What Are the Standard Breast Cancer Treatments?
Once breast cancer has been diagnosed and its subtype has been determined, the doctor will propose breast cancer treatments. Here are the most common:
- Surgery: partial mastectomy (also called lumpectomy) or total mastectomy
- Radiation therapy
- Hormone therapy
- HER2-targeted therapy
Breast cancer treatments aim to:
- Eliminate cancer cells
- Prevent their spread
- Reduce the risk of recurrence
The standard therapeutic approach
- Surgery is the option most often recommended. Its goal is to remove the tumor, and it is often used in combination with other therapies to increase its effectiveness.
- Radiation therapy is also often considered a complement to other treatments, to eliminate any cancer cells that may remain after surgery.
- Chemotherapy, hormone therapy and HER2-targeted therapies ensure that any cells remaining after surgery are removed.
- Oftentimes, treatments are combined to maximize the chances of eradicating the cancer.
Local vs. systemic therapies
Local therapy is applied to the breast only. Surgery and radiation therapy are local therapies.
Systemic therapies travel to all parts of the body to destroy any cancer cells that may have spread elsewhere. These are drugs that circulate through the blood to act on the whole body. Systemic therapy:
- Eliminates any cancer cells remaining after surgery
- Kills cells that have spread elsewhere in the body
- Slows the progression of the disease
- Improves the effectiveness of the overall treatment
Chemotherapy, hormone therapy and HER2-targeting therapies are systemic therapies.
Treatment takes the molecular type into account
Molecular type is a critical factor in the choice of treatment.
- Hormone therapy is used for cancers expressing ER and PR hormone receptors.
- HER2-targeting therapy is used when cancer cells strongly express HER2.
- Chemotherapy is administered for triple-negative breast cancer that does not express these receptors, for metastatic breast cancer, and, for more advanced-stage cancers, to decrease the risk of metastasis. It can be given as an adjunct to hormone therapy or HER2-targeted therapy.
Treatment of metastatic cancer
Treatments for metastatic breast cancer aim to slow the progression of the cancer, maintain the best possible quality of life, increase lifespan and relieve the pain caused by the cancer.
- You will be offered a combination or sequence of treatments depending on the histological type of your cancer and your overall health. Your healthcare team will discuss this with you to find the options best suited to your situation.
- Surgery and radiation therapy are not administered right away, except to alleviate certain symptoms and pain.
- You may be invited to participate in a clinical study to try a promising new approach. Visit our clinical studies section for more information.
Surgery is the most common option for breast cancer. An adjuvant treatment aims to increase therapeutic efficacy.
- Adjuvants are complementary and aim to maximize the chances of successful treatment, to increase the effectiveness of surgery and to decrease the risk of recurrence. The higher the risk of recurrence, the more likely the doctor will consider an adjuvant option.
- Risk of recurrence is assessed according to the size and grade of the tumour, the status of the cancer cells’ hormone and HER2 receptors, the spread of the cancer to the lymph nodes and lymphatic system invasion.
- Neoadjuvant therapy is administered before surgery to reduce the size of the tumour before it is removed.
- The choice of an adjuvant or neoadjuvant treatment depends on the histological type of cancer.
Treatments for breast cancer can cause side effects, including nausea, fatigue, loss of appetite and pain. It is important to understand that each patient experiences these symptoms at different levels of intensity and depending on the treatment received. Occasionally, medication may be prescribed to relieve or even eliminate any side effects. Do not hesitate to discuss the options with your healthcare team. Here are more facts you should know about side effects in general:
- Side effects depend on the type of treatment and the dose received, how the treatment is administered and your overall health.
- Each type of treatment can cause different side effects.
- The extent of the side effects and how they are experienced vary from one patient to the next.
- Side effects may appear during treatment or they may be delayed a few days, weeks, months or even years.
- Most side effects go away on their own. Some can be treated, while others last longer or may be permanent.
- Notify your healthcare team if you experience side effects. They will be able to take the appropriate actions to help you manage them.
Description: a new way of thinking about health care, initiated in the United States in the 1990s.
Method: combine conventional treatments with complementary holistic approaches.
Goal: achieve faster healing and improve patient care, health, well-being and quality of life.
- Trusting relationship between the physician and the patient
- Discussion to understand many aspects of the patient’s lifestyle:
- Physical activity level
- Stress level
- Suggestions of complementary approaches best suited to improve the patient’s well-being:
- Introduction to the appropriate professionals
- Follow-up of the chosen complementary approach(es)
- Desired improvement of the patient’s well-being
Approaches proposed in integrative medicin :
- Massage therapy
- Art therapy
- Supervised physical exercises
These complementary approaches aim to reduce the pain caused by cancer and treatment side effects, such as nausea and fatigue. Some approaches are beneficial in reducing anxiety and stress. In addition, they help integrate better lifestyle habits, which have a positive effect on overall health.
Approaches to feeling better during treatment
It is important to note that complementary approaches are not intended to cure the patient, but rather to contribute to his or her well-being. They aim to reduce the discomfort of chemotherapy, support the patient during this ordeal and improve his or her quality of life.
Complementary approaches should not replace conventional treatments, but rather complement them.
There are health risks associated with stopping or interrupting treatment without medical advice.
About Integrative Medicine Research
Integrative medicine is an approach that is on the rise. Several universities in the United States and Canada have formed groups, such as the Consortium on Heath Centers for Integrative Medicine (NCCIH) and the Consortium des centres de santé universitaires en médecine intégrative, that are studying the benefits and advantages of integrative medicine.
It is important to note that in order to be considered for integrative medicine, the benefits of complementary approaches must be scientifically validated for safety and effectiveness.
In Quebec, the CHUM and the Maisonneuve-Rosemont Hospital suggest this approach to their patients. Physicians who practice integrative medicine must be certified. Courses on the subject are given to oncology residents at the Université de Montréal.
Talk to your doctor!
If you are interested in complementary approaches, talk to your doctor. He or she will be able to guide you towards proper resources. Although they can be beneficial, some approaches may also be contraindicated. It is therefore essential to discuss them with your medical team and to make sure of the expertise and qualifications of those involved.