Treatment Archives - Male Breast Cancer

22FebJune 11, 2023

Breast Cancer Infographic Breast cancer is the second-deadliest cancer among American women. Other than adopting a healthier lifestyle, early detection with regular mammograms remains the single most effective way for combating the disease. Women diagnosed with breast cancer that has not spread outside the breast have a 99 percent survival rate. Steady declines in mortality among women since 1989 have been attributed to a combination of early detection and improvements in treatment.

Statistics

In the U.S., one in eight women will be diagnosed with invasive breast cancer during her lifetime.

In the U.S. in 2018, 266,120 women and 2,550 men are expected to be diagnosed with invasive breast cancer.

In 2018, breast cancer is expected to claim the lives of 40,920 women and 480 men in the U.S.

In Texas in 2018, an estimated 17,566 new cases of female and male breast cancer are expected, with 3,175 deaths.

Risk Factors

Age: Most invasive breast cancers occur in women over age 55.

Family History: Women with an immediate family member (mother, sister, daughter) who has had breast cancer are nearly twice as likely to develop the disease. Close male relatives with the disease also raises risk. If you have a family history of cancer, genetic testing may help determine risk.

Diet and Exercise: Overweight and/or physically inactive women have a higher risk, especially after menopause.

Breast Conditions: Women with dense breast tissue and some benign breast conditions are at higher risk.

Menstrual Cycles: Starting menstruation early (before age 12) or completing menopause late (after age 55) raises risk.

Radiation: Radiation to the chest for another cancer have a higher risk of breast cancer.

DES Exposure: Women who were exposed or had mothers exposed to diethylstilbestrol have a slightly higher risk.

Symptoms and Signs

Women are encouraged to consult their physician immediately for evaluation if any of the following signs and symptoms are present. The signs for breast cancer are not the same for all women, and some women show no signs in early stages.

A lump in the breast, under the arm or around collarbone

Change in breast size or shape

Thickening of breast or underarm

Nipple retraction or nipple discharge

Dimpled skin or skin resembling orange peel

Tenderness or pain in breast or nipple

Irritation, redness, scaliness, or swelling on the breast, nipple, or skin near the nipple

Prevention

Breast cancer cannot be completely prevented, but women can take steps to decrease risk and/or improve early detection of the disease. Screening recommendations are for women with average risk. It is important to discuss with a physician your individual risk factors, including age, menopausal status, and family history to determine your screening needs.

Screening
- Women should understand their risk as some women with a family history of breast cancer or known to be of higher risk should start screening early and can take other preventative measures.
- Women should check their breasts monthly. Report any changes to a physician immediately.
- Women in their 20s and 30s should have a clinical breast exam every three years.
- Women in their 30s should discuss their breast cancer risk level with a physician to determine the most appropriate cancer screening options, including mammograms and MRI screenings.
- Women age 40 and older should discuss individual risk factors with a physician to determine recommended timing and most appropriate screenings, including annual mammogram, annual clinical breast exam, and annual MRI screening.
- Women age 50 and older should have a mammogram and a clinical breast exam at least every two years after discussion with her physician, and if recommended by a physician, an annual MRI screening.

Lifestyle
- Regular exercise, limiting alcohol intake, and maintaining a healthy body weight may reduce the risk of breast cancer.

Higher Risk
- Women with a family history of breast cancer should discuss genetic testing with their physicians. If genetic tests indicate a woman has a genetic disorder that will increase her risk of breast cancer, like BRCA, there are a number of risk reduction strategies to discuss with her physician.
- Women with a first degree relative who had breast cancer before age 50 should begin receiving mammograms 10 years before reaching that relative’s age at diagnosis.

Treatment Options

Anyone with breast cancer should consult with a medical oncologist to determine their specific treatment needs. Treatment options can include surgery, radiation therapy, chemotherapy, proton therapy, targeted therapy, bone-modifying therapy, or hormone therapy. A combination of treatments may be used to provide the best chance of disease control.

Sources: American Cancer Society, American Society of Clinical Oncology, National Cancer Institute, and Texas Cancer Registry

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22FebJune 11, 2023

By MHN Author

NBCF Research | Stages, Types and Treatment of Breast Cancer

Breast cancer is a complex collection of many different subtypes, and there is no “one-size-fits-all” treatment. Health professionals may refer to a tumour by its size, grade or spread, as hormone receptive, invasive or metastatic.

“Staging” is a classification tool used by health professionals to describe:

the size of a breast cancer;
whether it is limited to one area in the breast or it has spread to healthy tissues inside the breast; and
whether the cancer has spread to the lymph nodes or to other parts of the body beyond the breast.

Stages of breast cancer are numbered from 0 to 4. Classification helps determine the right treatment plan – and is based on a pathologist’s study of any tumour tissue or lymph nodes removed during biopsy or surgery.

Stage 1 or 2 – Early breast cancer

Stage 1 breast cancers are smaller than two centimetres and have not spread to the lymph nodes in the armpit (axillary nodes). Stage 2A breast cancers are larger than 2cm but less than 5cm, and/or have spread to the axillary nodes. The goal of treatm …

Stage 2 or 3 – Locally advanced breast cancer

Stage 3 and some stage 2 breast cancers are locally advanced breast cancers. These have spread beyond the breast to either the chest wall, skin of the breast, or to lymph nodes in the underarm or breastbone area (internal mammary lymph nodes). They h …

Stage 4 – Metastatic Breast Cancer

Stage 4 (metastatic or advanced) breast cancer has spread beyond the breast to other organs in the body. Most commonly this is in the bones, lungs, liver or brain. There is currently no way to eradicate stage 4 breast cancer. The goal of treatment is …

Molecular types of breast cancer

Breast cancer treatments are based on the tumour’s specific biological or molecular signature. Find out about the different types of breast cancer, current research and personalised treatments.

Breast cancer treatments are based on the specific biological or molecular signature of a tumour. Each tumour is different and requires a personalised approach. The most common treatments include:

Surgery

The goal of breast cancer surgery is to remove the entire tumour from the breast. A lumpectomy aims to preserve the breast and remove only cancerous tissue. A mastectomy removes the entire breast. Some of the lymph nodes from the underarm area (axillary nodes) may also be removed to see if cancerous cells are present.

Radiation therapy

Radiation is given to the breast, chest, collarbone and underarm to kill any cancer cells that might remain after surgery.

Chemotherapy

Chemotherapy is a chemical compound that kills rapidly dividing cells, such as cancer cells. It is usually given to those with early breast cancer after surgery (adjuvant chemotherapy). For large tumours, it can be used before surgery (neoadjuvant chemotherapy) to shrink the tumour.

Hormone therapy

Some breast cancer cells need estrogen and/or progesterone (female hormones) to grow. Hormone therapy slows or stops their growth by preventing the cancer cells from getting these hormones. It is usually given after surgery as a long-term preventative treatment. High-risk women who have never had breast cancer may take it as a preventive therapy.

Targeted therapies

A targeted therapy is a drug designed to attack a molecular agent or pathway involved in the development of a particular breast cancer. For example, HER2 positive breast cancer has too many copies of a particular gene known as HER2 which stimulates cell growth. The drug trastuzumab (Herceptin) works by attaching itself to the HER2 receptors on the surface of breast cancer cells, blocking them from receiving growth signals. Unlike chemotherapy drugs, targeted therapies kill cancer cells with little harm to healthy cells.

Personalised therapy and/or precision medicine

Increasingly, research is allowing a combination of personalised treatments to be used. A person’s individual situation, overall health, age, lifestyle risk factors and the molecular make-up of his/her tumour are taken into account to provide the best strategy.

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22FebJune 11, 2023

By MHN Author

What It’s Like Living With Breast Cancer Treatment Side Effects

I was 49 years old, and I hadn’t had a mammogram in three years. I decided to get caught up. I went for the mammogram and, judging from the way the technician reacted to the image, I was pretty sure something needed further scanning. I had an ultrasound at another appointment. They sent the results to my primary doc, who told me I had cancer.

I got a breast MRI, and they found a second tumor in the same breast. The breast surgeon told me I also had all the signs of inflammatory breast cancer; my breasts were pinker than they should have been, and they were radiating heat.

I started chemo a month after the mammogram. The surgeon wanted to shrink the first tumor before surgery because it was large, and she also wanted to make sure the cancer hadn’t spread. Chemo was the most effective way to do it. I went for treatment every other week for five months, then had a bilateral mastectomy. When I recovered from that, I had 40 radiation treatments, one every weekday for eight weeks.

My treatment was intense because it was a very large tumor and there was the possibility of inflammatory breast cancer. Once I got through radiation, I had 52 weeks of Herceptin [a drug that targets the HER2 protein in some breast cancers], and I’ve been on tamoxifen [which blocks estrogen from causing cell mutations that could lead to cancer] for five years.

In September, I’ll have been cancer-free for seven years. But I’ve had minor–and major–side effects along the way. Some have been temporary, like nausea from chemo. My doctors managed to control that with anti-nausea medications.

Others are permanent. The first I really became aware of was neuropathy in my fingers and toes, which I still have to this day. I have tingling, numbness–my fingers and toes don’t feel right. I don’t take any medication for it, it’s just something I’m aware of and accept. I’m an accountant, so at first I was afraid I wasn’t going to be able to run a 10-key calculator. It was scary until I found out that I could.

Courtesy of the tamoxifen, about once a month or so, I get pain like a hot poker in the knuckles in my left hand. It only lasts a couple of minutes and then it stops, but it’s blinding pain.

When you start chemo, doctors tell you that your hair is going to fall out. You think it’s the hair on your head, forgetting that you have hair on other parts of your body. My nose kept running, and I realized I had lost all my nose hairs. On the bright side, I don’t have to shave my legs as often.

Because of the intense radiation, I couldn’t have the typical breast reconstruction surgery, so I ended up getting a Deep Inferior Epigastric Artery Perforator or DIEP flap. Basically, the surgeon takes tissue from your abdomen and makes breasts out of it. My surgery took more than 12 hours. I had a second surgery for refinements, and then another to actually rebuild the nipples.

“Chemo brain” has been an absolute nightmare. I had nearly a photographic memory before this all started. After the chemo, I looked at someone I knew I had known for 20 years at my church, and I had to apologize because I couldn’t remember their name. It’s so frustrating.

Since finishing chemo, my memory has returned to probably 98 to 99% of what it was, but every now and again I’ll still have an instance where I just have this block, and I attribute it to chemo brain. A couple of months ago, I started having chemo brain symptoms again, as well as fogginess, blurry vision, and headaches. I wasn’t able to do a simple math problem in my head that I normally would be able to do without a second thought. My brain just wasn’t functioning the way it normally does. My oncologist sent me for an MRI to make sure it wasn’t cancer in the brain, and fortunately it wasn’t. (The blurry eyes were from dry eye.)

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I had one other scare that the cancer had come back or spread. I put my hand on my chest and felt what I thought was a lump in my right breast, the one that had the cancer and is now basically abdominal tissue. I found out it was fat necrosis; the radiation was still killing tissue.

I get checked out every six months. I’m very aware of every ache and pain in my body. But I live every day to the fullest because tomorrow is not guaranteed.

Lora McCann is a member of the National Coalition for Cancer Survivorship’s Cancer Policy and Advocacy Team, which advocates to improve the delivery of cancer care for everyone impacted by cancer.

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22FebJune 11, 2023

By MHN Author

Male Breast Cancer – Sassy Chick

November 26, 2018 By: sassychickcomment

male breast cancer

I recently had a routine check-up with my radiation oncologist. While I was at the cancer center, I met Robert, a volunteer at the American Cancer Society kiosk. The station provides information regarding resources for patients and even has a few wigs to try on. I was fortunate enough to receive two wigs there while I was on treatment for FREE!

I got to talking to Bob. He said that the reason he volunteers for the American Cancer Society is to make folks aware that men have breast cancer too. What a great reminder!

Yes, Men Do Get Breast Cancer Too

Thankfully it is fairly uncommon. But male breast cancer does happen. According to the National Breast Cancer Foundation, Inc, male breast cancer makes up less than one percent of all breast cancer and only one in a thousand men will ever be diagnosed with breast cancer.

Bob told me that he was in the parking lot after his doctor’s appointment and realized that he forgot to bring the mass to his doctor’s attention. Thankfully he did go back and in and his work up was initiated.

Bob is correct. Men that do find a breast lump, are less likely to assume a mass is breast cancer which delays going to the doctor for diagnosis and treatment.

Symptoms

Men usually have a lump or mass that can be felt. Other symptoms can include, a change in size or shape of the breast, a dimple or puckering in the skin, a change in the nipple, fluid draining from the nipple and scaly, red or swollen skin on the breast, nipple, or areola. Just like women, if men have any of these symptoms they should seek prompt medical attention.

Treatment of Male Breast Cancer

Treatment can be similar to women’s breast cancer including surgery, radiation, chemotherapy, and hormone therapy.

Survival

According to the National Cancer Institute, survival for men with breast cancer is similar to survival to women with breast cancer. But again men tend to be diagnosed at a later stage due to not seeking diagnosis and treatment immediately.

Additional Information

The national cancer institute’s website has amazing resources for most types of cancer. See: https://www.cancer.gov/

Here is a link for more information specific to male breast cancer; male breast cancer

While researching information for this post another site that provided helpful information is from Comanche County Medical Center. Here’s a link: male breast cancer.

We are both breast CA survivors male breast CA

Robert and I. We’re both breast cancer survivors!

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22FebJune 11, 2023

By MHN Author

Inflammatory Breast Cancer Treatment: Johns Hopkins Breast Center

What are the symptoms of inflammatory breast cancer?

Inflammatory breast cancer, also called IBC, is an aggressive and fast growing cancer. In the past, it commonly was misdiagnosed as mastitis or dermatitis because it can look like an infection of the breast or a rash on the skin of the breast. If you do have a rash or suspect an infection, promptly see your gynecologist or primary care physician.

Most of the time, the infection or rash clears after treatment with topical cream or oral antibiotics. If your rash or infection does not heal after one week of treatment, make an appointment with a breast specialist immediately.

How is inflammatory breast cancer diagnosed?

Same Day Results

We know how quickly patients want results from a biopsy or scan if there is a suspicion of breast cancer, so we follow strict guidelines for biopsies and pathology reports. Most of our patients will receive the probability of breast cancer immediately following their biopsy, and a pathology confirmation within 24 hours. A diagnosis of inflammatory breast cancer is confirmed by obtaining tissue from the skin of the breast during a skin punch biopsy. If a patient has inflammatory breast cancer, the pathology report will indicate that breast cancer cells are present in the dermal lymphatics.

Learn more about the steps of diagnosis, including:

What is the treatment for inflammatory breast cancer?

Inflammatory breast cancer is a fast and aggressive cancer that needs to be treated as such. A diagnosis of inflammatory breast cancer is classified as stage III breast cancer. Treatment is as follows:

Neoadjuvant chemotherapy – This first line of treatment clears the breast and skin of the disease and to make the breast operable.
Mastectomy and chest wall radiation
Breast reconstruction – We do not recommend immediate reconstruction because of the high risk of local recurrence of inflammatory breast cancer. However, reconstructive surgery is an option at a later date, once risk of recurrence is assessed. (Autologous fat transfer is the preferred reconstructive method, as radiation can cause complications with implants.)
Hormonal therapy for estrogen receptor and/or progesterone receptor positive disease
Biologic targeted therapy such as trastuzumab for HER2 positive disease

The Breast Center is consistently focused on using cutting-edge techniques for the effective treatment of breast cancer. Research is a critical part of our program and we lead clinical trials for the investigation of new treatment methods.

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21FebJune 11, 2023

By MHN Author

Breast Cancer Treatment Introduction | Susan G. Komen®

This section discusses treatment for early and locally-advanced breast cancers.

Learn about treatment for ductal carcinoma in situ (DCIS).

Learn about treatment for metastatic breast cancer.

Breast cancer treatment

The goal of treating early and locally-advanced breast cancers (stages I, II and III) is to get rid of the cancer and keep it from coming back.

Treatment includes some combination of:

These treatments are designed to remove the cancer from the breast and destroy any cancer that might still be in the body.

Your breast cancer treatment plan

Your breast cancer treatment plan is based on both medical and personal choices.

Together, you and your health care provider make breast cancer treatment decisions. After you get a recommended treatment plan from your provider, take time to study your treatment options and make thoughtful, informed decisions. Each treatment option has risks and benefits to consider along with your own values and lifestyle.

Your treatment is tailored to:

Your specific breast cancer (the biology of the tumor)
The stage of the breast cancer
Your overall health, age and other medical issues
Your personal preferences

Because of the differences between tumors and between people, your treatment plan may differ from another’s, even though you both have breast cancer.

Breast cancer treatment can be divided into local and systemic therapy.

Local therapy

Local therapy removes the cancer from a limited (local) area, such as the breast, chest wall or lymph nodes in the underarm area.

It also helps ensure the cancer doesn’t come back in that area.

Local therapy involves surgery, with or without radiation therapy to the breast area.

Systemic therapy (adjuvant therapy)

The goal of systemic therapy is to get rid of cancer cells that may have spread from the breast to other parts of the body. These cells are too small to see on scans or to measure with lab tests.

Systemic therapy uses drug therapies that travel throughout the body to get rid of cancer cells. It includes chemotherapy, hormone therapy and targeted therapy.

Some drug therapies are given by vein (through an IV) and others are given in pill form.

Because systemic therapy is used in addition to (an adjunct to) breast surgery, these treatments are often called adjuvant therapy.

Learn about factors that affect treatment options.

Managing side effects (palliative care) and supportive care

Managing side effects and supportive care are important parts of breast cancer treatment.

Palliative care aims to prevent or relieve side effects (such as pain or nausea).
Supportive care includes palliative care as well as care of your emotional, social, spiritual and practical needs.

How age affects your treatment plan

No matter your age, your treatment plan depends on many factors, such as tumor stage, tumor grade, hormone receptor status and HER2 status.

Your overall health and other health conditions also play a role.

For example, if you have heart disease, some medications used to treat breast cancer can do more harm than good.

All of these things, as well as your age, are considered when planning your treatment.

Young women

Young women with breast cancer may have special concerns about early menopause and loss of fertility due to treatment.

Learn about these issues for young women with breast cancer.

Your health care team

Throughout your treatment and beyond, you will get care from many health care providers.

Your health care team may include:

Physicians involved in cancer treatment (oncologists, surgeons, radiation oncologists)
Physicians involved in other care for people with breast cancer (radiologists, pathologists, genetic counselors and others)
Nurses
Dietitians
Social workers
Physical therapists
Palliative care or pain specialists
Patient navigators
Pharmacists
Other providers

These professionals may be involved in your care during diagnosis, treatment and recovery.

Learn about choosing a physician.

Staying organized

It may be helpful to use a notebook, 3-ring binder or other organizer to keep track of your breast cancer treatments and health care team.

You may want to include:

A directory of the names, addresses and contact information for your health care team
Insurance information
Medication lists
Pharmacy contact information
Other medical information
A calendar to help plan and keep track of appointments
Blank paper to write down questions and answers or to record any side effects you are having or other information for your health care team
Pockets to store materials

The importance of following your breast cancer treatment plan

Completing your breast cancer treatment plan (called adherence or compliance) is very important. People who complete the full course of treatment have a higher chance of survival.

Sometimes completing your treatment plan may be hard, but there are things you can do to make it easier.

First, tell your health care provider right away if you have any side effects. Your provider may be able to help. Having fewer side effects can help you complete your treatment plan.

Sticking to your treatment plan can be very hard for long-term treatments, such as hormone therapy.

Planning ahead can help you juggle your treatment and daily life. For example, if you have trouble remembering to take your medicine, a daily pillbox or setting an alarm on your watch or mobile device (you may be able to download an app) may help [1].

Learn more about the importance of following your breast cancer treatment plan.

Insurance issues and financial assistance

Insurance issues (such as what to do if a claim is denied) can be a major concern while you are being treated for breast cancer.

Paying for medications and other out-of-pocket expenses can also be a burden.

Learn about insurance and financial assistance programs.

Transportation, lodging, child care and elder care assistance

If you need help getting to and from treatments or if you (or your family) need a place to stay overnight while getting treatment, there are programs that can help.

There are also programs to help with the cost of child care and elder care while you are undergoing treatment.

Learn about transportation, lodging, child care and elder care assistance programs.

Susan G. Komen®’s Breast Care Helpline:
1-877 GO KOMEN (1-877-465-6636)

Calls to our Breast Care Helpline are answered by a trained and caring staff member Monday through Friday from 9:00 a.m. to 10:00 p.m. ET and from 6:00 a.m. to 7:00 p.m. PT. Our helpline provides free, professional support services to anyone with breast cancer questions or concerns, including people diagnosed with breast cancer and their families.

You can also email the helpline at helpline@komen.org.

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21FebJune 11, 2023

By MHN Author

Should I Have Chemotherapy for Early-Stage Breast Cancer? Teton County, Idaho

You may want to have a say in this decision, or you may simply want to follow your doctor’s recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Breast Cancer: Should I Have Chemotherapy for Early-Stage Breast Cancer?

Get the facts

Your options

Have chemotherapy after your surgery for early-stage breast cancer.
Don’t have chemotherapy.

This information is for those who are deciding about chemotherapy for early-stage breast cancer. It is not about surgery or hormone therapy.

Key points to remember

Chemotherapy (“chemo”) is sometimes used after surgery for early-stage breast cancer to help lower the chances that your breast cancer will come back.
Some types of cancer have a very small chance of coming back. Women who have those types of cancer may not need chemo. There are gene tests that may show whether having chemo will help you reduce your chances that the cancer will return.
Your age, type of cancer, tumor size, and hormone receptor status have an effect on how well chemo will work to keep your cancer from coming back.
Different medicines used for chemo have different side effects. Your doctor can give you other medicines to help you deal with side effects like nausea and vomiting. Some women are bothered a lot by the side effects, but some aren’t.
The drugs used for chemo can be very expensive. Insurance policies don’t always cover the whole cost. If you have no insurance, your doctor may be able to help you find drug companies or organizations that will help you pay for this treatment.

FAQs

Breast cancer occurs when abnormal cells grow out of control in one or both breasts. These cells can invade nearby tissues and form a mass, called a malignant tumor. The cancer cells can spread (metastasize) to the lymph nodes and other parts of the body.

The first treatment for early-stage breast cancer usually includes surgery and sometimes radiation. Your doctor may also talk to you about added treatment, such as chemotherapy (“chemo”) and hormone therapy, that may help keep cancer from coming back.

Some people think of added treatment as an insurance policy designed to destroy any cancer cells that may still be in the body.

It isn’t possible for all women to know for sure who will benefit from added treatment. But if you have early-stage, estrogen receptor positive (ER+) breast cancer with no cancer in the lymph nodes, you may have a gene test. Gene tests, such as the Oncotype DX, may be done on the cancerous tissue that was removed to look for tumor markers. These tests can give your doctor important information about whether chemotherapy will help you.

The type of added treatment you have depends on the stage and classification of your breast cancer:

Stage: How far the cancer has spread in your breast and whether it has spread to nearby tissues or other organs is called the stage. This is one of the most important things in choosing the treatment option that is right for you. If breast cancer cells have spread to your lymph nodes, there is a greater risk that they may also have spread to other places in your body. Added treatment, including chemo, may help destroy cancer cells in your body.
Classification: Breast cancer is classified according to what the cancer cells look like under a microscope. This tells your doctor how fast the cancer cells are growing and dividing and where they may have started in the breast tissue. If your cancer cells are growing and dividing quickly, then chemo may help you. When cancer is the kind that grows quickly, doctors call it “aggressive” or “poorly differentiated.” Breast cancers are also classified by types, such as hormone-receptor-positive or triple-negative.

Different chemotherapy medicines tend to cause different side effects. Many women do not have problems with these side effects, while other women are bothered a lot. There are other medicines you can take to treat the side effects of chemo.

Talk to your doctor about the type of chemotherapy medicine that he or she is planning to give you. Ask about any side effects that the chemo may cause.

Short-term side effects can include:

Nausea and vomiting.
Loss of appetite.
Fatigue.
Hair thinning or hair loss.
Mouth sores.
Diarrhea.
Increased chance of bruising, bleeding, and infection.
Memory and concentration problems.

Long-term side effects of chemotherapy can include:

Early menopause, which means not being able to have children anymore. It also can include symptoms like hot flashes, vaginal dryness, and thinning bones (osteoporosis).
Concentration problems that may last for many months after your treatments are finished.
In rare cases, heart damage and a higher risk of other types of cancers, such as leukemia.

Your doctor might recommend chemotherapy (“chemo”) after surgery if:

You are younger than 35. Women younger than 35 usually have a more aggressive type of breast cancer.
Your breast cancer was bigger than a pea. Breast cancers that are at least 1 cm (0.4 in.) are more likely to come back later.
Your breast cancer has spread to the lymph nodes under your arm. If that’s the case, there is a bigger chance that the cancer may also have spread to other places in your body.
Your breast cancer is HER-2 positive or triple-negative. These types of cancer tend to grow faster and spread more quickly.

Your doctor may use a genetic test to find your risk for having your cancer come back. Or your doctor may use a computer program, such as Adjuvant!, to estimate your chances of having your breast cancer come back. This information can help you and your doctor decide about chemotherapy.

Compare your options


What is usually involved?
What are the benefits?
What are the risks and side effects?

Have chemotherapy after surgery Have chemotherapy after surgery

Most chemotherapy (chemo) medicines are injected into a vein in your hand or arm. This is called an IV. Sometimes the medicine is a pill that you take at home. Sometimes it’s a combination of the two.
You will go to a hospital or clinic for each IV treatment, but you won’t stay overnight. Treatments last from 10 minutes to an hour or longer.
You have a number of treatments several weeks apart. A complete course of chemotherapy may take a few months or a whole year.
Some women need to have a special catheter inserted if it’s hard to find a vein for the IV. This catheter stays in place between treatments.

Chemo may help keep breast cancer from coming back.

Breast cancer may come back anyway.
Short-term side effects may include such things as nausea and vomiting, fatigue, hair loss, and mouth sores.
Long-term side effects may include early menopause.

Don’t have chemotherapy Don’t have chemotherapy

You will have regular checkups with your doctor to make sure that the cancer hasn’t come back.

You avoid the side effects of chemo.

Depending on what type of breast cancer you have and how far it has spread, there may be a higher chance of your cancer coming back.

I was diagnosed with breast cancer 3 years ago. It was quite a shock. Even though my breast cancer was small and I did not have any cancer cells in my lymph nodes, I decided to take chemotherapy. My doctor said that even though it would not guarantee that the cancer would not come back, it would improve my chances for a cure. I was really worried about the side effects, but they were not that bad. I just wanted to do everything in my power to beat this breast cancer. My checkups have been fine so far, so I think I made the right choice.

Laurel, age 43

I was diagnosed with breast cancer about 3 years after I went through menopause. My breast cancer was small, and I did not have any cancer in my lymph nodes. I stopped taking my menopause hormones, had surgery and radiation, and have been taking tamoxifen ever since. I see my doctor a couple of times a year and so far have been okay. I’m going to ask my doctor if I’m a good candidate for switching to something like Arimidex. I hear that it’s a smart choice for some women.

Marty, age 56

I found out about my breast cancer earlier this year. I don’t have a family history of it or any of the risk factors that you read about. I chose to have a lumpectomy. My doctor had some gene tests done on the tissue that was removed during my surgery. The tests showed that my cancer was not very aggressive and that chemotherapy would not be helpful for me. So instead I’m taking letrozole every day. I am glad that there are tests for women with ER+ cancer that can show if chemo will help.

Brenda, age 57

I got breast cancer 2 years ago. What a surprise! I don’t have any family history (that I know of), and I don’t have the other risk factors that my doctor talked to me about. Fortunately, my breast cancer was really small, and it hadn’t traveled to the lymph nodes under my arm. My doctor used the Adjuvant! program and said that my chances of the cancer coming back were small, so I decided not to have the chemo. I keep in close contact with my doctor and really feel great. I think that passing on the chemo was the right decision for me.

Janice, age 40

I was diagnosed with breast cancer just last year. Thank goodness I have been having those mammograms. My breast cancer was small, and I didn’t have any cancer in the lymph nodes. I stopped taking my menopause hormones, and my doctor suggested that I try a medication called tamoxifen. I had a few hot flashes, but nothing bad. I feel really good and continue to see my doctor for checkups. I will take the tamoxifen for 2 years and then take something else. Who knows what will be on the market by then?

Paula, age 61

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have chemotherapy after surgery

Reasons not to have chemotherapy

I want to do everything possible to treat my breast cancer.

I would rather wait and see if my cancer comes back before I have more treatment.

More important

Equally important

More important

I would have strong feelings of failure if my breast cancer returned.

I know there’s no way to know for sure whether chemo would keep my cancer from coming back.

More important

Equally important

More important

I want to have the added treatment and be done with it.

I would be comfortable having frequent follow-ups, without treatment, to monitor my breast cancer.

More important

Equally important

More important

I feel ready to deal with the possible side effects of chemo.

I am very worried about the side effects.

More important

Equally important

More important

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you’ve thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having chemo

NOT having chemo

Leaning toward

Undecided

Leaning toward

What else do you need to make your decision?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

Use the following space to list questions, concerns, and next steps.

Your Summary

Here’s a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Next steps

Which way you’re leaning

How sure you are

Your comments

Key concepts that you understood

Key concepts that may need review

Credits

Author	Healthwise Staff
Primary Medical Reviewer	Sarah A. Marshall, MD – Family Medicine
Primary Medical Reviewer	Kathleen Romito, MD – Family Medicine
Primary Medical Reviewer	E. Gregory Thompson, MD – Internal Medicine
Primary Medical Reviewer	Wendy Y. Chen, MD, MPH – Medical Oncology, Hematology

Breast Cancer: Should I Have Chemotherapy for Early-Stage Breast Cancer?

Here’s a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts
Compare your options
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?

1. Get the Facts

Your options

Have chemotherapy after your surgery for early-stage breast cancer.
Don’t have chemotherapy.

This information is for those who are deciding about chemotherapy for early-stage breast cancer. It is not about surgery or hormone therapy.

Key points to remember

Chemotherapy (“chemo”) is sometimes used after surgery for early-stage breast cancer to help lower the chances that your breast cancer will come back.
Some types of cancer have a very small chance of coming back. Women who have those types of cancer may not need chemo. There are gene tests that may show whether having chemo will help you reduce your chances that the cancer will return.
Your age, type of cancer, tumor size, and hormone receptor status have an effect on how well chemo will work to keep your cancer from coming back.
Different medicines used for chemo have different side effects. Your doctor can give you other medicines to help you deal with side effects like nausea and vomiting. Some women are bothered a lot by the side effects, but some aren’t.
The drugs used for chemo can be very expensive. Insurance policies don’t always cover the whole cost. If you have no insurance, your doctor may be able to help you find drug companies or organizations that will help you pay for this treatment.

FAQs

What is breast cancer?

When is chemotherapy used to treat early-stage breast cancer?

Some people think of added treatment as an insurance policy designed to destroy any cancer cells that may still be in the body.

The type of added treatment you have depends on the stage and classification of your breast cancer:

Stage: How far the cancer has spread in your breast and whether it has spread to nearby tissues or other organs is called the stage. This is one of the most important things in choosing the treatment option that is right for you. If breast cancer cells have spread to your lymph nodes, there is a greater risk that they may also have spread to other places in your body. Added treatment, including chemo, may help destroy cancer cells in your body.
Classification: Breast cancer is classified according to what the cancer cells look like under a microscope. This tells your doctor how fast the cancer cells are growing and dividing and where they may have started in the breast tissue. If your cancer cells are growing and dividing quickly, then chemo may help you. When cancer is the kind that grows quickly, doctors call it “aggressive” or “poorly differentiated.” Breast cancers are also classified by types, such as hormone-receptor-positive or triple-negative.

What are the risks of chemotherapy?

Talk to your doctor about the type of chemotherapy medicine that he or she is planning to give you. Ask about any side effects that the chemo may cause.

Short-term side effects can include:

Nausea and vomiting.
Loss of appetite.
Fatigue.
Hair thinning or hair loss.
Mouth sores.
Diarrhea.
Increased chance of bruising, bleeding, and infection.
Memory and concentration problems.

Long-term side effects of chemotherapy can include:

Early menopause, which means not being able to have children anymore. It also can include symptoms like hot flashes, vaginal dryness, and thinning bones (osteoporosis).
Concentration problems that may last for many months after your treatments are finished.
In rare cases, heart damage and a higher risk of other types of cancers, such as leukemia.

Why might your doctor recommend chemotherapy?

Your doctor might recommend chemotherapy (“chemo”) after surgery if:

You are younger than 35. Women younger than 35 usually have a more aggressive type of breast cancer.
Your breast cancer was bigger than a pea. Breast cancers that are at least 1 cm (0.4 in.) are more likely to come back later.
Your breast cancer has spread to the lymph nodes under your arm. If that’s the case, there is a bigger chance that the cancer may also have spread to other places in your body.
Your breast cancer is HER-2 positive or triple-negative. These types of cancer tend to grow faster and spread more quickly.

2. Compare your options

	Have chemotherapy after surgery	Don’t have chemotherapy
What is usually involved?	Most chemotherapy (chemo) medicines are injected into a vein in your hand or arm. This is called an IV. Sometimes the medicine is a pill that you take at home. Sometimes it’s a combination of the two. You will go to a hospital or clinic for each IV treatment, but you won’t stay overnight. Treatments last from 10 minutes to an hour or longer. You have a number of treatments several weeks apart. A complete course of chemotherapy may take a few months or a whole year. Some women need to have a special catheter inserted if it’s hard to find a vein for the IV. This catheter stays in place between treatments.	You will have regular checkups with your doctor to make sure that the cancer hasn’t come back.
What are the benefits?	Chemo may help keep breast cancer from coming back.	You avoid the side effects of chemo.
What are the risks and side effects?	Breast cancer may come back anyway. Short-term side effects may include such things as nausea and vomiting, fatigue, hair loss, and mouth sores. Long-term side effects may include early menopause.	Depending on what type of breast cancer you have and how far it has spread, there may be a higher chance of your cancer coming back.

Personal stories

Personal stories about choosing chemotherapy for breast cancer

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

“I was diagnosed with breast cancer 3 years ago. It was quite a shock. Even though my breast cancer was small and I did not have any cancer cells in my lymph nodes, I decided to take chemotherapy. My doctor said that even though it would not guarantee that the cancer would not come back, it would improve my chances for a cure. I was really worried about the side effects, but they were not that bad. I just wanted to do everything in my power to beat this breast cancer. My checkups have been fine so far, so I think I made the right choice.”

— Laurel, age 43

“I was diagnosed with breast cancer about 3 years after I went through menopause. My breast cancer was small, and I did not have any cancer in my lymph nodes. I stopped taking my menopause hormones, had surgery and radiation, and have been taking tamoxifen ever since. I see my doctor a couple of times a year and so far have been okay. I’m going to ask my doctor if I’m a good candidate for switching to something like Arimidex. I hear that it’s a smart choice for some women.”

— Marty, age 56

“I found out about my breast cancer earlier this year. I don’t have a family history of it or any of the risk factors that you read about. I chose to have a lumpectomy. My doctor had some gene tests done on the tissue that was removed during my surgery. The tests showed that my cancer was not very aggressive and that chemotherapy would not be helpful for me. So instead I’m taking letrozole every day. I am glad that there are tests for women with ER+ cancer that can show if chemo will help.”

— Brenda, age 57

“I got breast cancer 2 years ago. What a surprise! I don’t have any family history (that I know of), and I don’t have the other risk factors that my doctor talked to me about. Fortunately, my breast cancer was really small, and it hadn’t traveled to the lymph nodes under my arm. My doctor used the Adjuvant! program and said that my chances of the cancer coming back were small, so I decided not to have the chemo. I keep in close contact with my doctor and really feel great. I think that passing on the chemo was the right decision for me.”

— Janice, age 40

“I was diagnosed with breast cancer just last year. Thank goodness I have been having those mammograms. My breast cancer was small, and I didn’t have any cancer in the lymph nodes. I stopped taking my menopause hormones, and my doctor suggested that I try a medication called tamoxifen. I had a few hot flashes, but nothing bad. I feel really good and continue to see my doctor for checkups. I will take the tamoxifen for 2 years and then take something else. Who knows what will be on the market by then?”

— Paula, age 61

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have chemotherapy after surgery

Reasons not to have chemotherapy

I want to do everything possible to treat my breast cancer.

I would rather wait and see if my cancer comes back before I have more treatment.

More important

Equally important

More important

I would have strong feelings of failure if my breast cancer returned.

I know there’s no way to know for sure whether chemo would keep my cancer from coming back.

More important

Equally important

More important

I want to have the added treatment and be done with it.

I would be comfortable having frequent follow-ups, without treatment, to monitor my breast cancer.

More important

Equally important

More important

I feel ready to deal with the possible side effects of chemo.

I am very worried about the side effects.

More important

Equally important

More important

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you’ve thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having chemo

NOT having chemo

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1. Is chemo the main treatment for early-stage breast cancer?

You’re right. Chemotherapy is an added treatment, a sort of insurance policy designed to kill any cancer cells that may still be in your body after surgery.

2. Should every woman with early-stage breast cancer have chemotherapy?

You’re right. Not every woman will need chemo. It depends on what type of breast cancer she has and how far it has spread.

3. Are the side effects of chemo always bad?

That’s right. Some women are not bothered by side effects. Your doctor can give you other medicines to help you deal with side effects like nausea and vomiting.

Decide what’s next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2. Check what you need to do before you make this decision.

I’m ready to take action.
I want to discuss the options with others.
I want to learn more about my options.

Use the following space to list questions, concerns, and next steps.

Credits

By	Healthwise Staff
Primary Medical Reviewer	Sarah A. Marshall, MD – Family Medicine
Primary Medical Reviewer	Kathleen Romito, MD – Family Medicine
Primary Medical Reviewer	E. Gregory Thompson, MD – Internal Medicine
Primary Medical Reviewer	Wendy Y. Chen, MD, MPH – Medical Oncology, Hematology

Note: The “printer friendly” document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.

Current as of: March 27, 2018

Author: Healthwise Staff

Medical Review:Sarah A. Marshall, MD – Family Medicine & Kathleen Romito, MD – Family Medicine & E. Gregory Thompson, MD – Internal Medicine & Wendy Y. Chen, MD, MPH – Medical Oncology, Hematology

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21FebJune 11, 2023

By MHN Author

Gynecomastia Breast Cancer Risk – Gynecomastia Lima

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