Your team of doctors will make treatment recommendations based on the stage of your cancer. Your standard treatment options may include surgery, chemotherapy, radiation, and hormone therapy. If you have been diagnosed with DCIS or LCIS, your stage is the lowest and the road you will travel will be easier. For DCIS, your options may include breast-conserving surgery or mastectomy with or without radiation and hormone therapy.
LCIS treatments options are a bit different. They include observation to determine changes, hormone therapy to prevent cancer from developing, or bilateral prophylactic (preventive) mastectomies.
Things get more complicated when your cancer spreads beyond the ducts or lobes/lobules. Once your cancer has been staged, you can visit www.cancer.gov to determine your treatment options. They will typically include: surgery, chemotherapy, radiation, and/or hormone therapy. For IBC, treatment options are similar to the other types of breast cancer, but they will always include chemotherapy because of its aggressiveness.
• Surgery: Breast surgery can be either a lumpectomy, where the tumor is removed, or a partial or modified radical mastectomy. With a lumpectomy, it is typically followed by radiation. This way, you get to keep your breast and studies have shown no difference in survival rates between lumpectomy/radiation and mastectomy.
Note: Not too long ago, they used to perform radical mastectomies where the breast, all the lymph nodes, and the underlying muscle were cut away. Thankfully, medicine has discovered that’s not necessary. Now, a partial or modified radical mastectomy is performed, where either part of the breast tissue, or the entire breast, and possibly a portion of the lymph nodes, are removed. On the whole, a mastectomy isn’t too bad a surgery, although everyone is different. I found both of mine to be quite easy, but you will wake up with drain tubes, which you’ll typically have for at least a week.
• Chemotherapy: Chemotherapy is defined by Wikipedia as “the use of chemical substances to treat disease. In its modern-day use, it refers primarily to cytotoxic drugs used to treat cancer.” This can be a frightening prospect for anyone. We’ve all heard horror stories about how very debilitating chemotherapy can be. However, much progress has been made in the management of chemo’s side effects, to the point that, once you have the right management tools, you can continue to enjoy the activities you typically do. Chemo is a means of treating your cancer systemically and is typically recommended for those whose tumor is larger than a certain size and/or the cancer has spread to your lymph nodes. The thinking is that if your cancer has had the opportunity to access the rest of your body, your treatment should be systemic as well.
• Radiation: Radiation therapy is typically a localized treatment option, where rapidly dividing cells are damaged. Cancer cells are very rapid dividers, so radiation is an effective option. Typically, radiation therapy is given for about six weeks, five days a week. It’s very much like lying still for an x-ray, only instead of lasting a second or two, it lasts a couple of minutes. It can cause fatigue, toward the end and slightly after, and can cause a sunburn effect on your skin.
• Hormone Therapy: Many breast cancers are hormone-dependent. In these cancers, there are receptors on the tumor that can be filled with estrogen. The thinking is that when estrogen fills these receptors, it causes the tumor to grow. This is called estrogen-receptor positive (ER). These cancers respond well to hormone therapy and the hormone therapy drug that will be recommended for you will depend on your menopausal status. These drugs are in pill form and you take them once a day. The most popular of these drugs, for pre-menopausal women, is Tamoxifen and, for post-menopausal women Femara or Arimidex. There is new evidence that suggests that taking Femara, after taking Tamoxifen for five years, increases survival rates.
• Immunotherapy: There is a fourth modality of treatment on the horizon and it’s called Immunotherapy. This involves getting your immune system to fight your cancer and there is, and will be, a lot of research being done in this area.