Treatments by Breast Cancer Stage
Treatment Options Stage III Breast Cancer
In stage III, breast cancer has not spread beyond the breast and nearby lymph nodes. However, the tumor may be large (over 5 cm in size) and multiple lymph nodes may be involved. With Stage 3A, 4-9 lymph nodes are involved. In stage 3C, greater than 10 lymph nodes are involved. In addition, the cancer may have spread to the chest wall, the skin of the breast, or skin lymphatics (stage 3B). However, even though the breast cancer is more advanced, the eight-year survival rate is still about 40%. This means that 40% of these women will live eight years, or longer,after diagnosis. A combination of different treatments often works best and may include:
- Chemotherapy. Chemotherapy is often used before surgery (neo-adjuvant therapy) to shrink the tumor and make it easier to remove. You may still need chemotherapy after surgery (adjuvant therapy) to help destroy any cancer cells that remain. In cases where surgery isn't an option, chemotherapy may be the main treatment.
- Surgery. You might get a lumpectomy, if the neo-adjuvant therapy such as chemotherapy shrinks the tumor to the point in which a surgeon can remove the tumor and surrounding tissue from the breast. This is possible in stage 3A breast cancer. However, for stage 3B and 3C breast cancers, you need a mastectomy, in which the whole breast is removed as well lymph nodes. A mastectomy should be performed after neo-adjuvant chemotherapy. After a mastectomy, you might choose to get breast reconstruction surgery.
- Endocrine 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 women and the aromatase inhibitors Arimidex, Aromasin, and Femara for postmenopausal women. Hormone therapy may be used before or after surgery, but not in combination with chemotherapy. 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 or taking drugs to stop the ovaries from making hormones that help cancer grow.
- Biological therapy. In about 25% of women with breast cancer, an excess of a protein known as HER2 makes the cancer spread quickly. Herceptin is a 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. Multiple clinical trials have shown an improved outcome when Herceptin was added to chemotherapy, and continued for a total of one year, in women with HER2-positive breast cancer. For HER2-negative breast cancer in postmenopausal women, Afinitor is used with exemestane after other treatments have been tried. Afinitor is for advanced hormone receptor-positive cancer.
- Radiation therapy is standard for women with stage III cancer who get surgery, including those who have a mastectomy. Radiation can destroy any of the cancer cells that were missed during surgery.
- 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, such as new drugs, new treatments, and new combinations are in current clinical trials.
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