There are many treatments available for women and men diagnosed with breast cancer. The best treatment options for breast cancer come with an early diagnosis.

One of the most important elements of the treatment decision will depend on the stage of the breast cancer, which is an indication of whether or not the breast cancer has spread and, if so, how far and to what areas of the body. The treatment protocol will depend on other factors as well, including:

• The size of the tumor
• The type and stage of breast cancer
• The estrogen-receptor progesterone-receptor status
• The patient’s age and general health
• Personal opinions and preferences of the patient

Other factors that are normally taken into consideration include whether or not the breast cancer is newly diagnosed or if it is a recurrence.

Most breast cancers are treated with a combination of therapies based on the stage and type of cancer. Options include:

• Surgery. There are several options with breast cancer surgery, and much will depend on the size and type of tumor involved, as well as its location within the breast. Surgeries commonly used in the treatment of breast cancer include:
  
  
• • Lumpectomy or segmental (partial) mastectomy. Both procedures are considered breast conservation surgery, which spare much of the breast tissue. Following this type of surgery, most patients will receive radiation therapy to destroy any remaining cancer cells in the breast tissue.
    
    
  • Mastectomy. Involves removing most of the breast tissue and may be accompanied by removal of most of the lymph nodes under the arm.
    
    
  • Radical mastectomy. Removes chest muscles, the entire breast and all of the lymph nodes under the arm plus additional fat and skin. This was the standard treatment for many years but is rarely used now.
    
    
  In addition to surgery of the breast tissues, a physician may perform diagnostic procedures to determine if the cancer has spread to the lymph nodes. These tests often involve surgical removal of one or more lymph nodes. The most common procedures are:

• • Axillary lymph node dissection. Removal of some or all of the axillary (underarm) lymph nodes for inspection by the pathologist for evidence of cancer. Many surgeons will also perform an axillary node dissection at the same time as the breast cancer surgery.   
    
    
  • Sentinel node biopsy. A procedure in which a dye and/or radioactive tracer is injected at the site of the tumor. The dye is followed to determine into which lymph node it drains. Only the first lymph node that the dye or tracer reaches is removed for analysis because it is believed this node is the most likely area for the spread of breast cancer. The information on involvement of lymph nodes (whether or not they contain any cancer cells) is used for staging and treatment decisions for the patient.
    
    
• Chemotherapy. Powerful drugs are used to treat the disease by destroying cancer cells but normal cells may also be involved. Chemotherapy may be accomplished using a single drug, but more often involves a combination of medications. The drugs may be given in several forms, such as intravenously or orally. Treatment with chemotherapy may be used before radiation therapy, surgery, biological therapy or bone marrow transplants. In other cases, chemotherapy may be used after or in conjunction with other treatments.
  
  
• Radiation therapy. High-energy x-rays are concentrated on the site where the tumor was removed to kill any remaining cancer cells following surgery. Radiation may also be used to shrink a tumor prior to surgical removal. Radiation targets dividing cancer cells and disrupts or destroys their genetic material, preventing the cells from continuing to grow and spread throughout the body. Radiation therapy is sometimes used alone to treat cancer. In other instances, it is combined with other cancer treatments such as chemotherapy or surgery. Radiation therapy normally involves short treatments once or twice a day for six to seven weeks.
  
  
• Hormone therapy. This type of therapy blocks the effect of estrogen on breast cancer cells. Hormone therapy is used with cancers that are estrogen or progesterone-receptor positive. It is commonly prescribed for men with metastatic breast cancer (breast cancer that has spread to other areas of the body). In men, more than 75 percent of breast cancer cases contain estrogen receptors. Anti-estrogens, such as tamoxifen, may be recommended for treatment and to prevent a recurrence. 
  
  Another group of drugs known as aromatase inhibitors are also used in hormone therapy. These drugs have been show to be effective in treating breast cancer in women. However, additional studies are needed to determine their effectiveness in mne. Clinical trials are examining the uses of aromatase inhibitors with other drugs to lower androgens (male sex hormones) in men. Research has shown that decreasing androgen levels in men may shrink breast cancer metastases.
  
  
• Biological therapy. A treatment designed to bolster or substitute for the body’s natural defenses against cancer. HER2/neu is an oncogene that is found to be abnormally expressed in some breast cancers (in addition to some stomach and lung cancers). It produces a protein that allows the entrance of growth factors into the cancer cell, monoclonal antibody or anti-HER2 antibody (Herceptin) that binds to the HER2 receptor on the surface of the tumor cells. Biological therapy is very different from chemotherapy, but they are often used togehter. The monoclonal antibody binds only to cells that over-express HER2/neu and not other cancer cells or normal cells. This type of therapy is now in regular clinical use.