Your breast cancer treatment options

Our patients work with their care team to develop a breast cancer treatment plan. The plan addresses the unique medical concerns, treatment options and preferences of each patient.

Facing a breast cancer diagnosis is difficult. That is why we encourage women to ask many questions—and even get second opinions—about their breast care.

Breast cancer treatments

These options may be a part of your breast cancer treatment plan.

Before making any decisions about breast cancer surgery, you should review your options and compare the differences between them. Our breast cancer surgery decision making aid can help you do this.

Your breast cancer treatment plan may include these types of surgery.

  • A lumpectomy removes a portion of the breast and is done to diagnose or treat breast cancer.
  • A mastectomy removes the breast (and usually the nipple). Factors that help determine whether this is the best option are the tumor size relative to the breast size, the number and location of tumors in the breast, family history and personal preferences.
  • If you choose to have a mastectomy, breast reconstruction surgery may follow. You will work with your care team to decide if and when you may choose have this surgery.
  • Sentinel lymph node mapping (sentinel node biopsy) helps determine if breast cancer has spread to the lymph nodes. Before the surgery, the patient may receive two injections:
    • A radioactive substance is injected into the breast several hours or a day before surgery.
    • Immediately before surgery, a blue dye is also injected near the tumor.

Both dyes move through the lymphatic system and identify the sentinel lymph node, the node to which cancer typically first spreads.

During the surgery, the sentinel lymph node(s) is removed. A pathologist examines it for signs of cancer. If no cancer is seen, more nodes are taken out during this operation. The following additional pathology studies are performed on this node(s). If cells are found by these special studies, additional surgery may be performed at a later date to remove more lymph notes.

Chemotherapy uses drugs usually given by mouth or injection into a vein or muscle to kill cancer cells or stop them from dividing. It may be used to cure breast cancer, keep it from spreading or ease symptoms

Radiation therapy uses high powered X-rays or radioactive seeds to kill or damage breast cancer cells to keep them from dividing. This breast cancer treatment may be used to:

  • shrink a breast tumor as much as possible before surgery
  • prevent cancer from returning after surgery
  • provide temporary relief of breast cancer symptoms
  • treat breast tumors that cannot be removed with surgery

Hormone therapy can help keep cancer from coming back after breast cancer treatment. It is also used for advanced breast cancer. This breast cancer treatment often uses medicine to interfere with or lower estrogen, a hormone made by a woman's ovaries. Estrogen promotes the growth of forms of breast cancer that have estrogen receptors (ER-positive cancer) and/or progesterone receptors (PR-positive cancer). 

During hormone therapy, your doctor may have you take one of these prescribed medicines:

  • Tamoxifen and toremifene (Fareston) temporarily block estrogen receptors on breast cancer cells, preventing estrogen from binding to them. They are taken daily as a pill.
  • Fulvestrant (Faslodex) eliminates estrogen receptors on breast cancer cells. It is given as an injection.
  • Aromatase inhibitors block an enzyme that makes small amounts of estrogen in post-menopausal women. Taken as pills, they include letrozole (Femara), anastrozole (Arimidex), and exemestane (Aromasin).

Hormone therapy for breast cancer differs from hormone replacement therapy, a treatment for menopause symptoms.

Source: American Cancer Society, Breast cancer hormone therapy; Virginia Piper Cancer Institute
Reviewed By: Timothy Sielaff, MD, PhD, FACS, president, Virginia Piper Cancer Institute; Carol Bergen, RN, manager, Piper Breast Center; Deborah Day, MD, medical director, Piper Breast Center; Tamera Lillemoe, MD, pathologist
First Published: 08/25/2009
Last Reviewed: 08/25/2009

A lymphedema therapist wraps a woman's arm with bandages. Compression therapy is a common treatment for lyphedema.

How to deal with menopausal symptoms

Your breast cancer treatment may cause you to have hot flashes, vaginal dryness, headaches, depression or insomnia.

Cancer rehabilitation and lymphedema therapy

During or after breast cancer treatment, you may feel symptoms that interfere with daily life. Our cancer rehabilitation team can help.

Cancer research

Participating in a clinical trial may help you take a more active role in your health care. You may also gain access to new drugs, treatments and disease management practices.