Breast cancer treatment by stage
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Summary
10 papers analyzed
These studies suggest that breast cancer treatment varies by stage, with early-stage treatments often involving surgery and endocrine therapy, while advanced stages may require a combination of surgery, radiation, chemotherapy, and systemic therapies, and that treatment costs generally increase with disease stage.
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Breast Cancer Treatment by Stage
Early-Stage Breast Cancer (Stage 0 and I)
Stage 0: Ductal Carcinoma In Situ (DCIS)
Stage 0 breast cancer, also known as ductal carcinoma in situ (DCIS), is a non-invasive form of breast cancer. Treatment typically involves a lumpectomy followed by radiation therapy or a mastectomy. For estrogen receptor-positive DCIS, endocrine therapy may also be recommended to reduce the risk of recurrence.
Stage I: Early Invasive Breast Cancer
Stage I breast cancer is an early invasive stage where the cancer is localized. Treatment usually involves surgery (lumpectomy or mastectomy) followed by radiation therapy. Systemic therapies such as endocrine therapy, chemotherapy, or HER2-targeted therapy may be used depending on the tumor's hormone receptor and HER2 status . Recent trials are exploring the de-escalation of radiation therapy in patients with low-risk profiles, aiming to reduce overtreatment while maintaining efficacy .
Intermediate-Stage Breast Cancer (Stage II and III)
Stage II: Locally Advanced Breast Cancer
Stage II breast cancer is more advanced but still localized. Treatment involves a combination of surgery, radiation, and systemic therapies. Preoperative (neoadjuvant) chemotherapy or endocrine therapy may be used to shrink the tumor before surgery. Postoperative treatments include radiation, chemotherapy, and/or endocrine therapy based on the tumor's characteristics.
Stage III: Advanced Locally Advanced Breast Cancer
Stage III breast cancer is divided into operable (IIIA) and inoperable (IIIB) categories. Treatment typically starts with neoadjuvant chemotherapy to reduce tumor size, followed by surgery and radiation therapy. The multidisciplinary approach has significantly improved survival rates, with 5-year survival rates ranging from 30% to 60% . For patients with hormone receptor-positive tumors, endocrine therapy is also a key component of treatment.
Metastatic Breast Cancer (Stage IV)
Stage IV: Metastatic Breast Cancer
Stage IV breast cancer is characterized by the spread of cancer to distant organs and is considered incurable. The primary goal of treatment is to improve the quality and length of life. Systemic therapies, including chemotherapy, endocrine therapy, HER2-targeted therapy, and immunotherapy, are the mainstays of treatment. Recent studies suggest that locoregional treatment (surgery and/or radiation) of the primary tumor, followed by systemic therapy, may offer a survival benefit in certain patients .
Conclusion
Breast cancer treatment varies significantly by stage, with early-stage cancers often being curable and advanced stages focusing on prolonging life and improving its quality. The treatment approach is multidisciplinary, involving surgery, radiation, and systemic therapies tailored to the tumor's molecular characteristics. Ongoing research aims to refine these strategies further, focusing on individualizing treatment and improving outcomes across all stages.
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