Doctors and researchers are learning more about breast cancer diagnosis and treatment every day. Women who learn they have breast cancer today have more treatment options and know more about their cancer than in the past.
Stages of Breast Cancer
Staging cancer is done to show how large the cancer is and whether it has spread. There are four stages of breast cancer, plus stage 0:
- Stage 0 cancer is limited to the inside of the milk duct and has not invaded normal tissue within or beyond the breast.
- Stage I cancer is an inch or smaller and has not spread to the lymph nodes.
- Stage II cancer is larger than stage I cancer and/or has spread to a few nearby lymph nodes.
- Stage III tumors are larger or are growing into nearby tissues (the skin over the breast or the muscle underneath), or they have spread to many nearby lymph nodes.
- Stage IV cancer has spread beyond the breast and nearby lymph nodes to other parts of the body.
Treatments Based on Cancer Type
There are multiple treatments based on the stage and type of cancer. As diagnosis has advanced, doctors are looking more closely at tumor makeup and molecular markers. This leads to personalized treatment based on tumor and chance of recurrence.
Doctors can tell if breast cancer is aggressive and where it has spread and can match treatments that fit the particular cancer. This also helps patients by delivering the right amount of treatment to match the cancer so if a cancer is less aggressive, doctors can treat it with treatments that aren’t as harsh and have fewer side effects.
For example, today women may undergo shorter courses of chemotherapy or lower dose radiation at the outset of diagnosis to reduce their tumor size instead of having a mastectomy right away. Others with a low likelihood of recurrence will have no course of chemotherapy and only have drug therapy.
Here are three types of cancer and how doctors are treating them today:
Hormonally-Fueled Cancers: Many cases of breast cancer are detected after age 50, with the most common at this time being hormone-sensitive tumors that have estrogen or progesterone receptors. These cancers can be treated with hormone therapy drugs that lower estrogen levels or block estrogen receptors. Doctors also may provide chemotherapy in addition to hormone therapy drugs to those with more aggressive cancer.
Genetic Markers: HER2 is a growth-promoting protein that is found outside of all breast cells. When breast cancer cells have higher levels of HER2 than normal, they are called HER2-positive. Specific drugs that fight the HER2 protein are sometimes given to women with HER2 cancers, along with chemotherapy.
Triple-Negative Breast Cancer: Triple-negative breast cancer means that the cancer isn’t high in HER2 and also doesn’t have progesterone or estrogen receptors. These cancers are normally treated with chemotherapy and radiation. Doctors are also using immunotherapy, a treatment that activates or suppresses the immune system, to treat triple-negative breast cancer.