In stage III, the cancer still hasn't spread far beyond the breast and nearby lymph nodes. However, in this stage there typically are many lymph nodes involved or the tumor is so large it extends to the chest wall or involves the skin of the breast. Even though the breast cancer is more advanced, the five-year survival rate is still about 41% - 67%. This doesn't mean that these women will only live five years. Doctors just measure success rates for cancer treatment by seeing how women are doing five to 10 years after treatment. A combination of different treatments often works best.
Chemotherapy is a common treatment for stage III breast cancer. This approach can help destroy cancer cells that remain after surgery. Chemotherapy may sometimes be used before surgery. It can shrink the tumor to make it easier to remove. You would still need chemotherapy after surgery. In cases where surgery isn't an option, chemotherapy may be the main treatment.
Surgery is an option for many women. You might get a lumpectomy, in which a surgeon removes the tumor and surrounding tissue from the breast. Or you might need a mastectomy, in which the whole breast is removed. The surgeon would also remove lymph nodes. After a mastectomy, you might choose to get breast reconstruction surgery. For larger tumors, you may need chemotherapy before surgery.
Radiation therapy is often recommended for women with stage III breast cancer who get surgery. Radiation can destroy cancer cells that were missed.
Hormone therapy can help women with hormone receptor-positive cancers. In these women, medications can 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, or Femara for postmenopausal women. It may also be used as a primary treatment if surgery isn't possible. Women who haven't reached menopause may consider having their ovaries removed to stop them from making hormones that help cancer grow. Drugs can also stop the ovaries from secreting hormones.
Biological therapy is a newer 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 III breast 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."