How is breast cancer treated?

General types of treatment

The main types of treatment for breast cancer are:

• Surgery
• Radiation
• Chemotherapy
• Hormone therapy
• Targeted therapy
• Bone-directed therapy (bisphosphonates and denosumab)

Treatments can be put into broad groups based on how they work and when they are used.

Local or systemic treatment

Local treatment is used to treat a tumor without affecting the rest of the body. Surgery and radiation are examples of local treatment.

Systemic treatment is given into the bloodstream or by mouth and goes throughout the body to reach cancer cells that may have spread beyond the breast. Chemotherapy (chemo), hormone therapy, and targeted therapy are systemic treatments.

Adjuvant and neoadjuvant therapy

When people who seem to have no cancer left after surgery are given more treatment it is called adjuvant therapy. Doctors know that cancer cells can break away from the main tumor and begin to spread through the bloodstream in the early stages of the disease. It’s very hard to tell if this has happened. But if it has, the cancer cells can start new tumors in other organs or in the bones. The goal of adjuvant therapy is to kill these hidden cells. Both systemic therapy (like chemo, hormone treatment, and targeted therapy) and radiation can be used as adjuvant therapy. But not every patient needs adjuvant therapy.

Some people are given treatment before surgery to shrink a tumor. This is called neoadjuvant therapy.