If you Google “breast cancer treatments,” we guarantee that conventional options will be the top search results. Surgery, chemotherapy, radiotherapy, and hormone therapy are four of the most common breast cancer treatments in the United States and the world. While these medical interventions can treat or remove malignant tissue, they often come with complex side effects.
Deciding the ideal treatment path for your unique case requires awareness of how these options work, including the side effects you may experience. Being well-informed allows you to make choices that align with your healthcare values, giving you the best chance of overcoming breast cancer.
Leading Breast Cancer Treatments and the Side Effects
This article explores the top conventional treatment options for breast cancer, how they work to eliminate cancer cells, and the side effects commonly associated with them.
1. Invasive Procedures
Surgery is often the first line of treatment for breast cancer. It involves removing the tumor and surrounding breast tissue via a lumpectomy or mastectomy.
A lumpectomy, also known as breast-conserving surgery or a partial mastectomy, removes the tumor and a small amount of healthy tissue around it. This surgical intervention preserves most of the breast. Radiotherapy sessions may follow to destroy any remaining cancer cells. Temporary side effects include swelling, tenderness, and pain, as well as possible bleeding and infection. Once the post-op physical discomfort subsides, scar tissue at the surgical site and changes in breast shape or size are among the lasting side effects.
A mastectomy removes the entire breast. It has several types:
- Total mastectomy (simple mastectomy): This procedure addresses breast cancer by removing an entire breast, including the tissue, nipple, areola, and skin. It may be an option for someone with extensive cancer or is unsuitable for a lumpectomy.
- Double mastectomy (bilateral mastectomy): This approach removes both breasts.
- Radical mastectomy: This procedure removes the breast, lymph nodes, skin, and chest muscles.
- Modified radical mastectomy: This surgical technique removes the breast, some of the lymph nodes underneath the arm, and the chest muscles’ lining.
- Skin-sparing mastectomy: This method removes the breast, areola, and nipple area. The surgeon saves most of the overlying skin, making it possible to perform breast reconstruction surgery.
- Nipple-sparing mastectomy: In this procedure, a surgeon will remove the tissue beneath the nipple and areola for pathology testing.
- Subcutaneous mastectomy: A surgeon will create an incision in the breast and remove the tissue, leaving the nipple and skin untouched. Reconstructive surgery may follow at the same time or later to rebuild the breast’s shape.
Other surgical options include axillary node dissection to remove lymph nodes, and contralateral prophylactic mastectomy to remove the unaffected breast to reduce future cancer risk. Treatments with chemotherapy, radiation, or hormone therapy may also be necessary based on test results and prognosis. In addition, ongoing monitoring is crucial to check for recurrence.
The risks and side effects of breast cancer surgery include:
- Physical discomfort
- Swelling
- Numbness
- Limited arm mobility
- Seroma (fluid accumulation)
- Hematoma (blood clot)
- Infection
- Changes in breast and nipple sensation
- Scarring and disfigurement
- Emotional distress (e.g., body image concerns, psychological stress)
Negative self-image is one of the most common emotional side effects women confront after a mastectomy. Survivors may feel less feminine or attractive, especially in the eyes of their significant other.
Consulting a mental health specialist in body image after breast cancer can help survivors work through these issues. Patients can ask their cancer care team for a referral, or call the American Psychosocial Oncology Society’s helpline at 1-866-276-7443 for assistance.
Also read: 10 Reassuring Statements for Breast Cancer Survivors and How to Prevent Recurrence.
2. Chemotherapy
Chemotherapy is a drug or a combination of medications used to kill cancer cells. It affects people in different ways, meaning two patients prescribed with the same chemotherapy drugs may feel or experience different effects from one another.
This approach temporarily affects the amount of healthy blood cells in the body by curtailing the bone marrow’s ability to produce them. A patient will require regular blood tests to determine whether to lower the dose or delay the next chemotherapy session. If white blood cells drop below the acceptable level, the risk of getting an infection rises. The physician may recommend antibiotics or administer growth factors to stimulate blood cell production.
The most common types of chemotherapy drugs used to treat breast cancer include:
- Anthracyclines: Drugs like doxorubicin and epirubicin interfere with DNA replication and gene transcription.
- Taxanes: Drugs like paclitaxel and docetaxel interfere with cell division.
- Cyclophosphamide: This alkylating agent cross-links DNA strands and interferes with cell division.
- 5-Fluorouracil (5-FU): This antimetabolite obstructs DNA synthesis.
Although effective for many patients, the majority of them experience post-therapy side effects. During the six-month follow-up period of a recent study, 97.4% of patients struggled with at least one of side effects of chemotherapy, and about 66.7% experienced six or more of the following side effects:
- Fatigue: Chemotherapy destroys healthy cells while killing cancer cells, causing fatigue in 87% of patients.
- Nausea and vomiting: Chemotherapy can irritate the entire digestive system, starting from the mouth to the anal area, including the salivary glands, stomach, upper and lower intestines, and rectum.
- Hair loss: Chemotherapy targets rapidly dividing cells, including hair follicles. While hair loss is often temporary, patients can wear wigs or seek insurance-covered cranial prosthesis. Using red light therapy and applying argan or castor oil on the scalp may also stimulate hair growth.
- Skin and nail changes: Some chemotherapy drugs can make the skin dry, red, sore, and itchy, and the nails brittle, flaky, and discolored.
- Loss of appetite: Chemotherapy causes loss of appetite in 71.4% of patients due to its impact on the digestive system and the production of inflammatory substances, leading to altered taste and a general aversion to food. Related: How Cancer Patients Can Prevent Malnutrition.
- Diarrhea: Chemotherapy-induced gastrointestinal toxicities cause diarrhea in almost half of all breast cancer patients.
- Infections: Ironically, chemotherapy can weaken the body’s ability to fight infection. As a result, patients are more likely to get infected with chickenpox, influenza, and COVID-19.
- Peripheral neuropathy: Chemotherapy can damage nerves in the arms, legs, hands, and feet. Symptoms include numbness, tingling, and pain, though they typically subside after treatment.
- Anemia: Anemia refers to having a red blood cell count of 100g/L or less. Its side effects include dizziness, lightheadedness, unusual heartbeat, headaches, shortness of breath, weakness, and cold hands and feet. Patients struggling with these symptoms must let their cancer care team know, as a blood transfusion may be necessary if the red blood cell level falls significantly. Untreated anemia is life-threatening and can cause death.
- Emotional issues: Undergoing chemotherapy can be stressful and traumatic. It increases the risk of emergent anxiety and depression, which coincide with severe pain, extreme fatigue, diminished quality of life, and lower life expectancy. Also read: Weathering the Emotional Storm of Breast Cancer.
Other side effects may include sleep disturbances, memory or concentration problems, and sex and fertility issues.
Chemotherapy is physically and emotionally demanding but often effective in destroying breast cancer cells. Unfortunately, it also damages healthy cells. Following an oncologist’s recommendations and seeking prompt medical assistance whenever a new symptom arises will help chemotherapy patients feel as comfortable as possible.
Additional resources:
- How to Deal with the Side Effects of Chemotherapy
- Not All Breast Cancer Patients Need Chemo, Study Confirms
3. Radiation Therapy
This treatment involves delivering powerful waves of energy to prevent the division and growth of cancer cells. It kills these problematic organisms, reducing the speed at which they grow, and shrinking tumors to allow surgery. It is part of treatment in approximately 70% of breast cancer patients, with 97.3% after lumpectomy and 26.1% after mastectomy.
The prevalent types of radiation therapy used to treat breast cancer are:
- External Beam Radiation Therapy: An oncologist directs an external beam of radiation to the entire breast or areas where a surgeon removed a tumor. Typically, treatments occur Monday through Friday for 2 to 10 weeks.
- Internal Radiation: Also called brachytherapy, it involves placing radioactive seeds or pellets inside the breast adjacent to the surgically removed tumor. The radiation releases over time, targeting cancer cells without damaging surrounding tissue. Brachytherapy enables a shorter treatment course and may cause fewer side effects compared to external beam radiation. However, it is only suitable for some patients depending on factors like the tumor’s size, location, and overall aggressiveness.
- Accelerated Partial Breast Irradiation (APBI): This form of radiotherapy delivers higher doses of radiation over a shorter period. It focuses on the tumor-removed area rather than the entire breast. APBI may be an option for patients with early-stage breast cancer.
The side effects of radiation therapy for breast tumors include:
- Fatigue and lethargy: Feeling weak, tired, or sleepy is common during and after radiation therapy treatments. These sensations may worsen as treatment progresses and improve over time after treatment ends.
- Hair loss: Balding in the chest or armpit is a common aftermath of radiation exposure to the breast area. Similar to chemotherapy, hair loss is often temporary. Hair will regrow after treatment ends.
- Radiation burn (radiation dermatitis): Skin issues may appear 10 to 14 days after starting radiotherapy, later in the program, or after completing treatment. The patient may notice the skin becoming darker or pink over time; it may feel dry, tender, sore, and itchy; appear moist and weepy; or flake and peel as therapy continues. Skin reactions depend on the radiation dose and treatment duration. Patients must look after their skin during treatment. Radiation therapists recommend taking daily showers using a mild soap to keep the treated area comfortable.
- Nausea and vomiting: These side effects occur due to receiving radiation to or near the abdomen or middle back. A patient may feel ill or have an upset stomach for hours after radiation treatment.
- Lymphedema: This swelling from lymph fluid accumulation in the body usually occurs in the arm on the same side as the radiation-treated breast.
- Radiation fibrosis: Those who receive radiation treatment for breast cancer are at risk of late side effects like radiation-induced fibrosis. This thickening or scarring of tissue can emerge months or years after radiation therapy, causing structural and functional breast changes.
Breast cancer patients must talk to their healthcare provider about side-effects prevention and management before the treatment program begins. Knowing what to expect and how to handle the possible health consequences are crucial for emotional preparedness and mental well-being.
4. Hormone Therapy
Hormone therapy, also known as endocrine therapy, is a standard treatment option for hormone receptor-positive breast cancers. If breast cancer tests positive for estrogen receptors (ER+) and/or progesterone receptors (PR+), hormone therapy may help minimize the risk of cancer recurrence after surgery and other treatments.
Hormone therapy works by hindering the effects of estrogen in the body or by lowering estrogen levels. Since estrogen can promote the growth of ER+ breast cancers, blocking it or lowering its levels can slow or stop the progression of these malignancies. The most common hormone therapies for breast cancer are:
- Tamoxifen: Tamoxifen is a Selective Estrogen Receptor Modulator (SERM) that inhibits estrogen from binding to estrogen receptors on breast cancer cells in men and women. Premenopausal and postmenopausal women also use it as a prophylactic agent against breast cancer. Related: Male Breast Cancer Is Real: A Wake Up Call for Early Detection.
- Aromatase inhibitors: Aromatase inhibitors block estrogen production in postmenopausal women. Common aromatase inhibitors include anastrozole (Arimidex), letrozole (Femara), and exemestane (Aromasin).
- Ovarian suppression: For premenopausal women, ovarian suppression therapies like ovarian ablation, ovarian suppression injections, or GnRH agonists help stop the ovaries from producing estrogen.
Deeper insights: Estrogen: Friend Now, Cancer-Causing Foe Later.
Although hormone therapy can be very effective at treating and reducing recurrence risk for ER+ and PR+ breast cancers, it also causes side effects, including:
- Hot flashes and night sweats: The most common side effect of hormone therapy is the sudden feeling of warmth in the uppermost body. They are usually manageable but can be severe for many women.
- Vaginal dryness: Reduced estrogen levels can induce vaginal atrophy and dryness. Lubricants and vaginal moisturizers can help relieve symptoms.
- Mood changes: Men and women may experience mood changes, depression, or anxiety throughout treatment.
- Bone changes: Decreased estrogen expedites bone loss and increases the risk of osteoporosis. A physician may prescribe bone-strengthening medications like bisphosphonates to help prevent bone loss and fractures.
- Joint pain: Male and female breast cancer patients can experience joint pain, stiffness, and muscle aches, especially with aromatase inhibitors. Exercise and over-the-counter pain relievers may help.
- Fatigue: A feeling of physical and mental exhaustion, even with enough rest and sleep, is common in patients receiving hormone therapy.
Close monitoring and effects management are critical to help patients adhere to treatment and preserve quality of life.
The Truth About Conventional Cancer Treatments and Recurrence
Facing a cancer diagnosis is undoubtedly a daunting journey, and traditional treatments play a role in fighting the disease. However, it’s essential to acknowledge the nuanced reality of these treatments and the potential for recurrence.
Research demonstrates that 40% of individuals diagnosed with early-stage triple-negative breast cancer may experience a recurrence. Also, a recurrence is likely in 50% of people diagnosed with inflammatory breast cancer. These subtypes are more prone to resurgence than others, but all breast cancer types can come back.
- Surgery: While surgery aims to eliminate the primary cancerous growth, the risk of recurrence exists if microscopic cancer cells remain. The thoroughness of the surgical procedure and the stage of cancer heavily influence the likelihood of recurrence.
- Chemotherapy: Chemotherapy, a systemic treatment, circulates throughout the body to destroy cancer cells. Although it can be effective, eradicating every cancer cell is the real challenge. Resistant cells may survive, contributing to the possibility of recurrence. The intensity and duration of chemotherapy also influence its success.
- Radiation Therapy: Despite radiotherapy’s efficacy, the potential for recurrence persists. In addition, a possible late effect is the development of a second cancer.
- Hormone Therapy: This treatment is common for hormone receptor-positive cancers. However, its effectiveness can diminish over time, sometimes leading to a resurgence of cancer cells. Monitoring hormonal changes and adjusting treatment accordingly is vital to prevent recurrence.
A breast cancer diagnosis is stressful and frightening. For that reason, many rush into the above treatments without knowing the possible side effects. Surgery, chemotherapy, radiotherapy, and hormone therapy can eliminate cancer cells and reduce tumor size, but remember that they also damage healthy cells and impact one’s quality of life.
The Unconventional Side of Cancer Care
From targeted breast cancer therapies to full-spectrum nutrition and immunomodulation, many alternative treatment options can heal the body, mind, and soul and even complement traditional medical care. They stimulate tumor regression, minimize side effects, support healing, and protect quality of life.
Discuss your options – conventional and holistic treatments – with your healthcare team before choosing which path to tread. Many cancer specialists give patients a few weeks to a full month to decide, and some doctors acknowledge both sides of medicine. Communicate with an open mind and understand the negative consequences of all options to make informed choices in your fight against breast cancer.
Learn how to tell your loved ones about your alternative treatment path here.
Receive the Medical Care You Deserve
New Hope Unlimited provides breast cancer treatment options that harness the true power of your immune system. From ozone therapy to immunotherapy for breast cancer, simply complete this online form to schedule a consultation and discuss therapeutic alternatives with our oncologists. Our cancer care providers will devote time to understanding your diagnosis and creating a customized treatment plan.
Further reading: Hope on the Horizon Part I and Part II: Recent Breast Cancer News.