Breast cancer is a complicated disease. Every woman experiences it differently. Treatment depends on a number of factors including the size of the tumor and how far it has spread, or the stage of the cancer. Staging is a way of summarizing your current condition. There are five basic stages, 0 through IV, and a number of sub-stages.
Staging doesn't tell the whole story. Multiple factors affect your breast cancer prognosis including:
The type of cancer you have
The speed with which the cancer is growing
Your general health and age at diagnosis
A prior history of breast cancer
Presence of female hormones or other genomic factors, such as the HER2 oncogene that makes cancer grow faster.
If you know the stage of your breast cancer, you can use this quick guide to see what kinds of treatments might help.
Treatment is not always necessary for stage 0 breast cancer. Sometimes careful observation is enough. When treatment is needed, it is usually very successful. The five-year survival rate is about 100%. Treatments differ depending on what kind of stage 0 cancer you have. Stage 0 cancer may include:
Ductal carcinoma in situ (DCIS) or intraductal carcinoma, in which abnormal cells appear in the ducts of the breast.
Lobular carcinoma in situ (LCIS) develops when abnormal cells appear in the lobes of the breast.
Paget's disease of the nipple is an uncommon type of cancer the develops in or around the nipple.
Treatments for DCIS include:
Surgery is a standard. For smaller tumors, you might get a lumpectomy, in which only the abnormal cells and some of the surrounding normal tissue are removed. Some women choose a mastectomy, in which the entire breast is removed. After a mastectomy, you might choose to have breast reconstruction surgery. Mastectomy is appropriate if a lumpectomy is unable to remove all of the in-situ cancer.
Radiation therapy is standard treatment after a lumpectomy. Radiation therapy attacks any abnormal cells that might have been missed and decreases the risk of cancer reoccurence/
Endocrine therapy with tamoxifen after surgery may also help prevent cancer from developing in the same or opposite breast. This is especially true if the tumor is estrogen receptor and/or progesterone receptor positive.
Biological therapy. In over 50% of people with DCIS, HER2 is over expressed. Herceptin, a drug which attacks the HER2 oncogene, is currently being studied in clinical trial to treat HER2-positive DCIS.
LCIS raises the risk of getting invasive breast cancer. Treatment may include:
Endocrine therapy with tamoxifen, raloxifene, or examestane to lower the risk of developing cancer.
Bilateral mastectomy -- the removal of both breasts. Historically this has been the treatment of choice to prevent breast cancer from developing in either breast. However, with the reducing risk effects of endocrine therapy, experts now think that a bilateral mastectomy is a more extreme approach than women usually need.
Paget's disease of the nipple is usually treated with surgery, without an axillary lymph node dissection, or wide local excision followed by radiation.