Treatments for early breast cancer

The treatment your medical team offers will depend on your individual situation. The best option is usually a combination of treatments.

Your breast cancer pathology report helps doctors decide which treatments to recommend, and in what order.

It is okay to take time to decide between the options. This will not affect the outcome of your treatment.

Find out How breast cancer treatment is decided.

Breast surgery

The aim of breast surgery is to remove the cancer from the breast and armpit. The tissue including the cancer is sent to a pathologist for testing. The results help to inform what other treatments you might be recommended.

You may be offered a choice between 2 types of breast surgery:

• lumpectomy (‘breast conserving surgery’ or 'wide local excision') – to remove the breast cancer and a small area of healthy tissue around it, usually followed by radiotherapy
• mastectomy – to remove all of the breast tissue.

If you are having a mastectomy, your breast surgeon should talk to you about your options for breast reconstruction – surgery to create a new breast. 

These are equally effective, so your personal preferences will be important.

Both types of surgery will also involve removal of one or more lymph nodes from the armpit ('axilla') to check for cancer in the lymph nodes.

To understand these, read Surgery options for breast cancer.

Radiotherapy

Radiotherapy (or radiation therapy) destroys cancer cells that cannot be seen but may be left in the breast, chest wall or armpit after breast surgery.

It is usually recommended after lumpectomy. Sometimes it is recommended after mastectomy, when the risk of cancer coming back in the breast or armpit is high.

For more information, read:

• About radiotherapy
• Radiotherapy for early breast cancer. 

Chemotherapy

Chemotherapy drugs destroy fast-growing cancer cells that may be left in the body but cannot be detected by scans or blood tests.

Chemotherapy works throughout the whole body, reducing the chance of cancer coming back in the breast or elsewhere.

For more information, read:

• About chemotherapy treatment
• Chemotherapy for early breast cancer. 

Hormone-blocking therapy

Hormone-blocking drugs are used to treat cancers that are hormone receptor-positive (HR+). These cancers have the hormone receptors oestrogen and/or progesterone on their cells and cause the cancer to grow.

Hormone-blocking therapy (or ‘endocrine therapy’) may be used alone or with other breast cancer treatments.

For more information, read:

• About hormone-blocking therapy. 

Targeted therapies

Targeted therapies (or ‘biological therapies’) are drugs that work by finding and attacking specific parts of cancer cells that help them grow or survive.

They may be used alone or with other breast cancer treatments

For more information, read:

• About targeted therapies
• Targeted therapies for early breast cancer.

Immunotherapy

Immunotherapy uses your body's immune system to help kill cancer cells. It has been used in treatment for other types of cancer for many years. It is now also used for some breast cancer types.

Read about Immunotherapy.

Before you start treatment

Medications and supplements

It’s important to tell your treating team about any medication you’re already taking, such as:

• contraceptive pill or implant
• HRT (also known as MHT), including vaginal oestrogen creams
• any prescription medications
• any non-prescription or complementary medicines, such as vitamins or herbal treatments. Some can interfere with breast cancer treatments and make them less effective.

They may ask you to stop or change some medications, in particular the contraceptive pill or hormone replacement therapy (HRT). The decision to stop HRT can be difficult, but it’s generally advised after a breast cancer diagnosis.

Your treating team can give you the best advice for your personal situation.

Exercise

Research has shown significant survival benefits from moderate, sustained exercise both during and after treatment. Exercise is now often prescribed as part of treatment for all people with breast cancer, in the same way that medicines are.

For more information about the benefits of exercise, read:  Exercise: why, what and how?

Emerging treatments

Research is looking into why cancers become resistant to treatments and stop working, and how we can overcome this. Research is also testing new drugs every day which target genetic mutations such as: 

• BRCA1/2
• AKT1
• ERBB2
• ESR1
• PALB2
• PIK3CA

Ask your medical oncologist about any trials or schemes that may be appropriate for you.

For more information, read:

• Ways to access new breast cancer drugs
• Clinical trials