The treatment you'll have for breast cancer depends on:
- the size and type of breast cancer you have
- where it is
- if it has spread to other parts of your body
- your general health
The main treatment for breast cancer is usually surgery.
Other common treatments include:
- radiotherapy
- chemotherapy
- treatment with hormones (hormone therapy)
- targeted therapy
- immunotherapy
You may have 1 or more of these treatments.
Your breast cancer treatment plan
If you have cancer, you will have a team of specialists who will work together to give you the best treatment and care.
Your care team will talk to you about your treatment plan.
When deciding what treatment is best for you, your care team will consider:
- the stage and grade of your cancer (how far it has spread and how quickly the cancer takes over)
- your general health
- if you have have gone through menopause
You should be able to talk about your treatment with your care team at any time and ask questions.
Treatment by cancer stage
Breast cancer diagnosed at screening is often at an early stage. But if your breast cancer is diagnosed when you have symptoms, it may be at a later stage.
Treatment for secondary (advanced) breast cancer
Most breast cancers are found at an early stage. But some women find out that they have breast cancer after it has spread to other parts of the body (metastases).
This is called secondary cancer, advanced cancer or metastatic cancer. It is not curable.
If you have secondary breast cancer, your treatment will aim to control it.
Many women live for a few years with secondary breast cancer, enjoying a good quality of life.
Surgery
Surgery (an operation) is usually the first type of treatment for breast cancer. The type of surgery you have will depend on the type of breast cancer you have.
Other treatment you may have includes:
- radiotherapy - after surgery
- medicines - before or after surgery
It depends on the type of breast cancer you have.
Types of surgery for breast cancer
There are 2 main types of breast cancer surgery:
- breast-conserving surgery (lumpectomy) - this removes the tumour from your breast
- mastectomy - a surgery that removes your whole breast
If you have a mastectomy you may also have surgery to make a new breast shape that looks like your other breast as much as possible. This is called breast reconstruction.
Breast-conserving surgery
Breast-conserving surgery will remove the tumour and a little surrounding breast tissue.
The amount of breast tissue you have removed will depend on the:
- type of cancer you have
- size of the tumour and where it is in your breast
- amount of surrounding tissue that needs to be removed
- size of your breasts
Further testing for cancer
Your surgeon will remove an area of healthy breast tissue around the cancer. They will test it for cancer.
If there is no cancer found in the healthy tissue, there's less chance that the cancer will return.
Further treatment
If there are cancer cells in the surrounding tissue, you may need more surgery. This will remove more tissue from your breast.
After having breast-conserving surgery, you may have radiotherapy. It is as successful as a total mastectomy at treating early-stage breast cancer.
Mastectomy
A mastectomy is a surgery to remove all breast tissue, including your nipple.
Sentinel lymph node biopsy
You will usually have surgery to remove some lymph nodes in your armpit.
This often happens at the same time as a mastectomy.
Sentinel lymph nodes are the first lymph nodes that the cancer cells reach if they spread. This is why they are checked for cancer with a sentinel lymph node biopsy.
What happens in a sentinel lymph node biopsy
Dyes are used to find the lymph nodes. A combination of a radioactive dye (radioisotope) and a blue dye (tracers) are used.
The sentinel lymph nodes are sent to a laboratory. There they are checked under a microscope for cancer. If any cancer cells are found it is a sign the cancer has spread.
You may need more surgery to remove more lymph nodes from under your arm.
Radiotherapy
Radiotherapy uses radiation to kill cancer cells. It's usually given after cancer medicines or surgery to remove cancer.
Radiotherapy lowers the risk of the cancer returning.
What to expect
If you need radiotherapy, your treatment will begin within:
- about 3 months after your surgery
- a month after finishing chemotherapy
This is to give your body a chance to recover.
You'll probably have radiotherapy sessions 5 days a week, for either:
- 1 week
- 3 to 6 weeks
Each session will only last a few minutes.
Your radiotherapy specialist will talk to you about the treatment and side effects.
Cancer medicines
Your care team may recommend treatment with cancer medicines. These will be to either kill or slow the growth of cancer cells.
Chemotherapy
Chemotherapy uses medicines to kill cancer cells.
It is also known as cytotoxic chemotherapy or cytotoxic cancer medicine. Cytotoxic means toxic to cells.
Hormone therapy
A hormone therapy can:
- lower the amount of certain hormones in your body
- block certain hormones from getting to cancer cells
You will only be offered hormone therapy for cancer if you have a type of cancer that depends on hormones to grow.
Immunotherapy
Immunotherapy medicines can either:
- use your immune system to find and kill cancer cells
- boost your immune system and help it work better to fight cancer cells
You may have tests to check if immunotherapy is likely to work for you. These are called biomarker tests.
Targeted therapy
Targeted therapy uses medicines to find and attack cancer cells.
Targeted therapy medicines target parts of cancer cells that have gene changes (mutations) that make them different from normal cells.
You will only be offered targeted therapy if your cancer has these gene changes.
You may have tests to check if targeted therapy is likely to work for you. These are called biomarker tests.
Content supplied by the NHS and adapted for Ireland by the HSE
