They may send you to a doctor who specializes in radiation a radiation oncologist for evaluation. For women who have a hormone receptor-positive ER-positive or PR-positive breast cancer, most doctors will recommend hormone therapy tamoxifen or an aromatase inhibitor, or one followed by the other as an adjuvant additional treatment, no matter how small the tumor is.
Women with tumors larger than 0. Hormone therapy is typically given for at least 5 years. A woman's age when she is diagnosed may help in deciding if chemo should be offered or not. Some doctors may suggest chemo for smaller tumors as well, especially if they have any unfavorable features a cancer that is growing fast; hormone receptor-negative, HER2-positive; or having a high score on a gene panel such as Oncotype DX.
After surgery, some women with HER2-positive cancers will be treated with trastuzumab with or without pertuzumab for up to 1 year. Many women with HER2-positive cancers will be treated with trastuzumab with or without pertuzumab followed by surgery and more trastuzumab with or without pertuzumab for up to 1 year.
If after neoadjuvant therapy, residual cancer is found during surgery, trastuzumab may be changed to a different drug, called ado-trastuzumab emtansine, which is given every 3 weeks for 14 doses.
If hormone receptor-positive cancer is found in the lymph nodes, your doctor might recommend one year of trastuzumab followed by additional treatment with an oral drug called neratinib for 1 year. Stage II cancers are treated with either breast-conserving surgery BCS; sometimes called lumpectomy or partial mastectomy or mastectomy.
Women who have BCS are treated with radiation therapy after surgery. Women who have a mastectomy are typically treated with radiation if the cancer is found in the lymph nodes. Some patients who have a SLNB that shows cancer in a few lymph nodes may not have the rest of their lymph nodes removed to check for more cancer.
In these patients, radiation may be discussed as a treatment option after mastectomy. If you were initially diagnosed with stage II breast cancer and were given treatment such as chemotherapy or hormone therapy before surgery, radiation therapy might be recommended if cancer is found in the lymph nodes at the time of the mastectomy. A doctor who specializes in radiation, called a radiation oncologist , may review your case to discuss whether radiation would be helpful to you.
In some cases, breast reconstruction can be done during the surgery to remove the cancer. But if you will need radiation after surgery, it is better to wait to get reconstruction until after the radiation is complete.
Systemic therapy is recommended for some women with stage II breast cancer. Your specialist may recommend that you have chemotherapy for one or more of the following reasons:. Chemotherapy drugs circulate in the bloodstream around the body. They can help treat cancer cells that have broken away from the breast cancer and spread to other parts of the body secondary cancer.
Your treatment plan might include other cancer treatments as well as chemotherapy. For example, you might have:. There are a number of chemotherapy drugs used to treat breast cancer.
You usually have a combination of 2 or 3 drugs together, but you might just have one. The type of drugs you have depends on different factors. These factors include your risk of the cancer coming back and whether you have other medical conditions, such as heart problems. Examples of chemotherapy for early and locally advanced breast cancer include:.
Check what the name of your regimen is with your doctor or nurse, then take a look at our A to Z list of cancer drugs.
You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:. If you don't have a central line you might have treatment through a thin short tube a cannula. The cannula goes into a vein in your arm each time you have treatment.
You usually have treatment into your bloodstream at the cancer day clinic. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you. You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home. For some types of chemotherapy you have to stay in a hospital ward.
This could be overnight or for a couple of days. Morning, Iris. My name is Clare. I am the nurse who is going to be looking after you today. And then I am going to come back to you and talk through the chemotherapy with you and the possible side effects you may experience throughout your treatment.
Is that okay? Each chemotherapy is made up for each individual patient, depending on the type of cancer they have and where it is and depending their height, weight and blood results.
So, depending on where your cancer is some people have their chemotherapy drug, their cancer drug by drip, some will have an injection and other people will have tablets. So, Iris, your chemotherapy is going to be given to you in what we call cycles and the cycles are given every three weeks for a period of six cycles. The benefits and risks of the treatment should be explained before you sign. This is because if the number of blood cells in the body is too low, treatment may need to be delayed.
You may be at the hospital for a short time only. However, because of tests, waiting times and how long it takes to prepare and give the chemotherapy drugs, some people are there for most of the day. You may be asked to have blood tests a few days before you have your chemotherapy. You might find it helpful to take things to help pass the time as well as snacks and drinks.
You may be able to take someone to go with you to keep you company. Talk to your chemotherapy nurse to find out if this is possible.
With some types of chemotherapy you may be given your first treatment as an inpatient and may need to stay in hospital overnight. Chemotherapy is commonly given as a series of treatments with a break between each treatment to give your body time to recover from any short-term side effects. The treatment and period of time before the next one starts is called a cycle.
You may have one drug or a combination of two or three drugs. The exact type and dose of chemotherapy will be tailored to your individual situation.
The length of time that you have chemotherapy will depend on your individual situation. Your treatment team will discuss this with you. Like any treatment, chemotherapy can cause side effects. Everyone reacts differently to drugs and some people have more side effects than others.
Find out about the side effects of chemotherapy. Many people find that complementary therapies help them cope with the side effects of chemotherapy, even though there may not be the evidence to support this. Check with your treatment team or GP before having any complementary therapies, and mention your breast cancer and treatment to any therapist you see.
You may be able to eat normally throughout chemotherapy or your eating habits may change because of side effects. Find out more about diet during treatment.
The evidence is not clear whether supplements such as vitamins, particularly high-dose antioxidants including vitamins A, C and E, co-enzyme Q10 and selenium , are harmful or helpful during chemotherapy.
You can still have sex during treatment. Most treatment teams will advise using barrier methods of contraception, such as condoms during treatment, and for a few days after chemotherapy is given. Your specialist will usually recommend barrier methods of contraception, such as condoms. The contraceptive pill is not usually recommended because it contains hormones. Emergency contraception such as the morning after pill can still be used.
Find out more about how breast cancer and its treatment can affect sex and intimacy and read our tips on how to manage these changes. Live vaccines include mumps, measles, rubella German measles , polio, BCG tuberculosis , shingles and yellow fever. Live vaccines contain a small amount of live virus or bacteria. If you have a weakened immune system, which you may do during chemotherapy, they could be harmful. Talk to your GP or treatment team before having any vaccinations.
If anyone you have close contact with needs to have a live vaccine speak to your treatment team or GP. They can advise what precautions you may need to take depending on the vaccination. Anyone at risk of a weakened immune system, and therefore more prone to infection, should have the flu vaccine. This includes people due to have, or already having, chemotherapy.
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