Breast Cancer Treatment By Stage

Medically reviewed by: Dr. Jay R. Anam

Breast Cancer Treatment By Stage

There are 5 stages of breast cancer, the treatment for each of the stage is different.

In some stages, a simple lumpectomy can remove the cancerous tissue while in some cases, a patient needs chemotherapy.

Doctors use different methods like mammogram, MRI, USG etc. to identify the stage of breast cancer. Depending on that stage, treatment begins.

Some patients go for breast-conserving techniques while some go for surgery. It is the oncologist who will determine which stage the cancer is in.

The stage of breast cancer depends on the size of the tumor, whether it has spread to other body parts and the number of lymph nodes it has affected and the receptor status. 

Stage 0 breast cancer treatment

The first stage is called the DCIS stage, or LCIS or with Paget’s disease, where the cancer is non-invasive, i.e they have not breached the basement membrane.

This is a pre-cancerous condition. Immediate treatment in this stage prevents obvious cancer.

  • Lumpectomy ( read as wide excision of lump with safe margins) is done to remove the cancerous cells.
  • Mastectomy ( read as removal of the entire breast) can be done to remove the breasts. Whenever mastectomy is done we should also do a sentinel node biopsy to identify any spread of tumor in the axillary nodes.
  • Radiation therapy after the lumpectomy lowers the risk of the spread and it is done 5 days per week for 5-7 weeks.
  • Targeted hormone treatment or oral hormone-like tamoxifen, etc.

Stage 1 breast cancer treatment

Stage 1A and 1B are the early stages of invasive cancers where the tumour is about 2cm and axillary lymph nodes are not affected.

To treat this cancer following treatments can be done:

  • Lumpectomy or Mastectomy. We need to stage the axilla, to see if any disease has spread to it. Sentinel node biopsy is the best tool available.
  • Radiation
  • Chemotherapy for hormone-negative breast cancers depends on the merits of the disease and the patient age.
  • Hormonal treatment for hormone receptor-positive tumors
  • Targeted therapy in the form of trastuzumab can be given in a post-operative setting.

Related Read : Is Stage 1 Breast Cancer Curable?

Stage 2 breast cancer treatment

In stage 2A and 2B, the tumour is 2-5 cm and has spread to nearby lymph nodes or 5 cm and hasn’t spread to lymph nodes. This stage requires a combined treatment of two or more therapies.

  • Lumpectomy or mastectomy along with surgery of the axilla when obvious metastatic nodes are present.
  • Chemotherapy using a variety of drugs like docetaxel, doxorubicin, cyclophosphamide etc.
  • Targeted therapies like herceptin for HER 2 neu receptor positive tumors
  • Radiation therapy is indicated in all cases of lumpectomy and in those cases of mastectomy where the tumor was more than 5 cms or if any axillary node was positive.

Related Read : Is Stage 2 Breast Cancer Curable?

Stage 3 breast cancer treatment

Stage 3 consists of three stages of breast cancer within it namely 3A, 3B and 3C.

In this stage, the tumours are large and have started growing into the internal mammary lymph nodes and in some cases, cancer has even spread across the chest bone, collar bone and internal mammary nodes.

  • Mastectomy
  • Effective and prolonged chemotherapy and hormone therapy.
  • In suitable cases, we give chemotherapy or targeted therapy before surgery so as to reduce the tumour size and conserve the breast.

Stage 4 breast cancer treatment

This is by far the last stage of recognising breast cancer. If breast cancer has reached the stage 4, cancer has already spread to several parts of the body- Metastasized.

  • A systematic drug therapy involving chemotherapy, radiation therapy and hormone therapy.
  • Immunotherapy
  • Patients with HER2 positive cancers who no longer respond to traditional drugs might certain drugs live Pertuzumab, Ado-trastuzumab etc. along with chemotherapy.
  • Surgery in the form of mastectomy is only done in palliative settings.

In all stages of breast cancer whenever lumpectomy is done – plastic surgery in the form of oncoplasty should be done which tries to restore the breast contour and symmetry.

Even in cases where mastectomy is done, whole breast reconstruction can be done by implants or else free flaps using the patient’s own body.

The aim of these procedures is to give the lady a positive self-body image, self-esteem and a right to live with dignity.

 

For advice regarding breast cancer treatment, you can talk to Dr. Jay Anam. He offers comprehensive treatment for all types and stages of breast cancer with the latest medical equipment. The best breast cancer doctor in Mumbai with over a decade of experience.

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What are the survival rates for breast cancer treatments?

The overall 5-year survival rate in breast cancer for all stages combined is 90%. This means even after getting diagnosed with breast cancer 90 out of 100 women are alive and kicking. The 10 year survival rate is a good 84%.

  • 100% in stage 0
  • 99% if breast cancer is localized, has not spread to axilla
  • 86% if it has spread to the axilla also
  • 29 % in stage 4 also called as metastatic

Emerging treatments

Immunotherapy is one of the emerging treatments for breast cancer. Few drugs have been approved by the FDA, it is still thought to be promising. Several independent clinical and preclinical studies are underway.

It is the oncologist who will first determine the stage of breast cancer and then suggest treatments. Patients must not lose hope and fight till the end. Breast Cancer has a very good prognosis and survival.

 

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      About Author
      Dr. Jay Rashmi Anam

      Surgical Oncologists

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      Dr. Jay Anam is one of the best surgical oncologists & breast cancer specialist in Mumbai.

      Dr. Jay Anam has Completed his M.Ch. Surgical Oncology training from Tata Memorial Centre. He did his Fellowship in Breast Oncology from Centre Oscar Lambret, Lille, France.

      As a breast cancer specialist, he believes in world-class cancer care for all patients.

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