Stage 1 Breast Cancer Treatment

Stage 1 breast cancer is defined as being small in size (tumor/cancerous tissue of approximately 20 millimeters or less) and isolated within the breast.

Typical treatment options for Stage 1 breast cancer may include one or more of the following treatment options:

Surgery

Surgery is usually performed for all stages of breast cancer in order for the tumor to be removed as well as to check the surrounding lymph nodes to see if the breast cancer has spread to other parts of the body.

One of two types of surgery may be performed during Stage 1 breast cancer:

Breast-sparing surgery

Also known as a lumpectomy or partial mastectomy, breast-sparing surgery removes only the area of the breast that is affected with cancer.

Mastectomy

Also known as a bilateral prophylactic mastectomy, a mastectomy removes an entire breast or both breasts. Reconstructive surgery may take place following a mastectomy.

Radiation Therapy

Typically, radiation therapy is given after breast-sparing surgery (referred to as adjuvant therapy) in order to kill and destroy any remaining cancer cells left behind from the surgery. It is commonly given externally five days a week over the course of six weeks.

Hormone Therapy

If the tumor is found to be hormone receptor-positive, hormone therapies such as tamoxifen (Nolvadex) or aromatase inhibitors (exemestane/Aromasin, anastrozole/Arimidex, or letrozole/Femara) may be recommended.

Used for more than 30 years to treat breast cancer, tamoxifen is given as a pill and works by blocking the activity of estrogen. Aromatase inhibitors are typically given to women who have already gone through menopause, and work by preventing the body from making estradiol, a form of estrogen.

Chemotherapy

The use of chemotherapy following surgery (adjuvant therapy) is usually not given for the treatment of Stage 1 breast cancer if the tumor is less than one centimeter in size. However, if the tumor is estrogen receptor-negative, larger than one centimeter or HER-2-positive, chemotherapy may be given to help reduce the chances of the cancer spreading.

There are many different types of chemotherapy agents and combinations of chemotherapy agents that are used to treat breast cancer. Some of the commonly used combinations include and are referred to as:

AC

Doxorubicin (Adriamycin) and Cyclophosphamide

A - CMF

Doxorubicin (Adriamycin) followed by CMF: cyclophosphamide (Cytoxan), methotrexate (Amethopterin, Mexate, Folex), and 5-fluorouracil (Fluorouracil, 5-FU, Adrucil)

AC - T

Doxorubicin (Adriamycin) and cyclophosphamide followed by paclitaxel (Taxol) or docetaxel (Taxotere). During this regimen, the targeted monoclonal antibody therapy trastuzumab (Herceptin) may be given if the tumor is HER2-positive tumor.

CAF (FAC)

Cyclophosphamide, doxorubicin (Adriamycin), and 5-fluorouracil (Fluorouracil, 5-FU, Adrucil)

CEF (FEC)

Cyclophosphamide, epirubicin, and 5-fluorouracil (Fluorouracil, 5-FU, Adrucil). This regimen also may be followed by Docetaxel (Taxotere).

CMF

Cyclophosphamide (Cytoxan), methotrexate (Amethopterin, Mexate, Folex), and 5-fluorouracil (Fluorouracil, 5-FU, Adrucil)

EC

Epirubicin (Ellence) and cyclophosphamide

TAC

Docetaxel (Taxotere), doxorubicin (Adriamycin), and cyclophosphamide

TC

Docetaxel (Taxotere) and cyclophosphamide

TCH

Docetaxel (Taxotere), carboplatin, and trastuzumab (Herceptin) for HER2-positive tumors

Besides these commonly used chemotherapy regimens, other chemotherapy drugs also are used to treat breast cancer. These include: albumin-bound paclitaxel (Abraxane), capecitabine (Xeloda), cisplatin (Platinol), gemcitibine (Gemzar), ixabepilone (Ixempra), mitoxantrone (Novantrone), pegylated liposomal doxorubicin (Doxil) and vinorelbine (Navelbine).

Targeted Therapy

If the Stage 1 tumor is larger than one centimeter and is found to be HER2-positive, which means that it is a more aggressive form of breast cancer, the use of the targeted monoclonal antibody trastuzumab (Herceptin) will likely be given in combination with the specific chemotherapy regimens listed above.

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