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Stage 1 Breast Cancer Chemo

Stage 0 Breast Cancer Treatment

How to Treat Stage I (1) Breast Cancer

Because its not possible to predict whether a stage 0 breast cancer will invade the breast tissue around it, most people undergo treatment, which may include surgery, radiation therapy and hormone therapies such as tamoxifen.

Surgical options for stage 0 breast cancer include breast-conserving surgery to remove the area of the breast with abnormal cells, or a mastectomy to remove the entire breast. In treating Pagets disease, the nipple and areola are removed. Many factors are considered when determining the type of surgery that will be recommended, including the size and extent of the DCIS growth, and whether the patient has any family history of breast cancer or BRCA gene mutations. During a mastectomy, the doctor may also remove one or more lymph nodes to be analyzed in a lab for signs of cancer.

Radiation therapy treatments often follow breast-conserving surgery to destroy remaining cancer cells, though its not usually required after a mastectomy. Stage 0 breast cancer treatment doesnt typically include chemotherapy.

If the abnormal cells are hormone receptor-positive, the next step may involve long-term treatment with a hormone-based drug. This medication, which is typically taken for five years, is designed to reduce the chances of cancer recurring or spreading.

What Questions Should I Ask My Doctor

You will have lots of questions about your cancer, starting with your diagnosis. Here are some basic questions you might ask:

  • What is triple negative breast cancer?
  • How do you know my cancer is triple negative breast cancer?
  • Why did I get this cancer?
  • Do I need genetic testing?
  • Has my breast cancer spread, and if so, how far has it spread?
  • What is the stage of my cancer?
  • What is my prognosis or expected outcome?
  • What treatments do you recommend?
  • Why do you recommend those treatments?
  • What are those treatment side effects?
  • Will I need surgery? If so, what surgery do you recommend and why?
  • Im interested in participating in clinical trials. Are you able to help me find one?
  • Do you know if there are any local support groups?

A note from Cleveland Clinic

Triple negative breast cancer is one of the more challenging breast cancers to treat. You might be discouraged by what you have read about triple negative breast cancer. But there are a number of very effective treatments for triple negative breast cancer, including immunotherapy, chemotherapy, surgery and radiation. And every day researchers learn more about this rare cancer. Their knowledge is your power. If youre concerned you arent getting the straight story about your cancer, ask your healthcare provider to walk you through your diagnosis and treatment options.

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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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After Breast Cancer Has Been Diagnosed Tests Are Done To Findout If Cancer Cells Have Spread Within The Breast Or To Other Parts Of Thebody

The process used to find out whether the has spread within the or to otherparts of the body is called .The information gathered from the staging process determines the of the disease. It isimportant to know the stage in order to plan treatment. The results of some of the tests used to are also used to stage the disease.

The following tests and procedures also may be used inthe staging process:

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Breast Cancer Staging Guidelines

Breast Cancer Staging

The TNM system is the most widely used cancer staging system and looks at the following cancer characteristics:

  • Tumor The size of the tumor and whether it has grown into nearby tissue.
  • Node Whether the cancer has spread to nearby lymph nodes. And if so, how many.
  • Metastasis Indicates whether the cancer has spread to distant organs, like the lungs or liver.

But when it comes to breast cancer staging, the TNM system was expanded to include additional cancer characteristics, including:

  • Estrogen-receptor status or progesterone-receptor status Whether the cancer has estrogen or progesterone receptors. A positive status means the cancer can use either hormone to grow.
  • HER2 status Whether the cancer produces HER2, a protein that promotes the growth of cancer cells.
  • Grade Indicates how much the cancer cells look like healthy cells.
  • Oncotype DX recurrence score Indicates how likely a group of genes may respond to treatment, depending on ER, PR and HER2 status.

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The Grading System Is Used To Describe How Quickly A Breast Tumor Is Likely To Grow And Spread

The grading system describes a tumor based on how abnormal the cancer cells and tissue look under a microscope and how quickly the cancer cells are likely to grow and spread. Low-grade cancer cells look more like normal cells and tend to grow and spread more slowly than high-grade cancer cells. To describe how abnormal the cancer cells and tissue are, the pathologist will assess the following three features:

  • How much of the tumor tissue has normal breast ducts.
  • The size and shape of the nuclei in the tumor cells.
  • How many dividing cells are present, which is a measure of how fast the tumor cells are growing and dividing.

For each feature, the pathologist assigns a score of 1 to 3 a score of 1 means the cells and tumor tissue look the most like normal cells and tissue, and a score of 3 means the cells and tissue look the most abnormal. The scores for each feature are added together to get a total score between 3 and 9.

Three grades are possible:

  • Total score of 3 to 5: G1 .
  • Total score of 6 to 7: G2 .
  • Total score of 8 to 9: G3 .

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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What Are The Different Grades Of Breast Cancer

There are three grades of invasive breast cancer:

  • Grade 1 looks most like normal breast cells and is usually slow growing
  • Grade 2 looks less like normal cells and is growing faster
  • Grade 3 looks different to normal breast cells and is usually fast growing

Sometimes the grade given to a cancer after a biopsy can change after surgery. This is because after surgery theres more tissue for the pathologist to look at, which can give them more detailed information about the cancer.

Stage 4 Breast Cancer

Treatment Strategies for Stage One Breast Cancer

What is Stage 4 breast cancer?

In Stage 4, the breast cancer has metastasized, which means the disease has spread to distant parts of your body. When breast cancer spreads, it can often invade the lungs, liver and bones, sometimes making its way to the brain or other organs.

What are the options for Stage 4 breast cancer treatment?

  • Systemic therapies A combination of systemic therapies are often recommended at specific times during the treatment of Stages 1-3. But in stage four, these therapies are the primary treatment and include:
  • Hormone therapy When you have Stage 4 breast cancer, hormone therapy can help slow or stop the growth of cancerous cells.
  • Chemotherapy This therapy can destroy cancerous cells throughout your body.
  • Targeted drug therapies Like chemotherapy, these targeted drugs help reach cancer in distant areas of the body. But depending on your type of cancer, HER2 status and hormone receptor status, different targeted drugs can work alongside chemotherapy or even better than chemotherapy.
  • Immunotherapy for breast cancer This therapy helps raise your bodys natural immune response to fight of the cancer.
  • Surgery and radiation During the most advanced stages of breast cancer, surgery and radiation are only recommend under specific circumstances, including:
  • When the breast tumor is causing an open wound in the breast
  • To treat a small number of metastases in a certain area, such as the brain
  • To help prevent bone fractures
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    Will I Need Chemotherapy

    Not everyone with early breast cancer will be recommended chemotherapy. Whether or not it is recommended for you will depend on your individual situation. Factors the doctors consider include the pathology of your breast cancer the risk of the cancer coming back or spreading to other parts of the body your general health and your preferences. Your medical oncologist will discuss whether chemotherapy is the right treatment for you and which combinations of medications are most appropriate.

    Genomic tests

    Some aspects of your type of breast cancer can influence whether chemotherapy is recommended for you. Your surgeon or medical oncologist may talk to you about genomic tests. Genomic tests can help predict the likelihood of an individual cancer recurring and can provide information to help you decide whether you may benefit from chemotherapy or some other breast cancer treatments.

    Your doctor may talk to you about genomic tests currently available, including:

    These tests are not covered by Medicare and can be quite expensive up to several thousand dollars. For further information about genomic testing, visit BCNAsMy Journey.

    What Is The Recovery Time After Chemotherapy For Breast Cancer

    When you finish chemotherapy, you may have remaining side effects of treatment. These symptoms may take months or weeks to go away. You may still experience:

    • Hair changes, such as hair growing back a different color or texture.
    • Nausea or vomiting for two to three weeks.
    • Tiredness or fatigue for three to six months.
    • Stress or chemo brain for six months to a year.

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    What Is Stage 0 Lcis

    Lobular carcinoma in situ at Stage 0 generally is not considered cancer. Although it has carcinoma in the name, it really describes a growth of abnormal but non-invasive cells forming in the lobules. Some experts prefer the name lobular neoplasia for this reason because it accurately refers to the abnormal cells without naming them as cancer. LCIS, however, may indicate a woman has an increased risk of developing breast cancer.

    If you have been diagnosed with LCIS, your doctor may recommend regular clinical breast exams and mammograms. He or she may also prescribe Tamoxifen, a hormone therapy medication that helps prevent cancer cells from growing.

    Can Stage 1 Breast Cancer Metastasize

    Stages 0 &  1

    When cancer spreads beyond the area where it originally developed, its called metastatic cancer. Breast cancers found in early stages, especially DCIS, are less likely to metastasize or come back after treatment, but its not possible to say for sure.

    Breast cancers caught early have a very positive prognosis. According to the National Cancer Institute Surveillance, Epidemiology, and End Results Program, 99 percent of patients with cancers diagnosed when still confined to the breast are alive five years later.

    Expert cancer care

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    Talk With Others Who Understand

    MyBCTeam is the social network for people with breast cancer and their loved ones. On MyBCTeam, members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.

    Have you or a loved one been diagnosed with stage 1 breast cancer? Share your experiences in the comments below, or start a conversation by posting on MyBCTeam.

    Does A Biopsy Tell You What Stage Cancer Is

    The biopsy results help your health care provider determine whether the cells are cancerous. If the cells are cancerous, the results can tell your care provider where the cancer originated the type of cancer. A biopsy also helps your care provider determine how aggressive your cancer is the cancers grade.

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    How The Breast Cancer Staging Process Starts

    The breast cancer staging process begins with diagnostic testing. Depending on previous screening results, if any breast cancer symptoms are present, and other factors, your doctor may recommend one of the following tests:

    • Diagnostic mammogram A mammogram involves using an X-ray to take photos of your breast tissue at different angles. To do this, your breasts are gently compressed between two plates so the X-ray can be taken.
    • Ultrasound An ultrasound is a non-invasive imaging test that bounces soundwaves of your breast tissue to create a picture of the inside of your breast.
    • MRI An MRI is another non-invasive imaging test that uses radio waves and a magnetic field to create an image of your breast tissue. This can help doctors determine the size and placement of tumors.
    • Biopsy A biopsy removes small masses and growths from your breast so they can be examined under a microscope by a pathologist and determine if theyre cancerous.

    If cancer is detected, a CT scan may be ordered to look for any distant metastasis or local invasion to other organs. And youll likely be connected with a breast surgeon right away, either through a nurse navigator or your doctor.

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    How Do You Treat Triple

    How to Treat Stage II (2) Breast Cancer

    The treatment for triple-negative breast cancer depends on the stage. Options include surgery, chemotherapy, immunotherapy, and radiation therapy.

    If the cancer is in stages 1 to 3, the primary treatment is surgery. This can be either a mastectomy or a lumpectomy . The surgeon usually performs a lymph node biopsy at the same time.

    Chemotherapy is often used to shrink a tumor before surgery. In other cases, chemotherapy can be given after surgery to prevent the cancer from coming back. Chemotherapy medications used in triple-negative breast cancer include doxorubicin, carboplatin, paclitaxel, and cyclophosphamide.

    Immunotherapy is a treatment that causes a persons own immune system to attack cancer cells. Like chemotherapy, immunotherapy can also help to shrink tumors before surgery. The two most common immunotherapies for triple-negative breast cancer are pembrolizumab and atezolizumab. Both of these medications are classified as immune checkpoint inhibitors.

    After surgery for triple-negative breast cancer, most people also get radiation therapy. The goal of radiation therapy is to prevent the cancer from coming back. It is a standard treatment after a lumpectomy. Some people also get radiation after a mastectomy, depending on the surgerys findings.

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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.

    Certain Factors Affect Prognosis And Treatment Options

    The prognosis and treatment options depend on the following:

    • The stage of the cancer .
    • The type of breast cancer.
    • Estrogen receptor and progesterone receptor levels in the tumor tissue.
    • Human epidermal growth factor type 2 receptor levels in the tumor tissue.
    • Whether the tumor tissue is triple negative .
    • How fast the tumor is growing.
    • How likely the tumor is to recur .
    • A womans age, general health, and menopausal status .
    • Whether the cancer has just been diagnosed or has recurred .

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    Statistics Dont Account For Late Recurrences

    When comparing triple-negative breast cancer to positive tumors, its important to keep in mind late recurrences. Most statistics are presented as five-year survival rate, and in this setting, triple-negative breast cancer can look more ominous. But looking at longer periods of time, say 20 years following diagnosis, this may be different.

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    Will I Need Chemotherapy After A Total Mastectomy

    Understanding the 5 Stages of Breast Cancer and Prognosis

    A total mastectomy is the surgical removal of the entire breast to treat breast cancer. A physician may recommend this treatment on its own or in combination with another therapy, such as chemotherapy. When chemotherapy is provided after surgery, it is called adjuvant chemotherapy. Whether or not chemotherapy is recommended following a total mastectomy will depend on many different factors, including the patients overall health, age and medical history as well as the type, stage and nature of the breast cancer.

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