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Options For Breast Cancer Treatment

Why Is The Immune System Important

Breast Cancer: Diagnosis and Treatment Options

An important part of the immune system is its ability to keep itself from attacking normal cells in the body. To do this, it uses checkpoints, which are proteins on immune cells that need to be turned on to start an immune response. Breast cancer cells sometimes use these checkpoints to avoid being attacked by the immune system. Drugs that target these checkpoint proteins, help to restore the immune response against breast cancer cells.

Adjusting To Body Changes After Treatment

Your feelings about your body may change after treatment for breast cancer. For example, you may find it hard to adjust to how your body looks after surgery. These and other physical changes may affect your body image. Or they may affect your desire to be intimate with a partner. Everyone has their own reaction to the challenges of cancer treatment.

If you have concerns, try to talk openly with your partner, if you have one. Or discuss your feelings with your doctor or nurse. Your care team may be able to help. Or they may refer you to counseling or a support group. Talking with others who’ve had similar feelings can be very helpful.

Treatment For Breast Cancer May Cause Side Effects

For information about side effects that begin during treatment for cancer, see our Side Effects page.

Some treatments for breast cancer may cause side effects that continue or appear months or years after treatment has ended. These are called late effects.

Late effects of radiation therapy are not common, but may include:

  • Inflammation of the lung after radiation therapy to the breast, especially when chemotherapy is given at the same time.
  • Arm lymphedema, especially when radiation therapy is given after lymph node dissection. For more information, see Lymphedema.
  • In women younger than 45 years who receive radiation therapy to the chest wall after mastectomy, there may be a higher risk of developing breast cancer in the other breast.

Late effects of chemotherapy depend on the drugs used, but may include:

Late effects of targeted therapy with trastuzumab, lapatinib, or pertuzumab may include:

  • Heart problems such as heart failure.

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What Are The Types Of Breast Cancer Treatment

Some treatments remove or destroy the disease within the breast and nearby tissues, such as lymph nodes. These include:

Surgery. For most people, the first step is to take out the tumor. An operation called lumpectomy removes only the part of your breast that has cancer. Itâs sometimes called breast-conserving surgery. In a mastectomy, doctors remove the whole breast. There are different types of mastectomies and lumpectomies.

Radiation therapy. This treatment uses high-energy waves to kill cancer cells. Most women under age 70 who have a lumpectomy get radiation, too. Doctors also might recommend this method if the disease has spread. It helps destroy any cancer cells that the surgeon couldnât remove. Radiation can come from a machine outside your body, or you might have tiny seeds that give off radiation placed inside your breast where the tumor was.

Other treatments destroy or control cancer cells all over your body:

Chemotherapy uses drugs to kill cancer cells. You take the medicines as pills or through an IV. Most people get it after surgery to kill any cancer cells left behind. Doctors also prescribe it before surgery to make tumors smaller. Chemo works well against cancer, but it also can harm healthy cells.

Immunotherapy uses your own immune system to target cancer. The drugs atezolizumab and sacituzumab govitecan-hziy have been approved to treat triple-negative breast cancer that has spread.

Complementary And Alternative Medicine

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Complementary and alternative medicine are medicines and health practices that are not standard cancer treatments. Complementary medicine is used in addition to standard treatments, and alternative medicine is used instead of standard treatments. Meditation, yoga, and supplements like vitamins and herbs are some examples.

Many kinds of complementary and alternative medicine have not been tested scientifically and may not be safe. Talk to your doctor about the risks and benefits before you start any kind of complementary or alternative medicine.

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Side Effects Of Radiation Therapy For Breast Cancer

Some patients may experience side effects of radiation therapy weeks or months after the treatments begin. In many cases, side effects go away after treatment ends. But patients may experience fatigue for weeks, even months, after treatments are over.

Other side effects of radiation therapy for breast cancer include skin irritation and breast pain.

Talk To Your Doctor To Find Out What Your Breast Cancer Stage Is And How It Is Used To Plan The Best Treatment For You

After surgery, your doctor will receive a pathology report that describes the size and location of the primary tumor, the spread of cancer to nearby lymph nodes, tumor grade, and whether certain biomarkers are present. The pathology report and other test results are used to determine your breast cancer stage.

You are likely to have many questions. Ask your doctor to explain how staging is used to decide the best options to treat your cancer and whether there are clinical trials that might be right for you.

The treatment of breast cancer depends partly on the stage of the disease.

For treatment options for stage IIIB, inoperable stage IIIC, and inflammatory breast cancer, see Treatment of Locally Advanced Inflammatory Breast Cancer.

For treatment options for cancer that has recurred near the area where it first formed , see Treatment of Locoregional Recurrent Breast Cancer.

For treatment options for stage IV breast cancer or breast cancer that has recurred in distant parts of the body, see Treatment of Metastatic Breast Cancer.

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Side Effects Of Chemotherapy For Breast Cancer

Chemotherapy works by targeting fast-growing cancer cells. But it may also kill other cells in the body that grow quickly, such as those in hair follicles, bone marrow and the digestive system. As a result, chemotherapy for breast cancer may cause a variety of side effects, including:

  • Suppressed immunity

How Does The Immune System Work

Breast cancer treatment options before surgery

Your immune system is made up of a number of organs, tissues, and cells that work together to protect you from foreign invaders that can cause disease. When a disease- or infection-causing agent, such as a bacterium, virus, or fungus, gets into your body, your immune system reacts and works to kill the invaders. This self-defense system works to keep you from getting sick.

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Does The Moon Shot Work For Prostate Cancer

For example, an ongoing clinical trial with the Prostate Cancer Moon Shot® is showing promising early results by using multiple checkpoint inhibitors to treat advanced prostate cancer. Insights from this work also showed when prostate cancer spreads to the bone, it leads to massive destruction of bone tissue. This sparks production of a protein called TGF- that can suppress the immune response. To better treat bone metastases, the platform is planning to launch a clinical trial that combines a checkpoint inhibitor together with a therapy that blocks TGF-.

Breast Cancer Is A Disease In Which Malignant Cells Form In The Tissues Of The Breast

The breast is made up of lobes and ducts. Each breast has 15 to 20 sections called lobes. Each lobe has many smaller sections called lobules. Lobules end in dozens of tiny bulbs that can make milk. The lobes, lobules, and bulbs are linked by thin tubes called ducts.

Each breast also has blood vessels and lymph vessels. The lymph vessels carry an almost colorless, watery fluid called lymph. Lymph vessels carry lymph between lymph nodes. Lymph nodes are small, bean-shaped structures found throughout the body. They filter lymph and store white blood cells that help fightinfection and disease. Groups of lymph nodes are found near the breast in theaxilla , above thecollarbone, and in the chest.

The most common type of breast cancer is ductal carcinoma, which begins in the cells of the ducts. Cancer that begins in the lobes or lobules is called lobular carcinoma and is more often found in both breasts than are other types of breast cancer. Inflammatory breast cancer is an uncommon type of breast cancer in which the breast is warm, red, and swollen.

For more information about breast cancer, see:

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Treatment Of Ductal Carcinoma In Situ

For information about the treatments listed below, see the Treatment Option Overview section.

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

Who Treats Breast Cancer

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Breast cancer is a complex disease that requires a team of experts who not only treat the cancer but who also help you manage its symptoms and side effects. At Cancer Treatment Centers of America® , your care team may include one or more of the following physicians:

Medical oncologist: Your cancer care team at CTCA will be led by a medical oncologist. This doctor diagnoses and treats cancer, usually with chemotherapy, targeted therapy, immunotherapy and other drugs. A medical oncologist also coordinates with other members of your care team, including oncologists who are experts in other aspects of cancer care, such as surgery or radiation therapy.

Breast surgeon: This surgeon is a type of surgical oncologist who specializes in operations on the breast. A breast surgeon may perform a variety of surgeries to treat cancer, including biopsies, lumpectomies and mastectomies.

Radiation oncologist: This doctor uses radiation therapy to treat cancer. Radiation oncologists may use one or a combination of radiation therapy technologies to treat breast cancer. Radiation therapy for breast cancer is used to kill remaining cancer cells after a tumor has been removed.

Plastic surgeon: This surgeon reconstructs the breast after a mastectomy or lumpectomy. Also called reconstructive surgeons, these doctors may perform these reconstructive procedures either immediately after surgery to remove a tumor, or later, depending on a variety of factors.

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Stage 2 Breast Cancer

Stage 2 breast cancers are larger than stage 1 tumors, and the cancer cells have spread and have been found in a few nearby lymph nodes.

If you are in stage 2, your cancer may be categorized as stage 2A or 2B. The secondary classification is based on the tumors size and spread. Treatment typically starts with breast-conserving surgery or a mastectomy. Your surgeon may remove some lymph nodes to examine the spread of the cancer cells. Radiation is often needed because the cancer has begun spreading to your lymph nodes.

Your care team may recommend systemic therapies, such as chemotherapy, HER2 drugs or hormone therapy, before and/or after surgery.

Pre-surgery treatments may help shrink a tumor enough that it may be removed through a breast conservation procedure.

Advanced Surgical Options For Breast Cancer

Advanced surgical options are available at the GW Comprehensive Breast Center from surgeons who specialize in cutting-edge breast procedures. Those options range from breast conserving treatments such as a lumpectomy to simple and modified radical mastectomies.

Doctors at the center may use sentinel node mapping to first examine the lymph nodes most likely to be affected by breast cancer and avoid more extensive full lymph node dissection procedure.

If a mastectomy is necessary, patients are referred to plastic surgeons to discuss reconstruction options. The center was the first in the region to offer the seed localization procedure that uses tiny radioactive seeds to mark a tumor to allow more accurate surgery.

Along with surgery, doctors at the GW Comprehensive Breast Center may use therapies, such as radiation, chemotherapy and hormone therapy, to treat breast cancer.

Acute Pain Management Service, a consult service provided by the Department of Anesthesiology and Critical Care Medicine, is also available to help patients manage post-operative pain while in the hospital. Watch how the Acute Pain Management Service is using multi-modal approaches at GW Hospital to help breast cancer survivors manage their pain.

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Stage 0 Breast Cancer

Stage 0 is the lowest-risk breast cancer stage. In this stage, breast cancer is detected before it spreads from the milk duct. Ductal carcinoma in situ is an example of stage 0 breast cancer.

Treatment may include surgery to remove the breast cancer, possibly followed by radiation or hormonal therapy if the cancer is hormone receptor-positive. Hormonal therapy may include tamoxifen or a type of drug known as an aromatase inhibitor, which is taken for five years after surgery to lower the risk of the breast cancer recurring.

The surgeon may remove just the tumor, via breast conservation surgery, or the entire breast, if the cancer is large or has been detected in several spots in the milk ducts.

Factors That Influence Choice

New Treatment Options for Metastatic Breast Cancer

There are many factors which may be considered in choosing the right treatment for your cancer, both initially, and as time goes on. Some of these include:

  • Receptor status of the tumor
  • Previous treatments
  • Tumor burden are and how large)
  • The specific symptoms you have related to your cancer and how bothersome these are for you
  • How fast the cancer is progressing
  • Your personal preferences for ease of treatment , and tolerance of side effects
  • Whether or not you are taking part in a clinical trial

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Radiation Therapy For Breast Cancer

Radiation therapy is not always required for women with breast cancer. If recommended, it is often administered to the whole breast after a lumpectomy surgery to kill any cancer cells left behind. It could also be given to the nearby lymph nodes. For women who had a modified radical mastectomy, it may or may not be recommended depending on the size of the tumor, whether it has spread to lymph nodes and how many lymph nodes.

Radiation oncologists have more than one type of radiation therapy available for breast cancer patients.

  • External radiation therapy: This is the most commonly used form of radiation therapy for breast cancer. The radiation comes from a large machine outside the body. You will go to a hospital or clinic for treatment. Treatments are usually five days a week for four to six weeks. External radiation is the most common type used for breast cancer.
  • Internal radiation therapy or brachytherapy: The radiation oncologist places one or more thin tubes inside the breast through a tiny incision. Most commonly, radioactive pellets are loaded into the tubes each day for about 5 days and pointed at the area where there was cancer. At the end of the treatment the device with the tubes is removed. This is a rapidly advancing breast cancer treatment technology and your radiation oncologist can discuss whether this type of treatment is best for you.

Tips To Help You Choose

Although there are some typical breast cancer treatment regimens, women do have choices.

  • Talk with your doctor about all the risks and benefits of each treatment option and how they will affect your lifestyle.
  • Think about joining a support group. Other people with breast cancer know what youâre going through and can give you advice and understanding. They might help you decide on a treatment, too.
  • Ask your doctor whether you should join a clinical trial, a research study that tests new treatments before theyâre available to everyone.

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Treatment Of Locally Advanced Or Inflammatory Breast Cancer

For information about the treatments listed below, see the Treatment Option Overview section.

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

Breast Cancer Treatments By Stage

Metastatic Breast Cancer â A Different Type of Breast Cancer

The care team will create a treatment plan based on a variety of factors, including the cancer stage. Throughout treatment, the cancer will be monitored to evaluate whether treatment is working as planned. For instance, the care team may order a CA 15-3 test, which uses blood samples to track the progression of breast cancer and how it responds to treatment. When used in conjunction with additional tests, the care team can use this data to adjust treatments when necessary.

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How Do I Know Which Breast Cancer Treatment To Choose

Your doctor will think about a few things before they recommend a treatment for you:

  • The type of breast cancer you have
  • The size of your tumor and how far the cancer has spread in your body, called the stage of your disease
  • Whether your tumor has things called receptors for HER2 protein, estrogen, and progesterone, or other specific features.

Your age, whether youâve gone through menopause, other health conditions you have, and your personal preferences also play a role in this decision-making process.


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