Stage I — The tumor is localized to the breast and is less than 2 cm in diameter. Stage II — The tumor is present in the breast and axillary (armpit) lymph nodes. It may be up to 5 cm in diameter. Stage III — The tumor is greater than 5 cm in diameter, and has spread to local areas surrounding the breast. Stage IV — The cancer has spread (metastasized) all throughout the body. This stage is unfortunately not curable.
At the time of surgery, you can opt for breast reconstruction if you wish. This can be done at the same time as your breast is removed, or it can be done at a later date. Many health care plans cover breast reconstruction surgery for women who have breast cancer. On the other hand, it is generally not covered when received for cosmetic reasons such as a breast augmentation. If your cancer is of an early enough stage, surgery alone may be enough. Radiation may or may not be done in addition to surgery depending upon the extent of your cancer. Your doctor will advise you. [6] X Trustworthy Source American Cancer Society Nonprofit devoted to promoting cancer research, education, and support Go to source It is often recommended to proceed with chemotherapy (at least hormone-based therapy) following surgery to be certain that you give yourself the absolute best chance to be cure.
Hormonal or endocrine therapy — When you are diagnosed with breast cancer, your doctor will test for the presence of estrogen and/or progesterone (hormone) receptors on the cancer cells. If your cancer tests positive for either estrogen and/or progesterone, your doctor will suggest that you take a hormonally-based treatment such as Tamoxifen. This will inhibit any further growth of your cancer and help to give you the best chance of cure. [8] X Trustworthy Source American Cancer Society Nonprofit devoted to promoting cancer research, education, and support Go to source Regular chemotherapy — If your cancer is at risk of having spread to other areas of your body, your doctor will likely recommend a standard chemotherapy regimen that travels throughout your body to hopefully eliminate any breast cancer cells that have spread beyond the breast itself. Molecularly targeted therapy — Your doctor will also test your breast cancer for a protein called HER2. [9] X Trustworthy Source National Cancer Institute An agency in the National Institutes of Health focused on cancer research and patient support Go to source If it is positive for this protein, your doctor can offer you molecularly targeted therapy to help fight the breast cancer and to optimize your chances of cure. These agents include trastuzumab and lapatinib, which both treat HER2-positive breast cancers.
Your doctor may also do a sentinel node biopsy, in which the lymph node most likely to be infected with cancer is removed and tested. This lymph node is identified when the surgeon injects a dye or radioactive substance near the tumor, then looks for which lymph nodes are dyed or radioactive. The node is then removed and tested for cancer cells. [11] X Trustworthy Source National Cancer Institute An agency in the National Institutes of Health focused on cancer research and patient support Go to source If the cancer has not spread to your lymph nodes, usually a combination of surgery followed by hormone therapy (such as tamoxifen) is sufficient to cure your cancer. On the other hand, if it has spread to your lymph nodes, your doctor will advise surgically removing the affected lymph nodes as well as the affected breast, and also offering you a generalized chemotherapy regimen in addition to hormone therapy. Note that, if your cancer has spread beyond your lymph nodes into distant areas of your body, a complete “cure” of your cancer will not be possible. The cancer can only be completely cured if it is isolated to the breast itself, or if your doctor is able to remove the lymph nodes prior to any further spread beyond them.
Regular physical exams with your doctor every three to six months for the first three years following treatment, where your doctor examines your breasts for any abnormalities. This can be reduced to every six to 12 months for the next two years, and annually thereafter. [13] X Expert Source Joshua Ellenhorn, MDBoard Certified General Surgeon & Surgical Oncologist Expert Interview. 28 April 2020. Continued mammograms and a chest radiograph annually following treatment. There may be additional screening protocols in place for people with more severe cancer, or for those with a genetic syndrome who are predisposed to cancer recurrences or to cancer developing in other areas of the body.
Women who are at high risk for getting breast cancer, like those with BRCA gene, will start getting mammograms earlier. Some people who test positive for the gene also receive what is called a “prophylactic double mastectomy,” meaning that they have their breasts removed before any cancer develops as a means of preventing it from occurring in the first place. This is a matter of personal preference, as it does have a significant cosmetic impact.
