Tools for Survivorship: Treatment Types

Learning about the major types of breast-cancer therapy can help you understand what to expect during treatment and make the right healthcare decisions for you. Many of these treatments present challenges, but know that with them, you have every reason to be hopeful and plan for a fulfilling future.

Treatment for breast cancer falls into two main categories: Systemic treatment that affects the whole body and local treatment that targets one specific part of the body. Additional treatments may be used to help treat your cancer or manage any pain or side effects the cancer or medications might cause.

Systemic treatments:

  • Chemotherapy uses powerful drugs to kill rapidly dividing cells in the body. That means it not only helps you fight off cancer cells but also kills some rapidly dividing healthy cells. You, in partnership with your doctor, may choose from many different chemotherapy drugs, to use alone or in combination.

    Some doctors opt for a newer method of chemotherapy called dose-dense therapy. This method increases the rate of treatment instead of the dose in order to better fight tumor cells when they are dividing most rapidly.

  • Hormonal therapy helps the body fight hormone-receptor-positive breast cancer. Drugs either reduce or block the hormones that help these cancers grow. For premenopausal women, hormonal treatment may be more difficult to tolerate than for women who have been through menopause. However, premenopausal women may receive the most benefit from hormonal treatment. Your menopausal status determines which hormonal drugs you can use since some only work on post-menopausal women. Know your status—but remember that missing your period doesn’t mean you’ve reached menopause. You and your doctor may determine to change your status by putting you into menopause either temporarily with an injection (ovarian suppression) or permanently by removing the ovaries (oopherectomy).
  • Targeted therapies attack genes or proteins in cancer cells to stop them from growing. Thanks to major, recent advancements in these therapies, some doctors predict they will help even more women survive their cancers. Treatments like this only work in specific types of breast cancer, so a targeted treatment that works very well for one woman may not work at all for another. Read more about receptor types in breast cancer here. Doctors can use targeted therapies in combination with chemotherapy or alone as a mono-therapy.
  • Bisphosphonates are drugs used to help prevent bone loss. In the case of disease that has spread to the bone, they are used to reduce pain, the need for radiation or prevent fractures. Talk with your doctor about the different bisphosphonates and their benefits and risks.

Local treatments:

  • Surgery removes a tumor or, in the case of reconstruction, repairs the breast. Doctors can choose to perform surgery after a first diagnosis, a recurrence or not at all.
  • Radiation treatment shrinks a tumor and kills cancer cells. It can come from various types of machines placed outside the body (external-beam radiation therapy) or from radioactive material placed in the body near cancer cells (internal radiation therapy or brachytherapy). Side effects of radiation therapy can be surprisingly mild. In the most aggravating, your skin can react as in severe sunburn.

Helping Treatments

Some types of therapy can assist with your main, or primary, treatment. They include:

  • Adjuvant therapy: treatment given after the primary treatment – which is usually surgery. This additional treatment can help keep you disease-free for the long term.
  • Neoadjuvant therapy: treatment given before the primary therapy. For example, doctors can make an inoperable tumor vulnerable to surgery by giving radiation treatment before the operation.
  • Adjunctive therapy: treatment given at the same time as the primary treatment in order to boost it.