Patient Education: Diseases Conditions Treatments & Procedures
Breast Cancer
Your Treatment Plan
There are many different ways to treat breast cancer. Based on the results of the surgery that confirmed your diagnosis, your healthcare team will develop a treatment plan just for you. They will recommend treatment options and talk to you about your possible choices.
Decisions about your treatment will depend on:
The stage of the cancer - The stage of a cancer describes the size of the tumor and whether it has spread beyond its original site to the lymph nodes or other areas of the body.
The grade of the cancer - The grade of a tumor describes how different the cancer cells look from normal cells, how quickly the cancer cells are growing and dividing, and how likely they are to spread. Tumors are graded from I to III, with a score of I indicating a slow growing type of cancer and III indicating a more aggressive growing cancer.
The hormone receptor status -The hormone receptor status describes whether there are receptors for the female hormones estrogen and progesterone in the cancer cells. A hormone receptor is a protein on the surface or inside of a cell. It connects to a certain hormone and causes changes in the cell that can cause cancer. For example, some breast cancer cells have receptors that the hormones estrogen and/or progesterone attach to, helping the cancer to grow. If the cells have these receptors, they are said to be estrogen receptor positive and/or progesterone receptor positive (ER+ and/or PR+). If there are very few or no receptors in the cells, they are estrogen receptor negative and/or progesterone receptor negative (ER- and/or PR-). If your breast cancer cells are found to be ER+ and/or PR+, your physician may recommend hormonal therapy to treat your breast cancer.
The Her-2 status - Human epidermal growth factor receptor number 2, also called Her-2, is a protein present on the breast cancer cell that, if present in greater than normal quantity, can promote the growth of breast cancer. About 20% of breast cancer patients will have a cancer that tests positive for Her-2. A strongly positive Her-2 test indicates a more aggressive form of breast cancer. If your breast cancer cells are found to be Her-2 positive, your physician may recommend a biological therapy, named Herceptin to treat your breast cancer.
Diagnostic Tests to Determine Your Treatment Plan
If you are found to have breast cancer by biopsy, further testing may be required to see if any breast cancer cells have left your breast and may be present in other parts of your body. These tests will also help determine the type of treatment that is recommended:
- Bone scan: This test is performed by the nuclear medicine lab to determine if there is breast cancer in your bone.
- Chest x-ray: This test is done to determine how healthy your lungs are and if the breast cancer has spread to your lungs.
- Blood tests: Blood tests will be done to check how well your kidneys, liver and bone marrow are working.
- MUGA scan: Also known as a Multi-Gated Acquisition scan, this test shows how well your heart pumps blood through your body. This information is important to know before you start chemotherapy as some drugs can affect your heart.
- CT scan: a Computed Tomography scan is a series of computerized pictures linked to an x-ray that takes pictures of the inside of your body. A CT scan is useful in finding a metastasis.
- PET scan: a positron emission tomography scan is a test where a small amount of radioactive glucose (sugar) is injected into a vein and then a scanner takes computerized pictures of the inside of the body. Areas of the body where glucose is used will "light up". Cancer cells often use more glucose than normal healthy cells and therefore these pictures can be used to find cancer cells in the body. This test is not routinely done in breast cancer and further studies are still required to study its value.
