormone therapy and surgery. Radiation may or may not be needed.
HER2/neu , is a protein molecule that has a role in cell proliferation in normal cells. In some breast cancers, this protein is overly produced or positive. For HER2-positive tumors, there a specific medication that targets this protein.
Triple-negative breast cancers are not positive for estrogen receptors, progesterone receptors or HER2 protein. Since these targets are absent in triple-negative breast cancer, chemotherapy is needed, Sun says. Triple-negative breast cancer is often very sensitive to chemotherapy, which, despite the side effects, is an effective treatment that can save lives. Because this is an aggressive cancer, treatment is aggressive also. But there are several ways we can address it.
Chemotherapy For Metastatic Breast Cancer
Advances in treatment are making it possible for women with metastatic breast cancer to live for many years. New drug therapies can not only slow down or stop a tumors growth but also keep symptoms at bay.
Which treatment your doctor recommends will vary based on your medical history, age, and breast cancer type, among other factors. Combinations of drugs are commonly prescribed for women with early-stage disease. Most women with advanced breast cancer generally receive only one drug at a time.
Chemotherapy drugs that MSK doctors commonly prescribe for advanced breast cancer include:
Women with advanced disease can also benefit from genomic testing. This is also called tumor sequencing or molecular profiling. It is offered to all MSK patients with metastatic breast cancer. Genomic testing involves looking at the cancer cells to see if there are any genetic mutations that could be linked to the specific type of breast cancer you have.
Our experts use a highly sophisticated testing approach developed by MSK researchers called MSK-IMPACT. The information gained from MSK-IMPACT can help us personalize your care. We can rule out drug therapies that may not work for you or sometimes recommend cutting-edge clinical trials designed to target the specific mutations in your tumor.
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Staging And Management Of The Axilla
It is often assumed that preoperative imaging is useful in selecting patients undergoing BCT who require axillary dissection. However, the clinical question has shifted from the identification of any nodal metastases to identification of patients with 3 or more nodal metastases who are not candidates for sentinel node biopsy alone, and current imaging modalities do not reliably make this distinction. Pilewskie at al examined the utility of preoperative imaging in predicting the need for additional axillary surgery in 425 patients with clinical T1-2 N0 tumors and 1 or 2 positive sentinel nodes. Among patients with abnormal axillary nodes identified by mammogram, axillary ultrasound, or MRI, 71% did not require ALND using Z0011 criteria. Even among patients with a needle biopsy demonstrating nodal metastases, only 45% required ALND. Thus, preoperative axillary imaging in clinically node-negative patients should be reserved for those undergoing mastectomy where the finding of any nodal disease is an indication for ALND or preoperative chemotherapy to downstage the axilla.
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Factors Your Physician Will Consider To Determine If Chemotherapy Is Recommended
If your physician has recommended that you have a total mastectomy, you may be wondering if your unique circumstances may require that you receive chemotherapy as well. Some of the factors that influence this decision include:
- The type of cancer Chemotherapy may not be recommended for certain forms of breast cancer, such as in situ cancers, that are unlikely to spread to other areas. For other types of cancers, such as triple negative breast cancers or HER2-positive breast cancers, chemotherapy may be recommended following the total mastectomy because these forms of cancer are typically more aggressive.
- The location of cancer cells If cancer is detected in the lymph nodes or has spread to areas outside of the breast tissue, chemotherapy will likely be recommended to remove any cancer cells that remain following the surgery.
- Previous chemotherapy treatments If a patient has previously received chemotherapy and subsequently developed cancer again, it may not be recommended because it was not effective the first time.
- The age of the patient Women who are premenopausal are more likely to have aggressive forms of breast cancer. This may also influence a physicians recommendation to include chemotherapy after a total mastectomy.
If you would like to learn more about the breast cancer treatment options that may be best for you, such as a total mastectomy and chemotherapy, call or fill out a new patient registration form online to schedule an appointment at Moffitt.
Treating Breast Cancer In People Age 70 And Up
Older age increases the risk of several types of breast cancer. But advancements in diagnosis and highly individualized treatment plans are increasing the odds of recovery for older patients and making it possible for many to live longer, healthier lives.
Breast surgeon Hanh-Tam Tran, M.D., explains what people age 70 and older should know about being diagnosed with breast cancer and why theres reason for hope.
Causes Of Cancer And Types Of Cancer
Lung cancer, skin cancer, prostate cancer, leukemia, which is blood cancer, throat cancer, but the most common types of cancers are skin, lung, and breast cancer. Breast cancer is also ranked as one of the commonly diagnosed cancers among women.
Some of the causes of cancer include genes and ones lifestyle. Alcohol or tobacco abuse may increase the chances of cancerous cell growth.
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Below is a detailed analysis of stage two breast cancer
- To better understand the growth and spread of the cells, doctors use T, to denote the size of the tumor in the breast.
- T0 means there is no tumor in the breast T1 implies the size of the tumor is two centimeters in diameter or less.
- T2 means the size of the tumor is between 2 to 5 centimeters.
- T3 means the tumor is over 5 centimeters in diameter.
- N, on the other hand, represents, the number of lymph nodes affected.
- N0 or N-0 means the cancer cells have not affected any lymph nodes N1mi, the cancer is in the lymph nodes but can only be identified under the microscope.
- N1 cancer has spread and can be detected in one lymph node around the tumor.
- N2 cancer has spread to more lymph nodes is further away from the tumor.
- M denotes metastasis. This means cancer has spread to other parts of the body, the liver, bones, or even the brain.
- However, at stage two, the cancer cells have not spread other parts, and the steps are described as M0.
Stage 2B: T3, N0, M0, the tumor is now larger than 5 centimeters,
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Blood Tests For Tumor Markers
In some cases, blood tests for tumor markers may be used to help monitor metastatic breast cancer.
For example, you may have blood tests every few months for cancer antigen 15-3 or cancer antigen 27.29 . These tests are similar. Health care providers usually check one, but not both of these blood tests.
Whether the tumor marker test score rises or falls over time may give some information on tumor response to a drug or tumor spread.
Tumor marker tests are not helpful in every case. Some people with rising tumor marker levels dont have tumor growth, and some people with tumor growth have normal or unchanged tumor marker levels.
Health care providers dont make treatment decisions based on serum tumor marker testing alone. They may combine findings from a tumor marker test with information on symptoms and findings from imaging tests . This combined information can help your health care providers understand if a treatment is working well for your cancer.
Talk with your health care provider about whether tumor marker testing is right for you.
Possible Side Effects Of Chemo For Breast Cancer
Chemo drugs can cause side effects, depending on the type and dose of drugs given, and the length of treatment. Some of the most common possible side effects include:
- Hair loss
- Hot flashes and/or vaginal dryness from menopause caused by chemo
- Nerve damage
Chemo can also affect the blood-forming cells of the bone marrow, which can lead to:
- Increased chance of infections
- Easy bruising or bleeding
These side effects usually go away after treatment is finished. There are often ways to lessen these side effects. For example, drugs can be given to help prevent or reduce nausea and vomiting.
Other side effects are also possible. Some of these are more common with certain chemo drugs. Ask your cancer care team about the possible side effects of the specific drugs you are getting.
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Signs Breast Cancer Has Spread
Your doctor may use several imaging tests to determine if your cancer has spread. An ultrasound, CT scan or MRI are the most common tests to see if cancer has spread to other organs. You may also receive a chest x-Ray to see if the cancer has reached your lungs.
For more advanced imaging, your doctor can order a PET scan in which a radioactive sugar travels through your body before images are taken where the sugar collects. Similarly, a bone scan uses a radioactive substance to determine if cancer has spread to your bones. Bone scans can pick up cancer cells that may not show on other scans.
However, it is not uncommon to not need any additional imaging to check for tumor spread. You should work with your doctor to decide which imaging, if any, is best.