Our patients work with their care team to develop a breast cancer treatment plan. The plan addresses the unique medical concerns, treatment options and preferences of each patient.
Facing a breast cancer diagnosis is difficult. That is why we encourage women to ask many questions – and even get second opinions – about their breast care.
Breast cancer treatments
These options may be a part of your breast cancer treatment plan.
Your breast cancer treatment plan may include these types of surgery.
A lumpectomy removes a portion of the breas and is done to diagnose or treat breast cancer.
A mastectomy removes the breast (and usually the nipple). Factors that help determine whether this is the best option are the tumor size relative to the breast size, the number and location of tumors in the breast, family history and personal preferences.
If you choose to have a mastectomy, breast reconstruction surgery may follow. You will work with your care team to decide if and when you may choose have this surgery.
Sentinel lymph node mapping (sentinel node biopsy) helps determine if breast cancer has spread to the lymph nodes. Before the surgery, the patient may receive two injections:
A radioactive substance is injected into the breast several hours or a day before surgery.
Immediately before surgery, a blue dye is also injected near the tumor.
Both dyes move through the lymphatic system and identify the sentinel lymph node, the node to which cancer typically first spreads.
During the surgery, the sentinel lymph node(s) is removed. A pathologist examines it for signs of cancer. If no cancer is seen, more nodes are taken out during this operation. The following additional pathology studies are performed on this node(s). If cells are found by these special studies, additional surgery may be performed at a later date to remove more lymph notes.
Chemotherapy uses drugs usually given by mouth or injection into a vein or muscle to kill cancer cells or stop them from dividing. It may be used to cure breast cancer, keep it from spreading or ease symptoms
Radiation therapy uses high powered X-rays or radioactive seeds to kill or damage breast cancer cells to keep them from dividing.
This breast cancer treatment may be used to:
shrink a breast tumor as much as possible before surgery
prevent cancer from returning after surgery
provide temporary relief of breast cancer symptoms
treat breast tumors that cannot be removed with surgery.
Hormone therapy can help keep cancer from coming back after breast cancer treatment. It is also used for advanced breast cancer. This breast cancer treatment often uses medicine to interfere with or lower estrogen, a hormone made by a woman's ovaries. Estrogen promotes the growth of forms of breast cancer that have estrogen receptors (ER-positive cancer) and/or progesterone receptors (PR-positive cancer).
During hormone therapy, your doctor may have you take one of these prescribed medicines:
Tamoxifen and toremifene (Fareston) temporarily block estrogen receptors on breast cancer cells, preventing estrogen from binding to them. They are taken daily as a pill.
Fulvestrant (Faslodex) eliminates estrogen receptors on breast cancer cells. It is given as an injection.
Aromatase inhibitors block an enzyme that makes small amounts of estrogen in post-menopausal women. Taken as pills, they include letrozole (Femara), anastrozole (Arimidex), and exemestane (Aromasin).
Hormone therapy for breast cancer differs from hormone replacement therapy, a treatment for menopause symptoms.
Source: American Cancer Society, Breast cancer hormone therapy; Virginia Piper Cancer Institute Reviewed by: Timothy Sielaff, MD, PhD, FACS, president, Virginia Piper Cancer Institute; Carol Bergen, RN, manager, Piper Breast Center; Deborah Day, MD, medical director, Piper Breast Center; Tamera Lillemoe, MD, pathologist First Published: 08/25/2009 Last Reviewed: 08/25/2009
Whether you are a breast cancer survivor or are undergoing cancer treatment, you may face symptoms that interfere with daily life. Our cancer rehabilitation team can help you overcome:
Participating in a clinical trial may help you take a more active role in your health care. You may also gain access to new drugs, treatments and disease management practices.
Breast cancer stages
Your doctors will use a variety of information like X-rays and biopsy results to determine the stage of your cancer.
When diagnosed with breast cancer, you will be told what stage the cancer is at. This can help you and your care team determine your goals, treatment options and outook.
Classification
Goal
Treatment options
Stage 0 or DCIS (ductal carinoma in situ) is the earliest, most treatable stage of breast cancer.
Cure the cancer and keep it from coming back.
lumpectomy or mastectomy
radiation therapy
Stage I is when the breast cancer tumor is 2 centimeters wide or less. It has not spread to other areas of the body.
Cure the cancer and keep it from coming back..
lumpectomy or mastectomy
radiation therapy
sentinel lymph node biopsy
chemotherapy
hormone therapy
Stage II is when the breast cancer tumor is more than 2 centimeters wide. It has spread to nearby lymph nodes.
Treat the cancer to keep it from coming back.
lumpectomy or mastectomy
radiation therapy
sentinel lymph node biopsy
chemotherapy
hormone therapy
Stage III is when the breast cancer tumor is 5 centimeters wide or larger. It may have spread to nearby lymph nodes or grown into the chest wall or skin. Sometimes, the tumor cannot be found, but cancer is found in nearby lymph nodes or tissue.
Treat the cancer and keep it from coming back.
lumpectomy or mastectomy
sentinel lymph node biopsy
chemotherapy
hormone therapy
Stage IV is the most advanced stage of breast cancer. It is metastatic breast cancer; the cancer has spread to other organs or lymph nodes far from the breast.
A five-year survival rate takes into account the percentage of patients who live at least five years after being diagnosed with cancer. A five-year relative survival rate acknowledges that some patients may die from other causes besides cancer.
Survival statistics offer general information; they do not determine anyone's personal outlook or breast cancer prognosis. Ask your doctor or other breast cancer care team member how such numbers apply to you.
The numbers on the table above are based on women who were diagnosed with breast cancer between 1988 and 2001.
The term "metastatic" refers to the metastases or spread of cancer to other parts of the body.
Metastatic breast cancer began in the breast, but can spread beyond that area. It can go to lymph nodes, in the armpit or to other organs like the lungs, liver, bones, etc.
Cancer is named according to where in the body it began. If cancer began in the breast and spread to another part of the body, for example, the lungs, it will still be called breast cancer or metastatic breast cancer.
Lymphedema is the swelling of a body part (usually arms or legs) as a result of poor drainage of fluid from the area. This can occur after radiation or removal of lymph nodes.
Your lymphatic vessels are a network of thin vessels that help move lymph fluid through your body and lymph nodes. This process helps drain extra fluid from body tissue.
Your lymph nodes filter the lymphatic fluid and help protect you from infection.
When lymph nodes are removed or treated with radiation, your lymphatic system is damaged. This protein-rich lymphatic fluid can build up in your tissues and cause swelling.
Your health care provider will talk with you about how to treat lymphedema.
Exercise is important to stimulate the flow of lymph fluids. A specific exercise program will be created just for you. It will have flexibility, strengthening and aerobic (heart) exercises. You will learn how to do this exercise program at home.
Education is important because if you have lymphedema, you have a higher risk of getting infections. You will learn the signs of infection and to care for your skin. If you follow these precautions, your risk can be lowered. You will also learn what activities may increase your risk (such as working in a garden) and how you can adapt those activities to fit your needs.
Compression therapy uses pressure with low-stretch bandages supports your lymphatic vessels. This helps keep the lymph fluid moving. You will learn how to put on the bandages, and when and how often you should wear them. When appropriate, you will be fit for compression garment(s).
Massage (manual lymphatic drainage) can help break down the lymph fluid and move it to other areas of your body. Massage also stimulates growth of tissue to help with moving the fluid.
Source:Allina Patient Education, How To Manage Lymphedema, pt-ahc-14216 (4/07) Reviewed by: Nancy Hutchison, MD, medical director for cancer rehabilitation and lymphedema at Sister Kenny Rehabilitation Institute and Virginia Piper Cancer Institute; Timothy Sielaff, MD, PhD, FACS, president, Virginia Piper Cancer Institute; Carol Bergen, RN, manager, Piper Breast Center; Deborah Day, MD, medical director, Piper Breast Center; Tamera Lillemoe, MD, pathologist First Published: 08/25/2009 Last Reviewed: 11/05/2009
Surgery