Treatment & Procedures
The staging system for breast cancer starts with stage 0 (carcinoma in situ), a noninvasive condition in which abnormal cells are confined to either the lining of the ducts, lobules of the breast or nipple only, and goes to stage 4, where the cancer has spread (metastasized) through the blood and lymph nodes to other parts of the body, such as the lung, liver or brain.
Once breast cancer has been diagnosed and staged, your oncologist at Houston Methodist may recommend one or more of the following treatments:
Surgery may be needed to remove cancerous tissue from the breast and breast area. Depending on the size and location of the tumor, your doctor may recommend one of the following options:
- Mastectomy involves removal of the entire affected breast
- Partial (segmental) mastectomy involves removing part of the affected breast, depending on the size and location of the tumor
- Lumpectomy involves removing only the breast lump and a small surrounding area (margin) of normal tissue
Radioactive seed localization (RSL) is a procedure in which your breast radiologist places a tiny radioactive seed, smaller than a grain of rice, into your abnormal breast tissue. This seed helps your surgeon locate the abnormal breast tissue that was seen on your mammogram, ultrasound or MRI that often cannot be felt or seen during surgery. The seed is removed along with the abnormal breast tissue during surgery. Studies have shown that RSL leads to better margin status, without removing too much healthy tissue, and less discomfort than wire localization. There is virtually no risk of the seed moving within your breast and the dose of radiation is very low and not harmful to you or those around you.
In some cases, your surgical plan might include the removal of lymph nodes from the breast region and the underarm area, as cancerous cells may gather in these nodes. Surgery is often followed by a course of radiation therapy or chemotherapy to kill any remaining cancer cells.
Your oncologist will also talk with you about breast reconstruction, if needed. Your care team can connect you to reconstructive surgeons at Houston Methodist, and work to coordinate your cancer treatment with the reconstructive procedure. Learn more about surgical procedures, including the roles that different surgical approaches have in preventing, diagnosing and treating cancer.
Radiation therapy is one of the most effective ways to destroy cancer cells in the breast that might remain after surgery. A high-energy beam damages cancer cells’ DNA, which is the material that causes the cells to divide.
Breast cancer is usually treated with external-beam radiation therapy, which is radiation given from a machine outside the body. High levels of radiation are precisely aimed at a targeted area. Treatments are given in the hospital or in a clinic, usually five days a week over several weeks or months. Side effects may include fatigue, mild skin reactions, upset stomach and loose bowel movements. Side effects typically go away after treatments.
Learn more about the variety of innovative radiation therapies offered at Houston Methodist.
Chemotherapy uses drugs to kill cancer cells and may be recommended in combination with surgery or other methods of treating breast cancer. At Houston Methodist we offer a full spectrum of chemotherapy medications, including the most advanced forms currently available. Many options are now available with few troublesome side effects, helping make the process of receiving chemotherapy easier than it once was.
Your medications may be administered intravenously through an IV line or via oral medication. You may receive your treatments at the hospital, in your oncologist’s office or, if oral therapy is prescribed, at home. Chemotherapy is usually administered in cycles, with each period of treatment followed by a period of rest.
If chemotherapy is part of your treatment plan, your care team will discuss the medications, any side effects, and the ways in which we can support you and your family during your course of treatment.
Learn more about chemotherapy treatment, including how it works within your body and what to expect while undergoing treatment.
Targeted therapy is a welcome advance in breast cancer research. This form of therapy uses medications developed to target specific cellular problems that cause or advance cancer growth, such as certain proteins or new blood vessel growth in tumors.
Targeted therapy medications have a minimal effect on other cells in the body and are most effective when combined with other treatments such as chemotherapy. The targeted approach means fewer side effects. Like chemotherapy, these drugs may be taken in pill form or given intravenously at your oncologist's office.
The ovaries produce the female hormones estrogen and progesterone, which can promote the development or return of most breast cancers. Your treatment plan may include hormone therapy that involves taking one or more medications daily either to prevent these hormones from affecting the body as they normally would or to stop the ovaries from producing those hormones altogether.
Your doctor will work with you to find the most effective therapy combination for you while minimizing uncomfortable side effects. Learn more about systemic hormone therapy.