If you have breast cancer, you have more treatment options than ever before. Some take less time, are safer, and are easier on your body. Others target the specific glitch in your cells that allows the cancer to survive or grow. But no matter which one you and your doctor choose, the goal is the same: get rid of the cancer so it doesn't come back.
How Do I Choose the Right Treatment?
To start, you and your doctor will want to know:
- 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
- How fast it will grow
- How likely the cancer is to spread or come back after treatment
- How well certain therapies will work for you
- Your age and how healthy you are
- The option you’d prefer
These details will help your doctor recommend some treatments that could work well for you.
What Are My Options?
The most common treatments for breast cancer are:
- Surgery. For most people, the first step is to take out the tumor. An operation called lumpectomy removes only the part of your breast that has cancer. Sometimes it’s called breast-conserving surgery. In a mastectomy, doctors remove the whole breast. Be sure to discuss the pros and cons of both types of surgery with your doctor. Often, removal of your whole breast does not work better or help you live longer.
- Radiation. This treatment uses high-energy waves to kill cancer cells. Most women under age 70 who have a lumpectomy get radiation, too. That helps destroy any cancer cells that the surgeon couldn’t remove. Doctors also might recommend this method if the disease has spread. Radiation can come from a machine outside your body. Or you can get tiny seeds that give off radiation placed inside your breast where the tumor was.
In the past, people had radiation every day for many weeks. But it works just as well to get the same total amount of radiation in less time. It’s also safer and causes fewer side effects. Ask your doctor if shorter therapy is an option for you.
- Chemotherapy. During chemo, you take drugs as pills or through an IV to treat the disease throughout your body. Most people get it after surgery to kill any cancer cells left behind. Doctors also prescribe it before surgery to make tumors smaller. Chemo works well against cancer, but it also can harm healthy cells. This can cause side effects such as hair loss, mouth sores, and nausea.
- Hormone therapy. In some breast cancers, the hormones estrogen and progesterone can make cancer cells grow. This treatment blocks these hormones.
- Targeted therapy. These fight the changes in cells that lead to cancer. For instance, some cells have too much of a type of protein, which makes them grow too much. Drugs can block how these proteins work. Targeted treatments often have fewer side effects than those that affect the whole body, like chemo.
Are There Side Effects?
Most breast cancer treatments cause side effects. Many, like nausea, go away when the therapy stops. But some may show up later. They’re called late effects, and they include:
- Symptoms of menopause, such as hot flashes
- Trouble getting pregnant
- Trouble sleeping
- Changes in the way your breast looks
- Trouble thinking clearly ("chemo brain")
What Else Should You Know?
You and your doctor will decide on your treatment together. When you’re choosing, think about:
- The risks. Talk to your doctor about the pros and cons of each option.
- Side effects. How will the way you feel affect your life?
- Whether you really need it. Some women do well with milder or shorter treatments.