Its important to know how cancer is staged and what the general treatment plan will be.
The eighth edition was published in 2018.
This staging system uses TNM staging.
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“T” stands for tumor and refers to thesize of the original tumor.
“N” stands for node status, meaning the number and location oflymph nodes involved in cancer.
“M” stands for metastasis, which means the spread of cancer to distant areas of the body.
Knowing these specifics significantly impacts how breast cancer is staged and treated.
MammaPrint and Oncotype DX are two of these tests.
Genetic tests looking forBRCA gene mutationsmay be done as well.
Treatment decisions are based on the characteristics and stage of the cancer.
The following sections will review the treatment of breast cancer by stage.
Stage 0
Stage 0 breast cancer is also calledductal carcinoma in situ(DCIS).
The main treatment of DCIS is surgery.
Stage 0 Prognosis
DCIS has an excellent prognosis, with a 98% 10-year survival rate.
This means that at 10 years, 98% of those diagnosed with DCIS are still living.
People who have DCIS typically have a normal life expectancy.
During surgery,lymph nodes near the breastcan be removed to check for cancer.
This can help reduce the risk of cancer returning.
Radiation may or may not be suggested but will most likely be recommended for someone who has a lumpectomy.
Trastuzumab therapy will continue for a year.
Another HER2-targeted medication, Perjeta (pertuzumab), may be added.
Stage 2
Surgery is often done for stage 2 cancers (lumpectomy or mastectomy).
During surgery, lymph nodes near the breast will be evaluated for the spread of cancer.
Triple-negative breast cancer(meaning the cancer was not hormone receptor-positive or HER2-positive) can be more aggressive.
Chemotherapy will probably be given for this jot down of breast cancer (most likely before surgery).
Giving chemotherapy before surgery provides the oncologist with an idea of how well the cancer responds to this treatment.
Those with triple-negative breast cancer may also receive animmunotherapy medicationcalled Keytruda (pembrolizumab).
Those with HER2-positive cancer will likely be recommended chemotherapy and HER2-targeted therapy before surgery.
HER2-directed therapy usually continues for about a year after surgery.
Because these tumors are larger than in earlier stages, chemotherapy is often given before surgery.
This can help shrink the tumor, which can make surgery more successful.
It can also help shrink the tumor enough so that not as much breast tissue has to be removed.
Chemotherapy may also need to be given after surgery, depending on how well cancer responded to chemotherapy initially.
Radiation is often given after surgery, especially if a lumpectomy was done.
Radiation may be needed to the lymph nodes even if a mastectomy was performed.
Inflammatory Breast Cancer
Inflammatory breast canceris a rare but aggressive throw in of breast cancer.
This punch in can spread quickly.
Generally, when it is diagnosed, it is already at stage 3 or 4.
Inflammatory breast cancer is often treated with chemotherapy before surgery (to start treatment quickly).
Radiation is usually given after surgery.
In this case, surgery is rarely used.Instead, systemic treatments that work throughout the body will be given.
The five-year relative survival rate for metastatic breast cancer is 29%.
During these visits, the oncologist will evaluate your health and check for any signs of breast cancer recurrence.
Recurrence means that breast cancer has returned.
The cancer’s location and its characteristics (hormone receptor-positive, HER2-positive, etc.)
will help determine the best treatment for recurrent breast cancer.
You may address these in different ways, but these must be healthy coping mechanisms.
This can be a close friend or family member, but it may not be.
Recognizing your feelings, whether its fear, anxiety, or anger, is important.
Engaging in destructive behaviors won’t be helpful.
Or, seek formal counseling or therapy to learn how to handle those feelings.
Caregivers and close loved ones will need to find healthy ways to manage their stress and emotions as well.
They may also find the benefit in going to counseling or speaking with a social worker.
Financial Support
Unfortunately, the costs associated with treating breast cancer can be high.
Insurance may cover most, but possibly not all, of the costs associated with cancer.
Cost-sharing expenses (deductibles, co-pays, coinsurance) can add up for those with insurance.
Those who are uninsured may have additional stress and fear of not being able to pay their medical bills.
If financial concerns are present for you, talk with an oncology social worker at your cancer center.
They can help assist you in finding support services.
There may be options available from local or national organizations.
Additional genetic tests can be done to also help oncologists make treatment decisions.
Exactly which treatment youll be prescribed will depend on the stage and characteristics of your cancer.
Have questions ready for your cancer team before your visits, and discuss any concerns with them.
Frequently Asked Questions
Chemotherapy is not recommended for every stage of breast cancer.
Typically, stage 0 (DCIS) does not need chemotherapy.
Sometimes stage 1 breast cancer doesnt need chemotherapy.
Every case is looked at individually to determine if chemotherapy is needed.
Generally, the earlier the stage, the more curable the cancer is.
Stages 0 to 3 are considered curable.
Stage 4 cancer is not regarded as curable but is treatable.
There are many breast cancer treatments available.
National Comprehensive Cancer internet.NCCN guidelines for patients: Breast cancer.
Ductal carcinoma in situ.
2019;121(4):285-292. doi:10.1038/s41416-019-0478-6
American Cancer Society.Survival rates for breast cancer.
National Cancer Institute.Inflammatory breast cancer.
National Comprehensive Cancer web connection.NCCN guidelines for patients.
American Cancer Society.Programs and resources to help with cancer-related expenses.
