Breast Cancer Treatments: What You Need To Know

There are many different breast cancer treatments available depending on your stage of breast cancer and your individual needs as a patient.

The most common treatments include surgery, radiation therapy, chemotherapy, hormone and targeted therapies, immunotherapy, as well as supplementary treatments to manage the side effects of chemotherapy.

Surgery

Surgery is a standard treatment for most stages of breast cancer and can be curative. Surgery aims to eliminate the main location of the cancer cells and will reduce the chance of future spreading. 

Surgery may also be a preventative measure for those with a high chance of developing breast cancer.

The two major surgeries for breast cancer are mastectomy and lumpectomy. Your doctor will advise as to the best option for you based on the size of the tumor.

Mastectomy

A mastectomy is the surgical removal of breast tissue. It usually involves removing the entire breast. 

If cancer cells are found in one or both breasts, this surgery will usually be recommended as the most effective treatment option. Sometimes axillary lymph nodes will be removed as well to ensure cancer hasn’t spread beyond the breast tissue. 

Breast reconstruction surgery can also be performed following the procedure to preserve the appearance of the breast. This is a type of plastic surgery in which a breast implant is inserted to recreate a natural breast shape. This surgery is elective and not necessary for removing cancer cells.

Lumpectomy

A lumpectomy is a type of “breast-conserving” surgery that does not involve the complete removal of breast tissue. Instead, this surgery involves only the removal of cancerous cells or tumors.

This is usually recommended for breast cancer that is isolated to just one location in the breast.

This surgery is relatively non-invasive, and patients will usually return home shortly after the surgery to rest and recover in comfort.

Reconstructive surgery is another option for those who have undergone a mastectomy.  

Radiation therapies

Radiation is recommended in instances where surgery is not possible or if there is a concern that cancer has spread beyond the surgical area. It is sometimes used alongside chemotherapy to try to eliminate any spread of disease and help improve symptoms such as pain, weakness, appetite, etc.

Radiation therapy targets and kills breast cancer cells with a high-powered x-ray. The therapy is administered five days a week for about seven weeks, although this will largely be decided by your doctor.

Radiation therapy can also significantly reduce your risk of recurrent breast cancer.

Imaging tests may be required to plan exactly where the radiation beam will be focussed to ensure the best results and fewer side effects. 

Side effects from radiation therapy can include localized pain, swelling, and redness. Some patients may also experience nausea in the short term while undergoing treatment.

Chemotherapy

Chemotherapy is probably one of the most well-known forms of breast cancer treatment available. This treatment uses very intense and powerful drugs to destroy cancer cells throughout the body. It is usually delivered orally, via an intravenous drip, or direct injection into the spinal cord.

Not every breast cancer patient will be a good candidate for chemotherapy, so it is important to seek advice from a trusted healthcare provider. 

In general, chemotherapy is offered to patients who have advanced or metastatic breast cancer that has spread to the lymph nodes and other areas throughout the body. 

Chemotherapy is also given before a mastectomy or lumpectomy to reduce the size of the tumor to make surgery less invasive and more effective. It may also be administered after surgery to destroy any lingering cancer cells and is known to improve breast cancer survival rates. 

Currently, there are three chemotherapy drugs used to treat breast cancer. Most patients will receive a mix of all three for maximum effectiveness. These may include docetaxel (also known as Taxotere), doxorubicin (also known as Adriamycin), capecitabine, and cyclophosphamide (also known as Cytoxan). 

Chemotherapy treatments are applied for two to three weeks, followed by a period of rest to help the body recover. Regular blood tests may be required to monitor for toxicities including bone marrow suppression.

Hormone therapy

About two-thirds of all breast cancer diagnoses in the United States are hormone-receptor-positive cases. These cancer cells express estrogen or progesterone on their surface which stimulates their growth. Hormone therapies (also known as endocrine therapies) block these two hormones from adhering to breast cancer cells, which stops the spread of cancer.

This type of treatment is usually given after a mastectomy or lumpectomy to reduce the chance of breast cancer returning significantly.

Unlike many other treatments, hormone therapy is long-term and will typically be administered for ten or more years.

Targeted therapy

Targeted therapy is not used as often as other forms of breast cancer treatment, but it can be effective for certain cases.

This type of treatment uses a mix of different drugs to destroy cancer cells in the body via the bloodstream. These drugs attack cancer cells without damaging healthy cells, resulting in fewer side effects compared to chemotherapy. The main receptor in breast cancer is HER2.

Targeted therapy for breast cancer will usually be used to treat HER2-positive cancers. These types of breast cancers produce a large amount of the HER2 protein, which is responsible for the growth of breast cancer cells.

Common types of targeted therapy drugs include:

• Monoclonal antibodies: These include trastuzumab (also known as Herceptin) which are synthetic antibodies that adhere to HER2 proteins to stop cancer cells from growing and spreading.

• Antibody-drug conjugates: These include ado-trastuzumab emtansine (also known as Kadcyla or TDM-1). These conjugates adhere to HER2 proteins on breast cancer cells to help chemotherapy drugs target them specifically.

• Kinase inhibitors: These include Lapatinib (also known as Tykerb) which are inhibitors that block HER2 proteins.

• CDK4/6 inhibitors: These inhibitors are designed to treat individuals with hormone receptor-positive breast cancers. They block CDK proteins present within cancer cells to stop them from dividing to slow cancer growth.

• mTOR inhibitors: These inhibitors are designed to treat individuals with hormone receptor-positive breast cancers. These inhibitors block mTOR proteins present in cancer cells to slow or stop growth and division. This treatment can help hormone therapy medications work more efficiently and effectively.

• PI3K inhibitors: These inhibitors are designed to treat individuals with hormone receptor-positive breast cancers as they block PI3K proteins and stop the growth of cancer cells.

Immunotherapy

Immunotherapy is a promising breast cancer treatment¹ approved for use by the FDA since 2017 for any unresectable or metastatic solid tumor.

This therapy involves stimulating the body’s immune system to destroy cancer cells on its own, rather than using invasive treatments to target cancer cells and potentially suppressing the immune system. 

Immunotherapy has fewer side effects compared to radiation therapy or chemotherapy. One main side effect of immunotherapy is overstimulation of the immune system resulting in autoimmune disease.

One such form of immunotherapy used is the immune checkpoint inhibitor called Pembrolizumab. A study from 2016 found that approximately 37% of patients that suffer from triple-negative breast cancers benefited from immunotherapy². New immunotherapies are being researched regularly. 

Supplemental therapies and treatments

In addition to surgical procedures and therapies, there are additional treatments that you may use to treat the side effects of invasive treatments.

Therapeutic massage can help nervous patients relax, especially if they experience illness following chemotherapy or radiation therapy.

Peppermint tea has also been found to help ease nausea experienced by chemotherapy patients.

Similarly, the use of cannabis³ is also believed to help cancer patients retain their appetite during chemotherapy or radiation therapy, in addition to its pain-relieving qualities.

Maintaining a healthy lifestyle, quitting smoking and minimal alcohol intake may improve outcomes as well. 

The lowdown

If you or a loved one have been diagnosed with breast cancer, your doctor will likely recommend a variety of treatment options and will be transparent with you about their side effects and chances of success.

Many factors play into what treatment will be recommended, such as age, cancer stage, medical history, and family history.

For example, treatments used for early-stage breast cancer may not be as effective for advanced-stage breast cancer.

Breast cancer may be daunting, but the good news is that there are many treatments available. At each stage of cancer, there are at least a handful of possible treatment options.

In general, many breast cancer patients will receive a combination of two or more treatments for the best results.

Knowing the costs of different breast cancer treatments can help you understand what’s ahead. And accessing support from awareness groups and charity organizations can go a long way in reducing the burden of care.