About treatment for breast cancer

The first treatment for breast cancer is often surgery to remove it. After surgery, you may have treatments to reduce the risk of the cancer coming back. These treatments include:

Some women have treatments before they have surgery.

Drugs called bisphosphonates are sometimes given to reduce the risk of breast cancer coming back. They can also be used to protect your bones from the side effects of treatments, such as hormonal therapies.

Your doctors look at different factors to help decide which treatments are likely to work best for you. These include:

Your cancer doctor and specialist nurse will explain the treatments that they think are best for you. They can help you to make decisions about your treatment.

Treatments for breast cancer are improving. Better treatments mean that more women are cured or living longer. Your cancer doctor may ask you if you would like to take part in a research trial.

Treatment before surgery

Some women have treatments such as chemotherapy or hormonal therapy before surgery. You may have these treatments to:

  • shrink a larger cancer to make it easier to remove with surgery
  • treat a cancer that is growing more quickly.

Surgery

Your surgeon will talk to you about having one of these operations:

You will usually need some, or all, of the lymph nodes in your armpit removed. This is done with both these operations.

Some women also have surgery to make a new breast shape (breast reconstruction) during the operation. Others choose to have this done at a later time.

Treatment after surgery

Your cancer doctor will usually offer you one or more of the following treatments after surgery. These treatments can reduce the risk of the cancer coming back.

  • Radiotherapy

    After breast-conserving surgery, your cancer doctor will usually advise you to have radiotherapy to the rest of the breast. You may also need radiotherapy to the lymph nodes near the breast. After a mastectomy, you may need radiotherapy to the chest and possibly the lymph nodes.

  • Chemotherapy

    Your cancer doctor may advise you to have chemotherapy if:

     

  • Hormonal therapy

    If the cancer is oestrogen-receptor (ER) positive, you will be given hormonal therapy for a few years. The drug or treatment you have will depend on if you have been through the menopause or not.

  • Targeted therapy

    If you have HER2 positive breast cancer, you will usually be given a targeted therapy drug called trastuzumab. You may also have a drug called pertuzumab (Perjeta®).

Your cancer doctor and specialist nurse will talk to you about the most effective treatments available to you.

They may use an online tool such as Predict. Predict is designed to help women and their doctors make informed decisions about treatment after surgery for breast cancer.

It can show how much treatments may reduce the risk of the cancer coming back. You might find it helpful, especially if your cancer doctor has asked you to decide about whether to have chemotherapy.

Sometimes, doctors may suggest having a tumour profiling test on the cancer cells. This gives more information about the risk of the cancer coming back. It may help you to decide about having chemotherapy after surgery.

Treatments and fertility

Some treatments for breast cancer can affect your fertility. This may be temporary, but for some women it can be permanent.

Before treatment starts, your doctors and nurses will talk to you about this. If treatment could affect your fertility, they will explain what may be done to help preserve your fertility.

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