In stage II breast cancer, the cancer is still confined to the breast and may sometimes have spread to nearby lymph nodes. There are multiple treatment options for stage II breast cancer, and patients may more often receive a combination of approaches.
Surgery
Surgery is the standard treatment for breast cancer. For smaller tumors, doctors may use breast-conserving surgery (which may also be called a mastectomy), which involves removing only the tumor and some of the surrounding tissue.
For larger tumors, your doctor may perform a mastectomy, in which the entire breast is removed.
With both of these procedures, the surgeon may remove some lymph nodes, and after mastectomy, the patient may choose to have breast reconstruction.
Radiotherapy
Radiotherapy (or radiation therapy) is usually given after a mastectomy to kill any cancer cells that remain after surgery.
Some patients who have undergone a mastectomy may also need radiation therapy, especially those with large tumors or cancer cells found in the lymph nodes.
Chemotherapy
Postoperative chemotherapy helps to kill any remaining cancer cells. Some patients receive chemotherapy to shrink the tumor before surgery, and if the chemotherapy is effective, then the tumor can be removed by mastectomy once it has shrunk to a certain size.
Chemotherapy can be given in a number of different ways, with patients taking pills or fluids by mouth, but often by direct infusion through a vein.
Depending on the treatment, chemotherapy can be given in cycles, which allows the body to rest in between cycles of chemotherapy.
Endocrine therapy
Postoperative endocrine therapy may be used in patients with hormone receptor-positive breast cancer, where the growth of these tumors requires hormones and the drugs prevent the hormones from acting on the tumor.
These drugs include tamoxifen for all women, and anastrozole, exemestane, and letrozole for postmenopausal women.
For women who have not yet reached menopause, doctors may consider removing the ovaries so that they cannot produce hormones that favor tumor growth, and these patients may also take drugs, such as leuprolide or goserelin, to stop the ovaries from releasing hormones.
Targeted therapy
Targeted therapy is a relatively new treatment for a protein called HER2, or human epidermal growth factor receptor 2, that is excessive in about 20% of breast cancer patients and causes tumors to spread more quickly.
Trastuzumab-metanephrine couples (T-DM1), lapatinib, lenatinib , patuximab, and trastuzumab are all used in the treatment of HER2-positive breast cancer.
These drugs block the HER2 protein’s role in promoting tumor growth and make certain chemotherapies more effective, and often, targeted therapies are used in combination with chemotherapy.
Clinical trials
Several clinical trials are open to many stage II breast cancers that have the potential to give patients access to the most advanced treatments, so talk to your doctor to see if there is a clinical trial for you.