Breast cancer treatment options
For Stage 0
Non-invasive cancers: Ductal carcinoma in situ (DCIS or intraductal carcinoma Most patients with a single, small lesion are candidates for lumpectomy plus radiation therapy. Consider hormonal/endocrine therapy.
For Stage I
When cancer limited, has spilled outside of the duct or lobule, but remains 2 cm or less in size. No cancer is in the nodes.
For Stage II
Cancer measures from 2 to 5 cm (up to 2 inches), and may have early spread to the nodes. Stage IIB also includes cancers larger than 5cm, but with no node involvement.
Lumpectomy and radiation therapy or mastectomy. Chemotherapy if there is node spread, and for tumors greater than 1 cm. Use endocrine therapy (e.g., tamoxifen) if either hormone receptor (ER, PR) is positive.
Patients with larger tumors are often treated with chemo first to shrink the tumor and thereby enable lumpectomy. May consider systemic therapy (e.g., chemotherapy) followed by lumpectomy plus radiation therapy.
For Stage III
Locally advanced cancer. For example, there is significant involvement of the nodes, or the tumor has invaded the chest wall and/or skin.
Usually mastectomy followed by chemotherapy. Selected patients may consider systemic therapy (e.g., chemotherapy) followed by lumpectomy plus radiation therapy. Also, chemotherapy. Add endocrine therapy (e.g., tamoxifen) if hormone receptors positive. Radiation therapy may be required after mastectomy.
For Stage IV
Metastatic breast cancer. The cancer has spread beyond the breast, leading to secondary tumors in the bone, liver, lungs, brain, or elsewhere.
Goal generally of life improvement and prolonging life a few months or years. Treatment may involve radiation therapy, chemotherapy, endocrine therapy (if estrogen receptor positive), immunotherapy (for example, if HER-2 overexpressed) and/or surgery.
Download and print a follow-up calendar for breast cancer to know what tests need to happen when following breast cancer treatment.