Your doctor will take a number of things into consideration when deciding what treatment to prescribe for breast cancer. His decision will depend on various factors such as what type of breast cancer you have, the size of the tumour in the breast, the grade of the cancer cells, your cancer cells test results, whether you have had your menopause and your health in general.
The five main treatments for breast cancer are surgery, radiotherapy, hormone therapy, chemotherapy and biological treatments. Depending on your situation you could have any or even all of these treatments. As each case of breast cancer is different one cannot generalize and prescribe a standard course of treatment without examining the case specifics.
Surgery and Radiation
Most treatments for breast cancer start with surgery, of which there are different types. In some cases it is possible to have only the tumor removed, depending on its size and position in the breast, or it may be necessary to have a mastectomy where your breast is removed. Some people prefer to have the breast removed completely once it has had cancer in it, but this is not a decision you have to make in haste. If you have the option, take your time to think of how you feel about the two procedures.
Surgery is often followed by radiotherapy as a back-up treatment. This procedure uses radiation to kill the cancer cells in the breast.
Chemotherapy and Hormone Therapy
Chemotherapy or hormone therapy may be prescribed for before or after your surgery and radiotherapy. Doctors may try to make the cancer smaller with chemotherapy prior to your surgery to make it easier to remove. Older women with locally advanced breast cancer may first be treated with a hormone therapy known as an aromatase inhibitor. Locally advanced breast cancer is cancer that has not spread to other parts of the body but may be larger than 5cm across, growing into the skin or muscle of the chest, or present in the lymph nodes which are stuck to each other or to other structures. Aromatase inhibitors block estrogen that may be produced by the adrenal glands in post-menopausal women and can help to shrink the cancer in the breast.
Your doctor may suggest chemotherapy or hormone therapy for after your surgery as it helps lower the re-occurrence of cancer.
Biological therapy, such as Herceptin, is the newest type of cancer treatment. Herceptin is a monoclonal antibody made in a laboratory designed to target and kill breast cancer cells. There is evidence that Herceptin may help to stop breast cancer from coming back and it may help keep advanced breast cancer under control for longer. Used initially for the treatment of advanced breast cancer, Herceptin is now also licensed in some places to treat early breast cancer, although continued research is necessary to get the full picture of its use as a treatment.
Talk to your doctor about the treatments he is prescribing for you. If you feel you would like a second opinion then ask for one. You may feel you are not getting the treatment you want or need and may want to discuss this with another specialist, and you should do so. Take all your test results and X-Rays with you so that they can assess your case with all the facts. It may not mean that they will take over your case, but they can give you their opinion on your situation and discuss with you how they would approach it. You may hear something new or merely a confirmation of what your doctor has suggested. Either way, ask any questions you may have to help you clarify the details. Bear in mind though, that organizing a second opinion may take time and could delay your treatment.