2.1 Breast Cancer Treatment

2.1.1 Making Decisions About Your Treatment

You will inevitably have to make decisions about your treatment plan. To do so, you need to know what your individual needs are. For example, you might consult your healthcare team regarding decisions or prefer to discuss them with close friends and family, or maybe you want to make all the decisions yourself. Either way, you have the most influence over what happens.

To understand your treatment options, you must understand the stage of breast cancer you have (Canadian Breast Cancer Network [CBCN], 2022). This understanding will ensure you have the appropriate information to make an informed decision. Other factors to consider when deciding your treatment plan are your beliefs about health, your age, and your lifestyle.

2.1.2 Breast Cancer Treatment by Stage

Breast cancer treatment changes based on the stage of your breast cancer.

As a refresher, here are the breast cancer stages listed in Chapter 1:

• Stage 0 — the cancer is not invading any surrounding structures (e.g., tissue) and is still inside the milk duct.
• Stage I — the cancer has not spread far into the lymph nodes, and if it has, it is in the sentinel lymph node.
• Stage II — the cancer has spread to some nearby lymph nodes.
• Stage III — the cancer has spread into the surrounding tissue and or many nearby lymph nodes.
• Stage IV — the cancer has spread into different parts of your body (metastasized). (American Cancer Society, 2019)

Stage I

If you have stage I breast cancer, then you have a few different treatment types, including local and systematic drug therapy (American Cancer Society, 2019).

Local therapies are the most common treatment methods, which include surgery and radiation therapy (American Cancer Society, 2019). Surgeries, such as breast-conserving surgeries and mastectomies, remove the cancer, while radiation lowers the chances of cancer recurrence. You might receive surgery without radiation therapy, or you might have both, depending on factors like your age and the cancer’s progression.

Systematic drug therapies, such as hormone therapy and chemotherapy, are used if you have hormone receptor-positive breast cancer (e.g., HER2) (American Cancer Society, 2019). Your treatment will likely include both hormone therapy and chemotherapy, but again, this depends on your age and the cancer’s progression.

The 5-year relative survival rate for stage I breast cancer is 100% (Canadian Cancer Society, n.d.14).

Stage II

Like stage I, stage II breast cancer can be treated with local and systematic drug therapies (American Cancer Society, 2019).

The 5-year relative survival rate for stage II breast cancer is 92% (Canadian Cancer Society, n.d.14).

Stage III

Unlike stage I and II, stage III breast cancer has three main treatment plans (American Cancer Society, 2019a). The most common one involves receiving chemotherapy treatment before having surgery; the goal is to make the surgery less invasive by attempting to decrease the size of the cancer first. If your breast cancer is hormone receptor-positive, then you might start by receiving hormone therapy before having surgery instead. Lastly, there is the option of having surgery first and then proceeding with other treatment options. Talk to your healthcare team to determine which treatment plan works best for your cancer.

The 5-year relative survival rate for stage III breast cancer is 74% (Canadian Cancer Society, n.d.14).

Stage IV

Treatment for stage IV breast cancer typically uses systematic drug therapies, including hormone therapy and chemotherapy (American Cancer Society, 2023). These treatments help decrease the size of tumours, manage symptoms, and extend life expectancy. Specific situations may require surgery and radiation therapy.

The 5-year relative survival rate for stage IV breast cancer is 23% (Canadian Cancer Society, n.d.14).

See Image 9 stages of cell changes that occur when normal duct epithelium of the breast becomes cancerous (Huckfinne, 2010).

Chapter 2: Learning Activity

Drag and drop the terms to match the description of each stage of breast cancer.