Interview has been edited for clarity.
Most common treatments for breast cancer
According to Dr. Thompson, most cases of breast cancer are treated with some combination of surgery, radiation, and a systemic therapy such as chemotherapy, targeted therapy, or endocrine therapy.
Surgery most often involves removing the cancer from the breast (lumpectomy) and taking a sample from the lymph nodes under the arm (sentinel lymph node biopsy), but it can also include removal of all breast tissue (mastectomy) and all of the lymph nodes under the arm (axillary lymph node dissection). Systemic therapies can be delivered using an IV, injection, or oral medication.
Breast cancer treatment during pregnancy
“In pregnancy, surgery can still be performed and certain chemotherapy regimens can still be administered, but pregnant patients can't receive radiation, certain targeted therapies, or endocrine therapy,” Dr. Thompson explains.
That means that these treatments need to be put on hold until after pregnancy if they’re part of the treatment plan for a pregnant patient.
Side effects of breast cancer treatments
Breast cancer treatment options have their side effects. Dr. Thompson explains in more detail what they are and how to manage them.
Surgery
The most serious long-term consequence of surgery, specifically surgery on the lymph nodes under the arm, is lymphoedema, which can result in chronic swelling and heaviness of the affected arm.
Lymphoedema can be managed with therapeutic massage and compression garments.
The prognosis for most patients diagnosed with breast cancer, especially early-stage breast cancer, is excellent.
Radiation therapy
The most common side effects experienced during radiation treatment are skin changes and fatigue.
Skin sensitivity can be managed with creams and topical medications, and fatigue can be abated by staying active and getting regular exercise.
Chemotherapy
Systemic therapies can cause a variety of side effects. The most pronounced side effects are typically seen with chemotherapy. These side effects include hair loss, skin and nail changes, nausea, vomiting, diarrhea, nerve problems — such as numbness, tingling, and pain of the hands and feet — hot flashes, and joint aches and pains.
These side effects are typically managed by a medical oncologist with medication and/or integrative medicine therapies, such as acupuncture.
Survival rates of breast cancer
Dr. Thompson says that in general, the prognosis for most patients diagnosed with breast cancer, especially early-stage breast cancer, is excellent.
“Prognosis and survival rates depend on the age of the patient and the stage of the disease. The stage of the disease is determined by the size of the tumor in the breast, the extent of spread of the cancer to the lymph nodes and other parts of the body, the subtype of the breast cancer, and the biology of the cancer, which can be determined with molecular tests.”
She says that the average 5-year survival rate for all women with invasive breast cancer is 90 percent, and the average 10-year survival rate is 83 percent.
If the cancer is confined to the breast, which is considered early-stage breast cancer, then the 5-year survival rate is 99 percent.
The majority of women are diagnosed with early-stage breast cancer. If the cancer has spread to the lymph nodes, then the 5-year survival rate is 85 percent. If the cancer has spread to other parts of the body or has “metastasized,” then the 5-year survival rate is 27 percent.
“However, even when cancer is diagnosed at a more advanced stage and has spread to other parts of the body, modern treatment regimens can help these patients maintain a good quality of life for years,” says Dr. Thompson.
History of updates
Current version (15 December 2021)
Reviewed by Dr. Carlie Thompson, Breast surgical oncologist and assistant professor, University of California, California, US