Treatment

A breast cancer care team often includes a variety of specialists, such as medical, surgical, and radiation oncologists, along with patient navigators, oncology nurses, dietitians, and other supportive care professionals. Choosing healthcare providers who specialize in breast cancer, communicate openly, encourage questions, and involve patients in treatment decisions can help foster confidence throughout the care journey.

A lumpectomy is a breast-conserving surgery that removes the cancer along with a small margin of surrounding healthy tissue, but not the entire breast. It is most often recommended for early-stage breast cancer or small tumors and is typically followed by radiation therapy to help reduce the risk of recurrence. The decision between a lumpectomy and a mastectomy depends on factors such as the tumor size, location, the number of tumors, and a patient’s overall treatment plan. The procedure, recovery process, potential risks, and follow-up care all play an important role in preparing patients for surgery and supporting informed treatment decisions.

A mastectomy is a surgical procedure that removes all or nearly all of the breast tissue to treat breast cancer or reduce the risk of developing the disease in people at high risk. Several types of mastectomies are available, and the most appropriate approach depends on factors such as the stage and location of the cancer, genetic risk, and individual treatment goals. Breast reconstruction may be performed at the time of surgery or later, and additional treatments may be recommended before or after surgery. Understanding the procedure, recovery, and potential risks can help patients make informed treatment decisions.

In addition to a lumpectomy or mastectomy, doctors may remove and examine lymph nodes to determine whether the cancer has spread. This plays an important role in staging and treatment planning. Depending on the diagnosis, surgeons may perform a sentinel lymph node biopsy or an axillary lymph node dissection, although lymph nodes do not always need to be removed. Because lymph node surgery can increase the risk of lymphedema—a chronic condition caused by disruption of the lymphatic drainage system—understanding prevention strategies, recognizing early symptoms, and seeking prompt treatment are important parts of long-term care.

Breast reconstruction is a personal option for rebuilding the breast after a mastectomy, and it may be performed at the same time as breast cancer surgery or at a later date. Reconstruction can be done using implants, the body’s own tissue, or a combination of both, depending on a person’s anatomy, treatment plan, and preferences. Not everyone chooses or is a candidate for reconstruction, and alternatives such as breast prostheses or going flat are also valid options. Understanding the available procedures, timing, recovery, and alternatives can help patients make informed decisions about their care.

Chemotherapy uses a combination of drugs to either destroy cancer cells or slow down the growth of cancer cells. Chemotherapy is a systemic treatment, meaning that the drugs travel in the bloodstream throughout the entire body. Whether chemotherapy is recommended depends on several factors, including tumor type, tumor size, tumor grade, receptor status, lymph node involvement, and whether the cancer has spread. While chemotherapy can cause side effects, many can be managed with supportive care and medications.

Radiation therapy uses high-energy rays to kill cancer cells. It affects cells only in the part of the body that is treated with the radiation, not the entire body. Breast cancer radiation therapy may be used to destroy any remaining cancer cells in the breast or lymph nodes after surgery. In some cases, it may be used for women with metastatic breast cancer experiencing painful bone metastases. Radiation may cause some side effects that can be managed through skin care and other supportive measures.

Hormone therapy is a treatment for hormone receptor-positive (HR+) breast cancers, which grow in response to estrogen and/or progesterone. There are two main types of hormone therapy used to treat breast cancer that is HR+: selective estrogen receptor modulators (SERMs) and aromatase inhibitors (AIs). SERMs work by blocking estrogen from attaching to breast cancer cells and are most commonly used in premenopausal women. AIs help lower estrogen levels in the body and are most commonly used in postmenopausal women. Despite hormone therapy causing side effects for some, it is important to take hormone therapy as prescribed, often for a period of 5-10 years, to help reduce the risk of breast cancer recurrence by about 50%.

Targeted therapy uses drugs that block the growth of breast cancer cells, while minimizing damage to healthy cells, often resulting in fewer side effects than traditional chemotherapy. Targeted therapy may be used alongside chemotherapy, hormone therapy, or other treatments, depending on the unique characteristics of the cancer. Different targeted therapies work in different ways, including blocking cancer cell growth signals or preventing tumors from developing a blood supply.

While breast cancer treatment is necessary, many types of treatment, such as chemotherapy, radiation, hormone therapy, and others, can cause side effects. Some side effects may be temporary, resolving when treatment ends, while others may be more long-term, called late effects. Knowing what side effects to expect, and how to manage and mitigate (relieve) them, can help make breast cancer treatment easier and less stressful for some. Remember that everyone experiences cancer treatment and side effects differently, making it important to remain in close contact with your care team.

Standard treatments for breast cancer are procedures that experts agree are appropriate, acceptable, and widely used, and have been proven in treating breast cancer in the past. Clinical trials, on the other hand, are research studies that experts believe have a strong potential to improve standard treatments. Your breast cancer treatment options, whether standard or a clinical trial, will depend on the type and stage of breast cancer you have.

After active treatment ends, breast cancer survivors will need regular check-ups with their care team. These check-ups help ensure that any changes in your health are identified and addressed promptly, if needed. Your treatment team will likely see you every few months at first, then gradually space out your appointments over time. If you had more advanced breast cancer, you will likely be seen more often and for longer. It is important that you report any changes in your health to your doctor right away, even in between follow-up appointments.

Managing mental health and wellness is an important part of the breast cancer journey. Support can make a meaningful difference during treatment and beyond. NBCF offers free mental health resources for everyone, from free eBooks and guides written in collaboration with mental health experts to blog posts, support groups, and even access to online therapy.

Breast cancer treatment can affect physical, emotional, and mental well-being. Prioritizing healthy lifestyle habits during and after treatment may help improve quality of life and support recovery. Overall wellness during and after breast cancer treatment may be supported by physical activity, stress management, good nutrition, and attention to mental and emotional health.

Breast cancer survivors, particularly those receiving certain hormone therapies, may have an increased risk of developing osteopenia and osteoporosis. Regular monitoring with bone-density scans and other assessments can help identify changes early. If bone loss is detected, medications and lifestyle strategies may help strengthen and protect bone health.