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Types of treatment for breast cancer

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Surgery

The types of operation which may be considered are:

Breast-conserving surgery. This is often an option if the tumour is not too big. A 'lumpectomy' (or 'wide local excision') is one type of operation where just the tumour and some surrounding breast tissue is removed. It is usual to have radiotherapy following this operation. This aims to kill any cancer cells which may have been left in the breast tissue.
Removal of the affected breast (mastectomy). This may be necessary if there is a large tumour or a tumour in the middle of the breast. It is often possible to have breast reconstruction surgery to create a new breast following a mastectomy. This can often be done at the same time as the mastectomy, although it can also be done months or years later. There now are many different types of reconstruction operations available.

Whatever operation is done it is also usual to remove one or more of the lymph nodes in the armpit. These lymph nodes are where breast cancer usually first spreads to. The lymph nodes which are removed are examined under the microscope to see if they contain any cancer cells. This helps to accurately stage the disease and helps to guide the specialist as to what treatment to advise following surgery.

Alternatively, a sentinel lymph node biopsy may be performed. This is a way of assessing if the main lymph nodes draining the breast cancer contain cancer. If they are clear then the remaining lymph nodes in the armpit will not need to be removed.

Radiotherapy

Radiotherapy is a treatment which uses high energy beams of radiation which are focused on cancerous tissue. This kills cancer cells, or stops cancer cells from multiplying. (See separate leaflet called 'Radiotherapy ' for more details.)

For breast cancer, radiotherapy is mainly used in addition to surgery. For example, if you have breast-conserving surgery it is usual to have radiotherapy to the affected breast after the operation. This aims to prevent breast cancer returning in the same breast. When radiotherapy is used in addition to surgery it is called 'adjuvant radiotherapy'.

New techniques for radiotherapy are currently being trialled. For example, brachytherapy is a type of radiotherapy in which radioactive implants are inserted into the space in the breast where tissue has been removed. This is still currently only being done as part of a trial.