Breast cancer treatments are getting better all the time, and people have many more options today than ever before. With so many choices, it’s a good idea to learn as much as you can about the ones that can help you the most.
No matter which ones you choose, all breast cancer treatments have two main goals:
- To rid the body of as much of the cancer as possible
- To prevent the disease from coming back
How Do I Know Which Breast Cancer Treatment to Choose?
Your doctor will think about a few things before she recommends a treatment for you:
- The type of breast cancer you have
- The size of your tumor and how far the cancer has spread in your body, called the stage of your disease
- If your tumor has things called "receptors" for HER2 protein, estrogen, and progesterone, or other specific features.
Your age, if you’ve gone through menopause, other health conditions you have, and your personal preferences also play a role in this decision-making process.
What Are the Types of Breast Cancer Treatment?
Some treatments remove or destroy the disease within the breast and nearby tissues, such as lymph nodes. These include:
- Surgery to remove the whole breast, called a mastectomy, or to remove just the tumor and tissues around it, called a lumpectomy or breast-conserving surgery. There are different types of mastectomies and lumpectomies.
- Radiation therapy, which uses high-energy waves to kill cancer cells.
Other treatments destroy or control cancer cells all over the body:
- Chemotherapy uses drugs to kill cancer cells. As these powerful medicines fight the disease, they also can cause side effects, like nausea, hair loss, early menopause, hot flashes, and fatigue.
- Hormone therapy uses drugs to prevent hormones, especially estrogen, from fueling the growth of breast cancer cells. Medicines include tamoxifen (Nolvadex) for women before and after menopause and aromatase inhibitors including anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara) for postmenopausal women. Side effects can include hot flashes and vaginal dryness. Some types of this therapy work by stopping the ovaries from making hormones, either through surgery or medication. Fulvestrant ( Faslodex) is an injection that keeps estrogen from attaching to cancer cells.
- Targeted therapy such as fam-trastuzumab-deruxtecan-nxki (Enhertu), lapatinib (Tykerb), pertuzumab (Perjeta), and trastuzumab (Herceptin) prompt the body’s immune system to help destroy cancer cells. These medicines target breast cancer cells that have high levels of a protein called HER2. T-DM1 or ado-trastuzumab emtansine (Kadcyla) is a medicine that combines Herceptin and the chemotherapy medicine emtansine to target HER2 positive cancer cells. Abemaciclib (Verzenio), palbociclib (Ibrance), and ribociclib (Kisqali) are often used with an aromatase inhibitor or fulvestrant (Faslodex), in women with certain types of advanced cancer. Abemaciclib (Verzenio) can be used alone in women who have already been treated with hormone therapy and chemotherapy. Alpelisib (Piqray) is a PI3K inhibitor that treats breast cancer in men and women who have a certain mutation resulting from treatment with hormonal therapy. Neratinib (Nerlynx) also works against HER2-positive breast cancer by blocking the cancer cells from receiving growth signals.A new class of drugs called PARP (poly ADP ribose polymerase) inhibitors targets an enzyme that feeds cancer cells. PARP inhibitors include olaparib (Lynparza) and talazoparib (Talzenna).
- Immunotherapy uses the body’s own immune system to target cancer. The drug atezolizumab (Tecentriq) has been approved as first line treatment for those with triple negative breast cancer which has spread.
You might get chemotherapy, hormone therapy, or targeted therapy along with surgery or radiation. They can kill any cancer cells that were left behind by other treatments.
Tips to Help You Choose
Although there are some typical breast cancer treatment regimens, women do have choices.
- Talk with your doctor about all the risks and benefits of each treatment option and how they will affect your lifestyle.
- Think about joining a support group. Other people with breast cancer know what you’re going through and can give you advice and understanding. They might help you decide on a treatment, too.
- Ask your doctor if you should join a clinical trial, a research study that tests new treatments before they’re available to everyone.