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 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 contain 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.
What Is Cam For Cancer
The prevalence of CAM use among cancer patients has been rising over the last few decades. The terms alternative and complementary are used to describe many kinds of products, practices, and treatments.
Alternative therapy refers to non-standard treatment used in place of standard treatment, while complementary therapy usually means methods used along with standard treatment.
Alternative and complementary therapies are often appealing because they use your own body, your own mind, or things that may be found in nature. But sometimes these methods wrongly claim to prevent, diagnose, or treat cancer even when they have not been proven to work through scientific testing.
Some complementary methods have been studied and shown to help people feel better under a doctors care. Examples might include meditation to reduce stress, or acupuncture to reduce pain and nausea.
Do I Need Genetic Counseling And Testing
Your doctor may recommend that you see a genetic counselor. Thats someone who talks to you about any history of cancer in your family to find out if you have a higher risk for getting breast cancer. For example, people of Ashkenazi Jewish heritage have a higher risk of inherited genetic changes that may cause breast cancers, including triple-negative breast cancer. The counselor may recommend that you get a genetic test.
If you have a higher risk of getting breast cancer, your doctor may talk about ways to manage your risk. You may also have a higher risk of getting other cancers such as ovarian cancer, and your family may have a higher risk. Thats something you would talk with the genetic counselor about.
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What Else Do You Need To Make Your Decision
Check the facts
- No, it’s not a main treatment. Chemotherapy is an added treatment, a sort of insurance policy designed to kill any cancer cells that may still be in your body after surgery.
- You’re right. Chemotherapy is an added treatment, a sort of insurance policy designed to kill any cancer cells that may still be in your body after surgery.
- It may help to go back and read “Get the Facts.” Chemo is an added treatment, a sort of insurance policy designed to kill any cancer cells that may still be in your body after surgery.
- No, not every woman will need chemo. It depends on what type of breast cancer she has and how far it has spread.
- You’re right. Not every woman will need chemo. It depends on what type of breast cancer she has and how far it has spread.
- It may help to go back and read “Get the Facts.” Not every woman will need chemo. It depends on what type of breast cancer she has and how far it has spread.
- No, some women are not bothered by side effects. Your doctor can give you other medicines to help you deal with side effects like nausea and vomiting.
- That’s right. Some women are not bothered by side effects. Your doctor can give you other medicines to help you deal with side effects like nausea and vomiting.
- It may help to go back and read “Get the Facts.” Some women are not bothered by side effects.
1.How sure do you feel right now about your decision?
Who Is A Good Candidate For Neoadjuvant Therapy
Patients should meet a few requirements to be a candidate for neoadjuvant therapy. The size of the tumor, the type of breast cancer they have, and whether lymph nodes are involved are all things a doctor will consider before suggesting this form of treatment. Some forms of breast cancer are more likely to respond well to neoadjuvant therapy.
Unless a tumor is small and there is no lymph node involvement, most patients who have eitherHER2-positive breast cancer or triple-negative are good candidates for using chemotherapy either before or after their mastectomy.
With the best outcomes, this therapy can eliminate all visible tumors from the breast and produce what is known as a pathologic complete response to the treatment. That means the doctor will find no trace of the invasive tumor in the breast or the lymph nodes after the patient has received treatment.
Women who have estrogen receptor-positive breast cancer, which is the most common type, may not be good candidates for neoadjuvant therapy. Instead, these patients may benefit from anti-estrogen treatment to help shrink their tumor before surgery.
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What Is Neoadjuvant Therapy
Neoadjuvant therapy is a treatment approach which focuses on this type of reverse order. The idea is to first shrink the tumor with chemotherapy before any next steps, specifically surgery.
This approach not only can improve surgical options, but also allows for a better assessment of the patients response to the chemotherapy, Dr. Moore says. It can also inform better recommendations for follow-up treatments after surgery. The approach doesnt work for everyone, but its certainly worth discussing with your doctor to find out if youre a candidate.
Are There Any Lasting Side Effects Of Chemotherapy
Sometimes people do experience problems that may not go away. For example, some of the drugs used for breast cancer may weaken the heart. Your doctor may check your heart before, during, and after treatment. A rare side effect of chemotherapy is that occasionally, years after treatment, a few women have developed leukemia .Some chemotherapy drugs can damage the ovaries. If you have not gone through menopause yet, you may have hot flashes and vaginal dryness. Your menstrual periods may no longer be regular or they may stop. You may become infertile .
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How Is Hormone Therapy Used To Treat Breast Cancer
There are three main ways that hormone therapy is used to treat hormone-sensitive breast cancer:
Adjuvant therapy for early-stage breast cancer:Tamoxifen is FDA approved for adjuvant hormone treatment of premenopausal and postmenopausal women with ER-positive early-stage breast cancer, and the aromatase inhibitorsanastrozole, letrozole, and exemestane are approved for this use in postmenopausal women.
Research has shown that women who receive at least 5 years of adjuvant therapy with tamoxifen after having surgery for early-stage ER-positive breast cancer have reduced risks of breast cancer recurrence, including a new breast cancer in the other breast, and reduced risk of death at 15 years .
Until recently, most women who received adjuvant hormone therapy to reduce the chance of a breast cancer recurrence took tamoxifen every day for 5 years. However, with the introduction of newer hormone therapies , some of which have been compared with tamoxifen in clinical trials, additional approaches to hormone therapy have become common .
Some premenopausal women with early-stage ER-positive breast cancer may have ovarian suppression plus an aromatase inhibitor, which was found to have higher rates of freedom from recurrence than ovarian suppression plus tamoxifen or tamoxifen alone .
Men with early-stage ER-positive breast cancer who receive adjuvant therapy are usually treated first with tamoxifen. Those treated with an aromatase inhibitor usually also take a GnRH agonist.
Sorry You Have To Go Through
Sorry you have to go through such a tough decision. I wasn’t given a choice, I was Stage 3 with 8 nodes involved.I remember trying to “bargain” with the doctor but I was so afraid of chemo that I asked if I had a mastectomy could I skip chemo?The answer was no, so I opted for the lumpectomy which they assured me was enough for the location and shape of the tumor.
Chemo isn’t great, but it’s very doable. The drugs that they have now help a lot with the side effects. It’s much different than the stories I’ve heard from years ago. I think chemo is still in the realm of so scary that we should all remind any newbies that it isn’t something to be petrified of. I know I sure was!
We are all different, as you’ll read here all the time. I can only tell you of my own experience and hope that somehow it helps in your decision.
I wish you the best in making the decision.
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External Beam Breast Cancer Radiation
External beam radiation is the most common kind of radiation treatment for breast cancer. Its a painless treatment, like getting an X-ray. A doctor will place a machine on the outside of your body and aim the radiation beams at the area of the cancer. Your doctor will figure out where to aim the rays and how much radiation to use before each treatment. They will mark the area with temporary or permanent ink.
Each treatment only lasts a few minutes. The session setup will take longer. External radiation treatment happens five days a week for about five to seven weeks. Its the longest type of radiation treatment available.
Short-term side effects of external radiation include:
- swelling and pain in the arm or chest
- weakened and fractured ribs
- future cancer in the inner lining of your blood vessels
External radiation does not leave radiation in your body. You will not be radioactive during or after treatment.
How Will I Know If The Chemotherapy Treatments Are Working
Some people may think that their chemotherapy treatment is not working if they do not experience side effects. However, this is a myth.
If you are receiving adjuvant chemotherapy , it is not possible for your doctor to directly determine whether the treatment is working because there are no tumor cells left to assess. However, adjuvant chemotherapy treatments have been proven helpful in studies in which some women were given chemotherapy, while others were not. If you are receiving chemotherapy for metastatic disease, the effects will be monitored, routinely, by blood tests, scans, and/or other imaging studies. These may include CT scans, bone scans, and/or X-rays).
After completing adjuvant chemotherapy, your doctor will evaluate your progress through periodic physical examinations, routine mammography, and appropriate testing if a new problem develops.
Last reviewed by a Cleveland Clinic medical professional on 09/05/2013.
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What You Need To Know About Breast Cancer Chemotherapy Pills
People commonly associate chemotherapy with intravenous cancer drugs in a hospital or doctors office. This has been the traditional nonsurgical method of treating cancer.
Due to recent advances in cancer treatments, oral chemotherapy pills have become more widely used for many types of cancer. There are a few that are approved for breast cancer, including capecitabine , which is often used to treat metastatic breast cancer.
Hi Katy I Had Bilmastectomy
Hi Katy i had Bil.mastectomy with out chem or rad.was just put on hormone therapy which is Tamoxifen for 5 years also had 2 lymph nodes from each side taken no cancer.It will be up to you and your oncologist on you what treatment is best for you.Strength,Courage and Hope your attitude is one of your best coping skills.Keep us posted.Hugs Frankie
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When Is Chemotherapy Used To Treat Early
The first treatment for early-stage breast cancer usually includes surgery and sometimes radiation. Your doctor may also talk to you about added treatment, such as chemotherapy and hormone therapy, that may help keep cancer from coming back.
It isn’t possible for all women to know for sure who will benefit from added treatment. But if you have early-stage, estrogen receptor positive breast cancer with no cancer in the lymph nodes, you may have a gene test. Gene tests, such as the Oncotype DX, may be done on the cancerous tissue that was removed to look for tumor markers. These tests can give your doctor important information about whether chemotherapy will help you.
The type of added treatment you have depends on the stage and classification of your breast cancer:
Duration And Frequency Of Oral Chemo
The American Cancer Society note that in most cases, a person receives chemo oral or otherwise in cycles that involve 23 weeks of treatment and then a few weeks of rest. A person must follow their treatment instructions precisely and alert their doctor if they miss a dose or take an extra dose.
There is no one-size-fits-all approach to oral chemo, so a person receiving it should contact a doctor if they have any questions.
A person may sometimes need additional treatment before or after oral chemo, such as radiation, surgery, or more chemo.
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Brachytherapy Via Implantable Device
There are two common types of internal radiation treatment: interstitial brachytherapy and intracavitary brachytherapy.
During interstitial brachytherapy, a doctor will insert several small tubes into your breast where the cancer was removed. The tubes deliver radioactive pellets to that area a few times each day over several days. This procedure is not commonly used today.
Intracavitary brachytherapy is the most common type of internal breast cancer radiation. Your doctor will place a tube-like device into your breast to send radiation to the location of the cancer. The end of the device expands in the breast to keep it in place, while the other end sticks out of the breast. Outpatient treatment sessions happen twice a day for five days.
Side effects of intracavitary brachytherapy may include:
Side Effects Of Breast Cancer Chemotherapy
Chemotherapy usually works by attacking rapidly dividing cells. This means that chemotherapy can harm not only cancer cells but also healthy cells that are dividing rapidly, like the ones that cause your hair to grow.
Whether you have side effects from breast cancer chemotherapy will depend on the details of your treatment plan. The care teams at MSK are committed to helping you feel your best during and after treatment. During treatment, well watch carefully for your reaction to the drugs and adjust the drugs or dose as necessary. Well also continue to monitor you for possible long-term effects after your treatment ends.
We offer a variety of other specialized services to support you during your treatment. Many MSK patients find that our Integrative Medicine Service can be a valuable part of their treatment plan. Programs include massage, acupuncture, hypnotherapy, meditation, visualization, music therapy, and nutritional counseling.
One side effect of chemotherapy can be hair loss. MSK offers scalp cooling to help minimize hair loss. Learn more about scalp cooling, or ask your care team for more information.
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Neoadjuvant And Adjuvant Systemic Therapy
For women who have a hormone receptor-positive breast cancer, most doctors will recommend hormone therapy as an adjuvant treatment, no matter how small the tumor is. Women with tumors larger than 0.5 cm across may be more likely to benefit from it. Hormone therapy is typically given for at least 5 years.
If the tumor is larger than 1 cm across, chemo after surgery is sometimes recommended. A woman’s age when she is diagnosed may help in deciding if chemo should be offered or not. Some doctors may suggest chemo for smaller tumors as well, especially if they have any unfavorable features .
After surgery, some women with HER2-positive cancers will be treated with trastuzumab for up to 1 year.
Many women with HER2-positive cancers will be treated with trastuzumab followed by surgery and more trastuzumab for up to 1 year. If after neoadjuvant therapy, residual cancer is found during surgery, trastuzumab may be changed to a different drug, called ado-trastuzumab emtansine, which is given every 3 weeks for 14 doses. If hormone receptor-positive cancer is found in the lymph nodes, your doctor might recommend one year of trastuzumab followed by additional treatment with an oral drug called neratinib for 1 year.
Possible Side Effects Of Chemo For Breast Cancer
Chemo drugs can cause side effects. These depend on the type and dose of drugs given, and the length of treatment. Some of the most common possible side effects include:
- Hair loss
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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