This is a very early stage of breast cancer. The cancer either hasn't spread beyond the breast at all or has spread in a very small amount to a lymph node. So you have a number of good treatments to choose from. The five-year survival rate for women with stage I breast cancer is about 88%. This doesn't mean that these women will only live five years. In fact, doctors usually measure success rates for cancer treatment by seeing how women are doing five years after treatment. Women usually do well with a combination of treatments. Here are your basic options:
Surgery for this stage of breast cancer is a standard. Since the tumor is still small, you may get a lumpectomy. In this procedure, just the tumor and some of the surrounding tissue are removed. Some women get a mastectomy, in which the whole breast is removed. In either case, the surgeon will likely take out one or more of the lymph nodes. After a mastectomy, you might choose to get breast reconstruction surgery. Surgery treats the disease of which we are aware. The other treatments of radiation, chemotherapy, and/or hormone therapy are considered "adjuvant" (added) treatments for occult (or hidden) disease. They are used to reduce risk of breast cancer recurrence.
Radiation therapy is usually given after a lumpectomy. It can kill off cancer cells that were missed. Women with stage I cancer who get a mastectomy sometimes need radiation.
Chemotherapy is treatment with drugs that attack cancer cells. It's often used after surgery to lower the risk of the cancer coming back. Women who had larger tumors are more likely to need it.
Hormone therapy is sometimes used after surgery in women who have hormone receptor-positive cancer (tumors whose growth seems dependant on estrogen). In these women, medications can help prevent the tumor from getting the hormone it needs to grow. These drugs include tamoxifen for premenopausal or postmenopausal women and newer aromatase inhibitors like Arimidex, Aromasin, and Femora for postmenopausal women. Women who haven't reached menopause may consider having their ovaries removed to stop them from making hormones that help cancer grow. Again, women with larger tumors are more likely to need hormone therapy.
Biological therapy is a new approach. In about 25% of women with breast cancer, an excess of a protein known as HER2 makes the cancer spread quickly. Herceptin is a new drug that's been approved to treat women with metastatic breast cancer that is HER2-positive. It stops this protein from making the cancer grow and makes chemotherapy more effective. It is most often used in combination with chemotherapy.
Clinical trials are open to many women with stage I cancer. A clinical trial may allow you access to cutting-edge treatments. Many new therapies -- new drugs, new treatments, and new combinations -- are in clinical trials now. Keep in mind that any successful treatment we have now started out in a clinical trial.
American Cancer Society.
National Comprehensive Cancer Network.
Clinical Practice Guidelines in Oncology, Breast Cancer, v.1.2004.
National Cancer Institute: "Breast Cancer PDQ: Treatment, Health Professional Version," "Breast Cancer PDQ: Treatment, Patient Version," "Understanding Breast Cancer: A Guide for Patients," and "What You Need to Know about Breast Cancer."