Breast Cancer: Common Treatment Pathways
Not all women will have all forms of treatment. You will discuss which treatments you need and in which order with your team of healthcare providers. Common treatment pathways, including the length and order of different treatments, are described below.
Most women diagnosed with breast cancer will be advised to have breast and lymph node surgery to remove the cancer and test to see if the cancer has spread to the lymph nodes. Most frequently, surgery is the first phase of treatment; however, some patients may have chemotherapy and/or targeted medical therapy before surgery.
If surgery is the first phase of treatment, it usually takes place two to six weeks after the cancer is diagnosed. After surgery, a patient can expect to heal for two to three weeks before the next phase of treatment begins.
Chemotherapy involves taking medication that stops cancer cells from dividing or growing. If a woman needs chemotherapy, it most often is started a few weeks after breast surgery. Chemotherapy usually is given through a needle into a vein (infusion) and is done at the chemotherapy clinic. Some chemotherapy may be taken by mouth (orally).
Chemotherapy can be the first phase of treatment for some women. When chemotherapy is given before surgery, it is called neoadjuvant chemotherapy. Neoadjuvant chemotherapy is given to shrink the cancer before surgery. This can create more options for breast-conserving surgery and help control the cancer before surgery.
Most women undergoing breast-conserving surgery will be advised to have radiation therapy. Some women having mastectomy because evidence shows that the cancer has spread beyond the breast also may have radiation therapy.
Radiation therapy is given after breast surgery and chemotherapy. Radiation treatments are given five days a week for four to seven weeks. Each treatment takes about 20 minutes.
Endocrine therapy involves medication that blocks hormones such as estrogen or progesterone. Endocrine therapy may be prescribed for women whose cancer cells have receptors for these hormones. It usually is started after chemotherapy or radiation therapy and is taken for five to 10 years. Some women may be advised to have endocrine therapy before surgery (neoadjuvant endocrine therapy) and may be used to help reduce the size of a cancer before removing it.