In general, there are five breast cancer-treatment options, and most treatment plans include a combination of the following:
Surgery: An operation where doctors cut out cancer tissue. Your options may include a lumpectomy (also called breast-conserving surgery), a mastectomy, or a mastectomy with breast reconstruction.
A Lumpectomy usually removes the least amount of breast tissue needed to get the tumor out and a margin of healthy tissue around it. The surgeon removes the cancer and a small portion or margin of the surrounding tissue, but not the breast itself.
A Partial Mastectomy requires the surgeon to remove a larger portion of the breast than in the lumpectomy — perhaps a whole segment or quadrant of tissue — in order to eliminate the cancer.
Skin-Sparing Mastectomy requires removal of the breast, nipple, areola, and sentinel lymph node (or nodes) but not the breast skin. Many women who intend to have breast reconstruction will opt for this procedure.
Simple Mastectomy requires removal of the breast, nipple, areola, and sentinel lymph node or nodes. It leaves the chest wall and more distant lymph nodes intact.
Modified Radical Mastectomy requires removal of the entire breast, nipple, areola, and axillary lymph nodes but often leaves the chest wall intact.
Radical Mastectomy Surgery often required removing the entire breast, chest wall, and all axillary lymph nodes. Radical mastectomies are less common today, there are instances in which this surgery is the best option to treat the cancer.
Chemotherapy: Using special medicines to shrink or kill the cancer cells. The drugs can be pills you take or medicines given in your veins, or sometimes both.
Hormonal therapy: Blocks cancer cells from getting the hormones they need to grow.
Biological therapy: Works with your body’s immune system to help it fight cancer cells or to control side effects from other cancer treatments.
Radiation therapy: Using high-energy rays (similar to X-rays) to kill the cancer cells.
Complete Decongestive Therapy (CDT)
Complete decongestive therapy (CDT) brings together three major therapies — massage, compression, and exercise. It also involves self-care related to skin health, eating well, and other recommendations you can practice at home.
A compression sleeve is a tight-fitting elastic garment that can be worn on the arm or hand to help drain the lymphatic fluid from your arm. It is one of the garments your lymphedema therapist may recommend as part of complete decongestive therapy.
Lymphedema exercises are another key component of complete decongestive therapy. The purpose of exercises for lymphedema is to reduce the volume of lymphatic fluid in the arm or other affected area.
Manual Lymph Drainage (Lymphedema Massage)
Manual lymph drainage is a specialized type of massage. Gentle massage techniques help direct excess lymph fluid away from affected body areas toward regions that can support drainage.
Cancer-related lymphedema may be prevented or treated through specialized surgical techniques. If lymph nodes are being removed as part of the surgery to treat your cancer, these procedures can be done at the same time to reduce your risk of lymphedema. They can also be performed in patients who already have lymphedema to reduce symptoms.
Breast Reconstruction and Alternatives
There are a few options for breast reconstruction:
Breast Implants: The breasts are filled with sacs of saline or silicone gel, or a combination of both.
Skin Grafts and Transplant (TRAM Flap, Latissimus Flap, or Gluteal Flap): An alternative solution is to use tissue the surgeon removes from another part of your body, like the belly (TRAM), back (latissimus), or buttocks (gluteal). The surgeon sculpts this tissue into the shape of your breast.
DIEP Flap (Deep Inferior Epigastric Perforator Flap): This solution uses the abdominal fat (no muscle) to sculpt the tissue into the shape of your breast, resulting in a full tummy tuck and no lifting restrictions later.
Additional Cosmetic Details: In addition to reconstructing the breast, the surgeon can add a nipple, change the shape or size of the reconstructed breast, and operate on the opposite breast as well for a better match. The plastic surgeon will be able to discuss with you the benefits and risks of each procedure and help you decide what will make you feel the most natural.
Alternatives To Breast Reconstruction
An alternative to breast reconstruction is a removable prosthetic breast that is worn in the bra. This will preserve the shape and look of the breast without the surgical procedures. Some women opt for a prosthesis to help balance out their weight and posture, too.