Type | Possible Treatments |
---|---|
Ductal carcinoma in situ (cancer confined to the milk ducts of the breast) | Lumpectomy (breast-conserving surgery to remove tumor and some surrounding tissue) or mastectomy Sometimes hormone blockers (medications, such as tamoxifen or aromatase inhibitors, that affect hormones) |
Lobular carcinoma in situ, classic (abnormal cells confined to the milk-producing glands of the breast) | Sometimes surgery to check for cancer If no cancer is detected, observation plus regular examinations and mammograms Tamoxifen or, for some postmenopausal women, raloxifene or an aromatase inhibitor (such as anastrozole, exemestane, or letrozole) to reduce the risk of invasive cancer Rarely, bilateral mastectomy (removal of both breasts) to prevent invasive cancers |
Lobular carcinoma in situ, pleomorphic (which, unlike the classic type, leads to invasive cancer) | Surgery to remove the abnormal area and some of the tissue around it Sometimes tamoxifen or raloxifene to try to prevent cancer from developing |
Stages I and II (early-stage) cancer | Lumpectomy, followed by radiation therapy Mastectomy with or without breast reconstruction After surgery, chemotherapy, hormone blockers, anti-HER2 medications (such as trastuzumab), or a combination Sometimes, neoadjuvant therapy (chemotherapy before surgery) to reduce tumor size and optimize the chances for breast-conserving surgery |
Stage III (locally advanced) cancer (including inflammatory breast cancer) | Often, chemotherapy or sometimes hormone blockers before surgery to reduce tumor size Lumpectomy or mastectomy, if the tumor is small enough to be completely removed Usually, radiation therapy after surgery Sometimes chemotherapy, hormone blockers, or both after surgery |
Stage IV (metastatic) cancer or cancer that recurs | For estrogen receptor–positive tumors, hormone blockers or removal or suppression of ovaries Chemotherapy For HER2 receptor–positive tumors, trastuzumab, sometimes with pertuzumab Radiation therapy for the following:
For metastases to bone, bisphosphonates (such as zoledronate or pamidronate) given intravenously to reduce bone pain and bone loss |