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NCCN Guidelines for Patients


Breast Cancer - Early-Stage


, Version 1.2016


Breast cancer basics

Treatment options

Breast cancer surgery

Surgery to remove the cancer is a central part of

treatment for stages I and II breast cancer. Cancer

in the breast and any lymph nodes will be removed.

However, other treatments will likely be used with

surgery to treat the cancer.

Treatment for stages I and II breast cancer has many

parts. As such, you will have many choices to face.

Read Parts 2 through 8 to learn what your options are.

Lumpectomy and a total mastectomy are two types of

breast surgery used for stages I and II breast cancer.

A lumpectomy is a surgery that removes the tumor

along with normal-looking tissue around its edge.

The normal-looking tissue is called a surgical margin.

Lumpectomy is a breast-conserving surgery because

most of the normal breast tissue won’t be removed. A

total mastectomy is a surgery that removes the entire

breast but not any chest muscle.

Part 3 Breast cancer


presents which surgery is an option for you.

Surgery is often the first treatment for stages I &

II breast cancer. It may not be the first treatment

if you have a large breast tumor and want to have

a lumpectomy. In this case, you may first receive

cancer drugs to try to shrink the tumor. Use of cancer

drugs for this purpose is called neoadjuvant (or

preoperative) treatment.

At the time of the breast surgery, most women with

stage I or II breast cancer will have some axillary

lymph nodes removed. Lymph nodes will be removed

by one or two methods. A sentinel lymph node biopsy

is a surgery that finds and removes the first lymph

nodes to which breast cancer spreads. It is also

called a sentinel lymph node dissection. An axillary

lymph node dissection removes more axillary lymph

nodes than a sentinel lymph node biopsy.

Part 3

Breast cancer surgery

addresses which surgery is an

option for you.

Breast reconstruction is a surgery that inserts breast

implants or uses your body tissue to make a more

normal-looking breast mound. Following the cancer

surgery, or in some cases at the same time, you may

want to have breast reconstruction. However, some

women use external fake breasts or do nothing.

Breast reconstruction is described in more detail in

Part 3 Breast cancer surgery


Chemotherapy and HER2 inhibitors

You may receive chemotherapy and HER2 (




pidermal growth factor




) inhibitors after

surgery. These cancer drugs lower the chances of

breast cancer returning. Treatment for this purpose is

called adjuvant treatment. Chemotherapy, or “chemo,”

includes drugs that disrupt the life cycle of cancer

cells. Thus, no new cells are made to replace dying

cells. HER2 inhibitors stop certain signals that tell

cancer cells to grow.

Part 4 Chemotherapy and HER2


addresses if these treatments are an option

for you.

Radiation therapy

Radiation therapy uses high-energy rays to treat

cancer. The rays damage the genes in cells. This

either kills the cancer cells or stops new cancer cells

from being made. If you will receive chemotherapy,

radiation therapy is most often given afterward.

Otherwise, radiation therapy follows surgery.

Part 5

Radiation therapy

addresses if radiation therapy is an

option for you.

Endocrine therapy

Female hormones help some breast cancers grow.

Endocrine therapy includes treatments that stop

cancer growth caused by hormones. Endocrine

therapy is sometimes called hormone therapy but is

not the same as hormone replacement therapy. It is

used as an adjuvant treatment and may be started

during or after radiation therapy.