Early Stage Breast Cancer: Treatment Options and Concerns

Breast cancer

My mother has stage I breast cancer with a 1.4 cm tumor.
After the doctor removed it and confirmed the diagnosis, the surgeon initially only removed half of the tumor, but at my mother's request, the remaining part was also removed.
Will this cause the cancer cells to spread? Does my mother need to have the entire breast removed? Should the lymph nodes also be removed? Does she need to undergo chemotherapy? What is the best way for us to proceed with treatment? Thank you.
The pathology report indicates malignancy.

ping, 40~49 year old female. Ask Date: 2009/03/16

Dr. Zhao Ming reply Breast and Thyroid

1.
Generally, this is a standard treatment approach and does not lead to the spread of breast cancer.

2.
The survival rate for breast cancer primarily depends on the malignancy of the individual cancer cells rather than the treatment method (chemotherapy can improve survival rates; for example, the 10-year survival rate for stage III breast cancer is originally 50%, which can be increased to 75% with chemotherapy).

3.
Lymph node removal can be either total axillary lymphadenectomy or sentinel lymph node biopsy (the NCCN treatment guidelines in the United States indicate that lymph node removal is a basis for staging breast cancer, and there is currently no evidence showing an absolute benefit for patient survival).
Therefore, if patients can understand this new treatment approach, they may consider opting for sentinel lymph node biopsy.

4.
There are many treatment options for breast cancer; there is no single "correct" method, but rather the best treatment approach.

Reply Date: 2009/03/16

More Info

Understanding early-stage breast cancer can be daunting, especially when faced with treatment options and concerns about the potential spread of cancer cells. Your mother's situation, with a diagnosis of stage I breast cancer and a tumor size of 1.4 cm, raises several important questions regarding her treatment plan and the implications of the surgical decisions made.

Firstly, it’s essential to clarify that the surgical approach taken during your mother's procedure is critical in determining the next steps in her treatment. If the surgeon initially removed only part of the tumor and then, at your mother's request, removed the remaining tissue, this should not inherently cause cancer cells to spread. The concern about cancer cell dissemination typically arises during the surgical procedure itself, particularly if the tumor is manipulated or if there is a breach in the tumor capsule. However, if the tumor was excised cleanly and the margins were clear (meaning no cancer cells were found at the edges of the removed tissue), the risk of spread is minimized.

Regarding whether your mother needs a complete mastectomy, this decision depends on several factors, including the tumor's characteristics, the surgical margins, and the presence of any lymph node involvement. In many cases of early-stage breast cancer, especially when the tumor is small and has been completely excised with clear margins, a lumpectomy followed by radiation therapy may be sufficient. However, if there are concerns about the completeness of the excision or if there are multiple tumors, a mastectomy might be recommended.

As for lymph node removal, this is often determined by whether the cancer has spread to the lymph nodes. If the pathology report indicates that there is no lymph node involvement, then additional lymph node removal may not be necessary. However, if there is any indication of cancer in the lymph nodes, a sentinel lymph node biopsy or axillary lymph node dissection may be warranted to assess the extent of the disease.

Chemotherapy is another consideration in your mother's treatment plan. In early-stage breast cancer, chemotherapy is typically recommended based on specific factors such as hormone receptor status (ER/PR), HER2 status, tumor grade, and the overall risk of recurrence. If your mother's tumor is hormone receptor-positive, she may be a candidate for hormone therapy instead of chemotherapy. Conversely, if the tumor is aggressive or has certain high-risk features, chemotherapy might be advised to reduce the risk of recurrence.

The best approach for your mother’s treatment should involve a multidisciplinary team, including her oncologist, surgeon, and possibly a radiation oncologist. They can provide a comprehensive evaluation of her specific case and recommend the most appropriate treatment options based on the latest clinical guidelines and her individual circumstances.

In summary, your mother’s treatment plan should be tailored to her specific situation, considering the tumor characteristics, surgical outcomes, and overall health. Open communication with her healthcare team is crucial to ensure that she receives the most effective and appropriate care. It’s also beneficial to seek a second opinion if there are uncertainties or if you feel more information is needed to make informed decisions about her treatment.

Similar Q&A

Understanding Breast Cancer Surgery and Post-Operative Treatment Options

Hello Doctor, My mother has been undergoing regular mammograms every six months and was diagnosed with breast cancer last week. The tumor is located at the 9 o'clock position in the right breast, measuring 1.2 cm, and is a single tumor (the doctor mentioned that lymph node...

Dr. Lai Yicheng reply Oncology
Dear Madam, Thank you for your letter. Here are my responses: 1. If the malignant tumor is small, partial resection followed by adjuvant radiation therapy can be considered. However, if your mother has multiple benign fibromas in both breasts as you described, total mastectomy ...

Understanding the Necessity of Chemotherapy and Targeted Therapy for Early-Stage Breast Cancer

Hello Doctor: I would like to ask about my sister, who has stage I breast cancer. She has already undergone a mastectomy and axillary lymph node dissection, and tests show that the cancer cells have not spread. However, there is a risk of recurrence, and the doctor has recommende...

Dr. Lai Yicheng reply Oncology
Hello, Miss: Thank you for your inquiry. In response, it was mentioned that your sister is in stage I of breast cancer and has undergone a total mastectomy and axillary lymph node dissection. For a detailed assessment, we will need to review your pathology report. If necessary, p...

How to Handle Early Stage Breast Cancer: A Guide for Patients

Hello Doctor: My mother is 52 years old. In late December of last year, a tumor was discovered in her right breast during a check-up. The tumor is located deep and cannot be felt by touch, measuring about 1 cm. It is painless and asymptomatic. After examination, the doctor stated...

Dr. Yu Mingchang reply Surgery
Hello: 1. If the pathology report has been confirmed, trust the report and find a way to address the issue. 2. Based on the stated tumor size of 1 cm, if the pathology report indicates early stage (Stage I), breast-conserving surgery can be performed, which has minimal impact on ...

Exploring Non-Surgical Treatment Options for Early Stage Endometrial Cancer

Hello, Doctor. My mother is 60 years old and has recently experienced abnormal bleeding, so she went to a nearby large hospital for medical attention. After examination, the doctor initially diagnosed her with endometrial cancer; however, her condition seems to be stable and was ...

Dr. Huang Yuande reply Obstetrics and Gynecology
1. Unless there is still a desire for fertility, the primary approach should be surgical removal. If the condition is in the early stage or precancerous lesions, hormonal therapy or chemotherapy may be considered after endometrial curettage, but the risk of recurrence is higher. ...