There are several treatment options; often more than one treatment is used.

Surgery: taking out the cancer in an operation.
Radiation therapy: using high-dose x-rays to kill cancer cells or keep them from dividing and growing.
Chemotherapy: using anticancer drugs to kill or stop the growth of cancer cells.
High dose chemotherapy: using high doses of anti-cancer drugs to kill cancer cells.
Hormonal therapy: using hormones to stop cancer cells from growing.
Biological therapy (immunotherapy): using the immune system to fight cancer or to lessen the side effects that may be caused by some cancer treatments. Many biological therapies are being tested in clinical trials. See below for more information

Bone Marrow or Stem Cell Transplants

Ffficacy still being tested in clinical trials.

Types of surgery

Lumpectomy: a surgeon removes the breast cancer, a little normal breast tissue around the lump, and some lymph nodes under the arm. The surgeon is trying to totally remove the cancer, altering the breast as little as possible. Lumpectomy is usually accompanied by radiation therapy to destroy any remaining cancer cells.
Total mastectomy: The surgeon removes the entire breast. Some lymph nodes under the arm may be removed also.
Partial mastectomy: This surgery conserves as much as the breast as possible. Some breast tissue is removed, the lining over the chest muscles below the tumor, and usually some of the lymph nodes under the arm. Radiation therapy usually follows.
Modified radical mastectomy: the surgeon removes the breast some of the lymph nodes under the arm, and the lining over the chest muscles, and sometimes part of the chest wall muscles.
Radical mastectomy: The surgeon removes the breast, chest muscles, and all the lymph nodes under the arm. This was the standard operation for many years, but it is used now only when the cancer has spread to the chest muscles.
Radiation Therapy

High energy x-rays are used to destroy cancer cells that might still be present in the breast tissue. Doctors sometimes use radiation therapy following a lumpectomy or mastectomy, before or instead of surgery, and/or in conjunction with chemotherapy.

Possible problems: feeling more tired than usual; skin itchiness, redness, soreness, peeling, darkening, or shininess; decreased sensation. Radiation does NOT cause hair loss, vomiting or diarrhea.

Chemotherapy

Even when a lump is small, cells may have broken off and spread outside the breast. Doctors can use chemotherapy to destroy them, using either a single drug or a combination of drugs.

The drugs are often injected into the bloodstream through an intravenous needle that is inserted into a vein, but sometimes they are administered by pill. Treatment can range from two months to two years.

Possible problems: hair loss, loss of appetite, nausea, vomiting, diarrhea, constipation, fatigue, infections, bleeding, weight change, mouth sores, and throat soreness, infertility, early menopause, weakening of heart, damage to ovaries, secondary cancers such as leukemia.

You can learn more about chemotherapy by contacting NCI's 1-800-4-cancer and requesting the following booklets: Helping Yourself During Chemotherapy, Chemotherapy and You, and Eating Hints for Cancer Patients.

Hormonal Therapy

If lab tests show that your tumor relied on your natural hormones to grow, any remaining cancer cells may continue to be stimulated by your body's hormones. Hormonal therapy can prevent your body's hormones from reaching any remaining cancer cells.

Tamoxifen is one of the most common drugs used for hormonal therapy, taken daily as a pill. Although benefits are generally considered to far outweigh risks, you should be aware that tamoxifen use can increase risks for cancer of the uterus and, rarely, blood clots for patients also undergoing chemotherapy.

Possible problems: hot flashes, nausea, vaginal spotting, increased fertility. Less common side effects include depression; vaginal itching, bleeding, or discharge; loss of appetite; eye problems; headache; and weight gain.

Biological Therapy

Antibodies are proteins made by the body's own natural immune system that are directed against foreign and infectious agents, called antigens. Monoclonal antibodies engineered through biotechnology are produced as therapeutic drugs to provide specific anti-tumor action within the human body. Herceptin (trastuzumab) is a monoclonal antibody approved in 1998 by the Food and Drug Administration for the treatment of metastatic breast cancer. It inhibits cancer cell division and growth.

New treatments designed to repair, stimulate, or increase the body's natural ability to fight breast cancer are currently being investigated in clinical trials worldwide. Some of these experimental immunotherapies utilize, and in others boost, substances produced naturally by the body's own cells. One such promising therapy (Theratope cancer vaccine) is currently being evaluated in a Phase III clinical trial and plans to enroll 900 patients with metastatic breast cancer by the end of year 2000.

Bone Marrow or Stem Cell Transplants (please make this a new sub-heading

Bone marrow transplantation is a newer type of treatment currently undergoing evaluation in clinical trials. The procedure entails removal of the patient's bone marrow prior to high-dose chemotherapy, with or without radiation therapy. Then the marrow is given back to the patient through a needle inserted into a vein to replace any marrow that was destroyed during therapy. This type of transplant is called an autologous transplant. If the marrow that is given is taken from another person, the transplant is called an allogeneic transplant.

Leukapheresis (peripheral blood stem cell transplantation) is another experimental procedure being evaluated in clinical trials. Here, a patient's blood is passed through a machine that removes the stem cells (immature cells from which all blood cells develop) and then returns the blood back to the patient. The stem cells are treated with drugs to kill any cancer cells and then frozen until they are transplanted back to the patient. This procedure may be done alone or with an autologous bone marrow transplant.