After the cancer has progressed to stage III, it can spread outside the breast or into the surrounding lymph nodes. Often many of the lymph nodes have cancer cells, or the tumor is too large to invade the chest wall or within the skin of the breast. A combination of different treatments will often provide good results.
Chemotherapy
Chemotherapy is a common treatment for stage III breast cancer. Sometimes patients receive chemotherapy before surgery to shrink the tumor and make it easier to remove.
How chemotherapy works
Chemotherapy helps destroy cancer cells that are still present after surgery. In some patients who are not candidates for surgery, chemotherapy may be the primary treatment.
Types of chemotherapy
Patients may receive chemotherapy in different ways, either as a pill or as a liquid, but usually the drug is infused directly into a vein. Depending on the type of treatment, patients may receive cycles of treatment to allow the body to rest.
Surgery
Patients may have a mastectomy to remove the tumor and some of the tissue around the breast.
Or the patient will have a mastectomy, which removes the entire breast. The doctor may also remove the lymph nodes.
After a mastectomy, the patient may choose to have a breast reconstruction.
Radiotherapy
For stage III breast cancer, postoperative radiation therapy is usually recommended. Radiation therapy can destroy cancer cells left over from surgery.
Endocrine therapy
Endocrine therapy is usually effective for hormone receptor-positive breast cancer. This type of breast cancer means that the tumor needs to be stimulated by hormones in order to grow. For these women, drug therapy can stop the hormones from working on the tumor.
Medications for endocrine therapy
These include tamoxifen for all women, and the aromatase inhibitors anastrozole, exemestane, and letrozole for postmenopausal women.
For some postmenopausal patients with advanced breast cancer, in addition to the aromatase inhibitors, fulvestrant, CDK4/6 inhibitors such as abemaciclib, palbociclib, or ribociclb (i.e., cell cycle protein-dependent kinase 4/6 inhibitors) may be used. inhibitors) for treatment.
For non-menopausal women, removing the ovaries may be considered to prevent them from secreting hormones that help the tumor grow. Drugs can also help stop the ovaries from secreting hormones.
Targeted therapy
Targeted therapy is a new type of therapy. About 20% of breast cancer patients express too much HER2, or Human Epidermalgrowth Factor Receptor 2, a protein that allows the cancer to spread rapidly.
Drugs for targeted therapy
Patients with HER2-positive breast cancer may be treated with trastuzumab-medetansine coupling (Ado-trastuzumab emtansine,T-DM1), lapatinib, pertuzumab, or trastuzumab. These drugs stop the HER2 protein from promoting cancer growth and may make chemotherapy more effective.
Clinical trials
Patients may also want to consider participating in a clinical trial. There are many clinical trials available for patients with stage III breast cancer that can lead to advanced treatments. For more information about participating in a clinical trial, talk to your doctor.