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Treating early breast cancer and managing risk of recurrence with hormonal treatment

Common treatments for early breast cancer

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Treatments are available for many women with breast cancer, whatever the stage, even palliative care. Today, most breast cancer is found at an early stage, and many women can benefit from up-to-date and effective treatments. Treatments are constantly evolving, and sometimes more than one treatment is needed, so it is important to talk to your doctor about your treatment. Your breast cancer treatment may include the following:

• Surgery: Surgery is an important part of treatment for many women with breast cancer. Many women can choose between lumpectomy or mastectomy.
  • Lumpectomy (also may be referred to as a partial mastectomy) is breast-conserving surgery in which just the tumor and some surrounding normal tissue are removed. Often, some lymph nodes in the underarm area are also removed.
  • Mastectomy is the removal of all of the breast. Sometimes, the lymph nodes are removed, and very rarely for a large and aggressive tumor, part of the chest wall muscle is removed.
• Radiation therapy: Radiation therapy is often used after lumpectomy and partial mastectomy to kill any cancer cells that may not have been removed during surgery.
• Chemotherapy: Cytotoxic chemotherapy is treatment with drugs that attack and kill cancer cells and some rapidly growing normal cells, such as the cells in the hair follicles.
• Hormonal treatment: Hormonal treatment is a common way of treating breast cancer in women whose tumors are hormone receptor-positive. These drugs can block the effect of estrogen or reduce estrogen levels, thereby reducing the risk of cancer coming back (recurrence).

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For information on treatment for advanced breast cancer, see For patients with advanced breast cancer.

What is adjuvant therapy?

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The term "adjuvant" means "in addition to." With breast cancer treatment, this means that in addition to your primary (or initial) treatment, another type of therapy is being used. Radiation therapy, cytotoxic chemotherapy, and hormonal treatment are three common forms of adjuvant treatment. Here is why you might need adjuvant treatment:

After surgery, a small number of cancer cells may still remain in your body. Not all patients have these cells, but if you do, they can continue to multiply and spread. Adjuvant therapy is given to prevent or delay these cells from multiplying. A decreased chance the cancer will come back or recur is a benefit of adjuvant therapy in breast cancer.

Managing risk of recurrence with hormonal treatment

Hormones, such as estrogen and progesterone, are naturally produced by organs in the body, and they regulate bodily processes. Some breast cancer tumors need estrogen and/or progesterone to grow. These tumors are said to have receptors for the hormones estrogen and/or progesterone. Breast cancer tumors that have these receptors are called estrogen receptor-positive and/or progesterone receptor-positive, and are also referred to as hormone receptor-positive.

Hormonal (estrogen-blocking/reducing) treatment is a way of treating breast cancer through the use of drugs that either block the effect of estrogen or that reduce estrogen levels.

Lab tests of your cancer biopsy can give your medical team information about the hormone receptor status of your cancer. Hormonal treatment works best when the tumor cells are hormone receptor-positive. For those cancers that are not hormone receptor-positive, hormonal treatment usually has little effect and thus is not used.

It is important to note that hormonal treatment is not the same as hormone replacement therapy (HRT). Hormonal treatment for breast cancer is used to block the effect of estrogen, or to reduce estrogen levels. The goal is to keep estrogen from reaching cancer cells. Hormone replacement therapy, on the other hand, supplies estrogen to women to help to ease the symptoms of menopause. HRT should not be used if you have been diagnosed with breast cancer.

Hormonal treatment is commonly used as adjuvant therapy. This means that it is used in addition to surgery and/or radiation. Hormonal treatment is not meant to take the place of surgery and/or radiation. Rather, it acts in a different way to help decrease the chance of the breast cancer coming back (also called recurrence).

There are several types of hormonal treatments used. These treatments differ in the way that they work in the body. Talk to your doctor about which hormonal treatment is right for you.

To learn more about how hormonal treatment works and the different types of hormonal treatments, click here.