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Does Stage 1 Breast Cancer Require Chemo

Increased Risk Of Leukemia

Good news for breast cancer victim: Many not need chemotherapy

Very rarely, certain chemo drugs, such as doxorubicin , can cause diseases of the bone marrow, such as myelodysplastic syndromes or even acute myeloid leukemia, a cancer of white blood cells. If this happens, it is usually within 10 years after treatment. For most women, the benefits of chemo in helping prevent breast cancer from coming back or in extending life are far likely to exceed the risk of this rare but serious complication.

Chemotherapy For Breast Cancer

Chemotherapy uses anti-cancer drugs that may be given intravenously or by mouth. The drugs travel through the bloodstream to reach cancer cells in most parts of the body. Sometimes, if cancer spreads to the spinal fluid, which surrounds and cushions the brain and spinal cord, chemo may be given directly into in this area .

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Purpose Of This Summary

This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of adult breast cancer. It is intended as a resource to inform and assist clinicians in the care of their patients. It does not provide formal guidelines or recommendations for making health care decisions.

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Personal Stories About Choosing Chemotherapy For Breast Cancer

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I found out about the breast cancer earlier this year. I don’t have a family history of it or any of the risk factors that you read about. I chose to have a lumpectomy. My doctor had some gene tests done on the tissue that was removed during my surgery. The tests showed that the cancer was not very aggressive and that chemotherapy would not be helpful for me. So instead I’m taking letrozole every day. I am glad that there are tests for women with ER+ cancer that can show if chemo will help.

Brenda, age 57

I got breast cancer 2 years ago. What a surprise! I don’t have any family history , and I don’t have the other risk factors that my doctor talked to me about. Because of my age and the type of breast cancer I had, my doctor did some tests. It turned out that I was at a higher risk for having the cancer come back. So, I had chemo. I’m doing fine so far. And I think this was the right decision for me.

I was diagnosed with breast cancer just last year. The breast cancer was small, and I didn’t have any cancer in the lymph nodes. But my doctor did a gene test and said my risk was high enough that I needed to decide whether I wanted to have chemo. I decided to go ahead and have it. And even though that was harder than I thought, I’m still glad I made that choice. It was the right one for me.

Paula, age 61

Complementary And Alternative Treatments

Stages 0 &  1

Some people with breast cancer might be interested in exploring complementary or alternative treatments like vitamins, herbs, acupuncture, and massage.

These treatments are used alongside traditional breast cancer therapies to treat cancer or relieve cancer symptoms and uncomfortable side effects of treatments like chemotherapy. You can explore these treatments at any stage of breast cancer.

Examples of alternative therapy include:

  • using massage to relax
  • using peppermint tea to reduce nausea
  • using cannabis to relieve pain

While some alternative medicine treatments might help you feel more comfortable, its important to keep in mind that many are unproven and could be harmful to your health. To be safe, talk with your doctor about alternative treatments youre interested in pursuing.

Breast cancer that spreads to other parts of the body can cause pain, such as bone pain, muscle pain, headaches, and discomfort around the liver. Talk with your doctor about pain management.

Options for mild to moderate pain include acetaminophen and nonsteroidal anti-inflammatory drugs , such as ibuprofen.

For severe pain in a later stage, your doctor may recommend an opioid such as morphine, oxycodone, hydromorphone, or fentanyl. These opioids have the potential for addiction, so they are only recommended in certain cases.

While breast cancer stage has a lot to do with treatment options, other factors can impact your treatment options as well.

Read Also: Can Stage 2 Breast Cancer Be Cured

Treatment Of Breast Cancer Stages I

The stage of your breast cancer is an important factor in making decisions about your treatment.

Most women with breast cancer in stages I, II, or III are treated with surgery, often followed by radiation therapy. Many women also get some kind of systemic drug therapy . In general, the more the breast cancer has spread, the more treatment you will likely need. But your treatment options are affected by your personal preferences and other information about your breast cancer, such as:

  • If the cancer cells have hormone receptors. That is, if the cancer is estrogen receptor -positive or progesterone receptor -positive.
  • If the cancer cells have large amounts of the HER2 protein
  • How fast the cancer is growing
  • Your overall health
  • If you have gone through menopause or not

Talk with your doctor about how these factors can affect your treatment options.

How Grade Affects Treatment Options

Your treatment team will consider the grade of your cancer when deciding which treatment to offer you.

If you have grade 3 breast cancer, youre more likely to be offered chemotherapy. This is to help destroy any cancer cells that may have spread as a result of the cancer being faster growing.

Chemotherapy is less likely for grade 1 and grade 2 cancers.

The grade of your cancer alone will not determine what treatment youre offered. Your treatment team will consider the grade alongside all other information about your cancer when deciding on the best treatment options for you.

Find out more about breast cancer and prognosis.

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Bringing All The Information Together

So what does this mean for our patients in the clinic? Let us consider two hypothetical clinical scenarios.

Patient 1 is a 55-year-old woman with a 1.5 centimeter tumor that is ER+, low-grade, low proliferative rate with 0 of 3 sentinel lymph nodes, or nodes to which the tumor is most likely to have spread. Proliferative rate refers to the rate of growth of cells within the tumor less than six percent is low, and greater than 10 percent is high.

Based on these clinical-pathologic features of her tumor, she is considered to have low clinical risk. According to results from the MINDACT trial, her clinical risk would trump her genomic risk, therefore, getting a MammaPrint test would be a waste of time and money.

Patient 2 is a 55-year-old woman with a 3.0 cm tumor that is ER+, high-grade, intermediate proliferative rate, with 2 to 5 positive sentinel lymph nodes. The patient is adamant about not receiving chemotherapy. Based on the clinical-pathologic features of her tumor, she is considered to have high clinical risk, and chemotherapy followed by endocrine therapy would be the standard of care recommendation.

It is not clear, however, whether she would be in the 1.5 percent of patients who might have benefited from chemotherapy but did not receive it, or in the group of patients who were spared the toxicity of chemotherapy based on the MINDACT trial.

Key Points To Remember

Women With Early Stage Breast Cancer Can Skip Chemo, Study Says
  • Chemotherapy is sometimes used after surgery for early-stage breast cancer to help lower the chances that your breast cancer will come back.
  • Some types of cancer have a very small chance of coming back. Women who have those types of cancer may not need chemo. There are gene tests that may show whether having chemo will help you reduce your chances that the cancer will return.
  • Your age, type of cancer, tumor size, and hormone receptor status have an effect on how well chemo will work to keep your cancer from coming back.
  • Different medicines used for chemo have different side effects. Your doctor can give you other medicines to help you deal with side effects like nausea and vomiting. Some women are bothered a lot by the side effects, but some aren’t.
  • The drugs used for chemo can be very expensive. Insurance policies don’t always cover the whole cost. If you have no insurance, your doctor may be able to help you find drug companies or organizations that will help you pay for this treatment.

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What Every Physician Needs To Know:

Breast cancer is the most common cancer in women in the developed world. It is expected that in 2017 an estimated 252,710 new cases of invasive breast cancer will be diagnosed in women in the US, along with 63,410 new cases of non-invasive breast cancer. Unfortunately, it is estimated that there will be 40,610 deaths from the disease.

The estimate for men is less than 1% of cases for a total of 2470 cases.

Of note, although this is the most common cancer it is not the leading cause of cancer deaths in women, a distinction held by lung cancer. Recent studies suggest there has been a slight decrease in the incidence of breast cancer, which is coincident with the reporting of the womens health data on the use of hormone replacement therapy and the decreased use of these medications.

In the last 20 years there has been an improvement in the overall survival of breast cancer, which is credited to screening mammography resulting in earlier diagnosis as well as the increased use of adjuvant therapy and multidisciplinary care. Screening mammography has been shown in both clinical trials and in geographic studies to decrease mortality from breast cancer and has been widely available in the developed world for over 20 years. Controversy remains, however, over the appropriate age to begin screening, the frequency of screening, and whether a high-risk population can be defined.

Breast cancer care requires a multidisciplinary approach for the diagnosis, treatment and follow-up care.

What Is Stage 0 Dcis

Stage 0 breast cancer, ductal carcinoma in situ is a non-invasive cancer where abnormal cells have been found in the lining of the breast milk duct. In Stage 0 breast cancer, the atypical cells have not spread outside of the ducts or lobules into the surrounding breast tissue. Ductal Carcinoma In Situ is very early cancer that is highly treatable, but if its left untreated or undetected, it can spread into the surrounding breast tissue.

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How Often Does Stage 1 Breast Cancer Come Back After Treatment

If stage 1 cancer is treated comprehensively, it rarely comes back. A new, unrelated breast cancer is more likely to emerge after stage 1 breast cancer is treated than a recurrence. Your healthcare provider will recommend a surveillance schedule for you so that new breast cancer or a recurrence can be identified and treated as quickly as possible.

The Overall Goal Is Your Personalized Care

Many With Early

The importance for breast cancer patients to consult with a multidisciplinary team prior to initiating treatment cant be overstated it can be a lot to take in, but youre not alone and theyre there to help, Dr. Moore says.

The goal is to individually tailor your therapy in order to avoid both undertreatment and over treatment of the cancer, she emphasizes. Rest assured your medical team will always walk you through what the best options are for you personally, .

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General Indications For Chemotherapy

We outline below some of the more common indications for needing chemotherapy. The decision to undergo chemotherapy also involves being healthy enough to tolerate the treatment. Deciding who needs chemotherapy and what type of chemotherapy to administer is one of the most difficult decisions made in medicine. Your medical oncologist will guide you.

Is Breast Cancer Curable In The 3 Stage

What does stage 3 mean? Because stage 3 breast cancer has spread outside the breast, it can be harder to treat than earlier stage breast cancer, though that depends on a few factors. With aggressive treatment, stage 3 breast cancer is curable however, the risk that the cancer will grow back after treatment is high.

Read Also: Stage 3 Cancer Definition

Treatment For Stage 3 Breast Cancer

for stage 3 breast cancer may include the following, depending on the type of cancer and other factors:

  • chemotherapy

stage 4 breast cancer , also called metastatic breast cancer, has cancer that has spread to nearby lymph nodes and also more distant lymph nodes and other organs in the body.

Stage 4 breast cancer is the most advanced stage. Stage 4 breast cancer also may be breast cancer that returned to affect other parts of the body. Cancer that has returned in other parts of the body is called recurrent metastatic breast cancer

What Stage Of Breast Cancer Requires A Mastectomy

Study: Many with breast cancer don’t need chemo


People also ask, is mastectomy necessary for breast cancer?

In the past, breast cancer surgery often required removing the entire breast, chest wall, and all axillary lymph nodes in a procedure called a radical mastectomy. While radical mastectomies are less common today, there are instances in which this surgery is the best option to treat the cancer.

Subsequently, question is, is it better to have a lumpectomy or mastectomy? Mastectomy takes longer and is more extensive than lumpectomy, with more post-surgery side effects and a longer recuperation time. Mastectomy means a permanent loss of your breast. You are likely to have additional surgeries to reconstruct your breast after mastectomy.

Correspondingly, can you die from stage 2 breast cancer?

While it may seem frightening to be diagnosed with stage 2 breast cancer, remember that it is still considered early-stage cancer. Most women diagnosed at this stage do extremely well with treatment and go on to live normal lifespans.

Do you need chemo for Stage 1 breast cancer?

Chemotherapy is usually not part of the treatment regimen for earlier stages of cancer. Stage 1 is highly treatable, however, it does require immediate treatment, typically surgery and often radiation, or a combination of the two. Like stage 0, Chemotherapy is often not necessary for earlier stages of cancer.

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Chemotherapy Regimens For Early

At some point, your medical oncologist will recommend a chemotherapy plan for you. Also called a chemotherapy regimen, the plan will have important details about your treatment, including:

  • which drugs youre receiving
  • the order in which you receive them
  • the amount of each drug
  • how often and how long you will need chemotherapy

Most women with early-stage breast cancer receive chemotherapy for approximately three to six months. Theres time in between treatments to allow your body to recover. If you are receiving targeted therapy for early HER2-positive breast cancer, treatment could last up to a year.

For some people, doctors may recommend a dose-dense chemotherapy regimen. Dose-dense chemotherapy means there is less time between treatments. You will not need to have a larger dose of chemotherapy.

Research has shown that dose-dense chemotherapy can improve survival and lower the risk of the breast cancer coming back compared to a traditional chemotherapy schedule. Dose-dense chemotherapy does not result in more side effects.

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.

Read Also: What Is Stage 3a Cancer

Menstrual Changes And Fertility Issues

For younger women, changes in menstrual periods are a common side effect of chemo. Premature menopause and infertility may occur and could be permanent. If this happens, there is an increased risk of heart disease, bone loss, and osteoporosis. There are medicines that can treat or help prevent bone loss.

Even if your periods stop while you are on chemo, you may still be able to get pregnant. Getting pregnant while on chemo could lead to birth defects and interfere with treatment. If you have not gone through menopause before treatment and are sexually active, its important to discuss using birth control with your doctor. It is not a good idea for women with hormone receptor-positive breast cancer to take hormonal birth control , so its important to talk with both your oncologist and your gynecologist about what options would be best for you. When women have finished treatment , they can safely go on to have children, but it’s not safe to get pregnant while being treated.

If you think you might want to have children after being treated for breast cancer, talk with your doctor soon after being diagnosed and before you start treatment. For some women, adding medicines, like monthly injections with a luteinizing hormone-releasing hormone analog, along with chemo, can help them have a successful pregnancy after cancer treatment. To learn more, see Female Fertility and Cancer.


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