In stage II, the cancer is still contained within the breast and in some cases in nearby lymph nodes. Several treatments may help. You would likely use a combination of them.
Treatments
Surgery is standard. For smaller tumors, you might get a breast conserving surgery, or lumpectomy, in which only the tumor and some of the tissue around it are removed. For larger tumors, you might need a mastectomy, in which the breast is removed. In either case, the surgeon will likely remove some of the lymph nodes. After a mastectomy, you might choose breast reconstruction surgery.
Radiation therapy usually follows a lumpectomy. It can kill cancer cells that were missed during surgery. Some women who get a mastectomy will also have radiation, especially if the tumor was large or there were cancer cells in the lymph nodes.
Chemotherapy after surgery can help destroy remaining cancer cells that were missed. Some people have chemotherapy before surgery to try to shrink a tumor. If it works, the tumor might then be small enough to remove with a lumpectomy.
You can get chemo several different ways. You may take pills or liquids, but often the drugs are put right into your veins. Depending on the type of treatment, it may be given in cycles that allow your body breaks in between.
Hormone therapy after surgery may help women who have hormone receptor-positive cancer. That means the cancer needs hormones to grow. Medicines can prevent the tumor from getting the hormones. These drugs include tamoxifen for all women, and anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara) for postmenopausal women. There are also other estrogen receptor blockers: elacestrant(Orserdu), fulvestrant (Faslodex) and toremifene (Fareston), for metastatic breast cancer.
Women who haven't reached menopause may consider having their ovaries removed to stop them from making hormones that help cancer grow. They also can take a drug, such as goserelin (Zoladex) or leuprolide (Lupron), to stop their ovaries from releasing 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. Ado-trastuzumab emtansine (Kadcyla); fam-trastuzumab deruxtecan (Enhertu); lapatinib (Tykerb); margetuximab (Margenza); neratinib (Nerlynx); pertuzumab (Perjeta); trastuzumab (Herceptin); trastuzumab-hyaluronidase-oysk (Herceptin Hylecta); trastuzumab-pertuzumab-hyaluronidase (Phesgo); and tucatinib (Tukysa), treat women with HER2-positive cancer. They stop this protein from making the cancer grow and can make some chemotherapy more effective. It’s often used in combination with chemotherapy.
Clinical trials are open to many women with stage II 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.
