Breast Cancer Treatment Options

Breast cancer is more treatable today thanks to the most advanced surgical techniques, chemotherapies and targeted therapies. Our center is equipped with the latest tools, research and expertise. Treating over 2,500 breast cancer patients each year, Dana-Farber Brigham Cancer Center is ready to treat your unique cancer immediately with the highest standard of care. Our team is dedicated to finding the best care path for each patient, without delay, using the latest diagnostic and treatment tools. We provide a comprehensive full range of breast cancer therapies, along with promising new treatments through clinical trials.                                      

With the results of your diagnostic tests and assigned cancer stage, our specialists from both Dana-Farber and Brigham and Women’s — including medical oncologists, radiation oncologists and surgical oncologists — will work closely together to develop a unique treatment plan that works best for you and your specific breast cancer. We will ensure coordinated care, carefully monitoring and treating your cancer as well as helping to provide relief for your symptoms. Your care team will work together to organize your individualized health care plan to achieve the best possible outcomes for your cancer.

We want you to feel like you are an active participant in your care. Please talk to your care team about your treatment goals. Learn treatment-related questions to ask during your healthcare appointments.

Treatment options and the length of treatment vary from patient to patient. Treatment options are based on various factors, including your age, overall health, stage of cancer, disease aggressiveness, potential side effects and your personal preferences. Treatment commonly involves surgery to remove the tumor from your breast. Surgery can also be used to see if the cancer has spread to lymph nodes under your arm. If your doctor recommends that you consider removing your breast, you will be offered the opportunity to discuss potential reconstructive breast surgery using your own tissue or an implant. Learn more about breast reconstruction, as well as about all of our treatment options for breast cancer.

Fertility Preservation

Cancer treatments like chemotherapy, radiation, and surgery can affect fertility in both women and men and it's essential to talk about these effects before starting treatment. The Adult Fertility Preservation Program at Dana-Farber Brigham Cancer Center understands how important fertility is for long-term quality of life. Our team of gynecologic oncologists collaborates closely with other specialists to offer comprehensive care. We specialize in designing treatment plans that preserve fertility for those who wish to have children now or in the future.

Non-Surgical Treatment Options

Radiation Therapy: Radiation therapy uses high-energy rays to shrink and kill cancer cells. The two main radiation therapy approaches used at Dana-Farber Brigham Cancer Center are external radiation therapy (external beam therapy), which beams radiation directly to the cancer cells from outside of the body, and internal radiation therapy (implant therapy), in which pellets that emit radiation are implanted into the body.

The Department of Radiation Oncology has two separate units, one at Brigham and Women’s Hospital and the other at Dana-Farber Cancer Institute, staffed by providers who work at both locations. If your treatment includes radiation therapy, your health care team will decide with you which is the right location for you.

Chemotherapy: Chemotherapy, or chemo, uses medicine to shrink and kill cancer cells. It is often used in combination with surgery to treat breast cancer. You may be given more than one type of chemo to treat breast cancer. Your health care provider can give you more information about which chemo you’re getting.

Learn more about how chemotherapy is used to treat breast cancer.

Immunotherapy: We provide all state-of-the-art treatments, including incorporating immunotherapy into the treatment of advanced breast cancer.

Learn how immunotherapy use the body's own immune system to combat diseases.

Clinical Trials: Patients with breast cancer may also be eligible to participate in clinical trials at Dana-Farber Brigham Cancer Center. Clinical trials study the effectiveness of new cancer treatments and may offer benefits to patients with varying stages of breast cancer. Previous clinical studies have resulted in a variety of new treatments that have helped to advance the field of cancer medicine. Ask your healthcare team if this may be an option for you.

Surgical Treatment Options

Our surgeons perform more than 1,800 breast cancer surgeries each year between our three surgical sites — Brigham and Women’s Faulkner Hospital, Brigham and Women’s Hospital and South Shore Hospital. Surgery for breast cancer is a critical part of cancer treatment and contributes to achieving high rates of survival. Approximately 80 percent of breast cancer patients may be eligible for surgery upon initial diagnosis while other patients may benefit from chemotherapy before surgery. The decision to have either surgery or chemotherapy first is dependent on many factors, including the size and type of breast cancer you have.

Our breast surgical oncologists offer extensive expertise in the most advanced approaches for breast cancer, including nipple and skin sparing mastectomy, oncoplastic surgery (preserving the breast’s natural appearance) and radioactive seed localization for non-palpable lesions. Our reconstructive surgeons offer a full range of breast reconstruction surgeries, including implant/expander reconstruction and advanced procedures, such as DIEP (deep inferior epigastric perforators) flaps, and SGAP (superior gluteal artery perforator) flaps.

Our surgeons use evidence-based guidelines and advanced surgical techniques to shorten your hospital stay, recovery time and complications while improving outcomes and patient satisfaction. They also work collaboratively with breast medical oncologists to identify patients that would benefit from pre-operative treatments, including targeted therapy, chemotherapy or a combination of drugs, to decrease tumor size and allow for less extensive surgery.

Brigham and Women’s Hospital is among the few hospitals in Massachusetts to offer radioactive seed localization for breast-conserving surgery. This is an innovative, patient-friendly approach for doctors to precisely pinpoint and remove non-palpable breast cancers. With radioactive seed localization, a seed containing a very small amount of radioactivity is placed into the breast by the breast imaging specialist up to one week before the surgery. In the operating room, the surgeons use a handheld radiation detection device to locate the seed and precisely navigate to the cancer, which is removed along with the seed during the operation.

Patients receiving breast surgery from high-volume surgeons like ours at high-volume hospitals like the Brigham have higher success rates and fewer complications. Our surgeons’ success rates are among the best in the country. Your surgeon and care team will work with you to understand your options and ensure the best possible outcomes.

The two most common types of surgery to remove breast cancer include:

• A lumpectomy, also known as wide excision or partial mastectomy, is a surgery that removes the cancer with a rim of normal tissue. This breast-conserving surgery may be an option if the cancer is localized to one area of the breast. Benefits of this surgery include conserving the breast and nipple, and this surgery is equally effective in treating breast cancer as a mastectomy in certain patients. For some patients, a small radioactive seed will be placed in the breast before the surgery to help the surgeon locate the breast tissue that needs to be removed. This is called a radioactive seed guided lumpectomy. In most cases, radiation treatment is recommended post-surgery.
• A mastectomy is a surgery that removes the entire breast. This surgery may be medically necessary if your cancer has spread beyond a single mass or if early-stage cancer exists in multiple areas of the breast. In some cases, choosing a mastectomy over a lumpectomy may make further radiation treatment unnecessary.

In addition to a lumpectomy or mastectomy, surgery is also used to evaluate the lymph nodes under the arm:

• Sentinel lymph node biopsy is a surgery that removes the first draining lymph nodes (typically 2–3 glands under the arm) to determine whether cancer cells have spread beyond the breast.
• Axillary lymph node dissection is a surgery that removes the majority of the nodes under the arm. This is generally only indicated when breast cancer has spread to multiple nodes under the arm.

Learn more about these surgical treatment options, including what to expect before and after surgery. Learn more about all of our center’s treatment options.

View our patient resources and videos with more information on these procedures and common questions about breast surgery and the post-operative experience.

Breast Reconstructive Surgery Following Mastectomy

Our breast cancer surgeons and reconstructive breast surgeons work together to provide patients with options for both immediate breast reconstruction (at the same time as your mastectomy) or delayed breast reconstruction (at a second procedure) based on the characteristics of your cancer, the overall treatment plan and your preference.

Breast reconstruction is achieved through several different plastic surgery techniques that are done to restore the breast mound to near normal shape, size and appearance following a breast cancer diagnosis and mastectomy.

If you having a mastectomy and would like to learn about these options, your surgeon will refer you to one of our specialized breast reconstructive surgeons who will discuss the various options for breast reconstruction and help you decide the best procedure, based on your particular type of breast cancer and expected treatment plan.

Learn more about our reconstructive breast surgery program.

Before Surgery

If you have any questions about your surgery or treatment, including regarding a leave of absence from work (FMLA/PFML/disability), please talk with your health care team. They can help you know what to expect before, during and after your surgery.

In advance of your surgery, we recommend planning ahead for your surgery including designating someone to bring you to and from your procedure. You can also prepare for surgery by exercising and limiting alcohol. Your care team will provide you with specific instructions to best prepare for your surgery.

Learn more about preparing for your surgery:

• Enhanced Recovery After Surgery and same day mastectomy (mastectomy patients only)
• Pre-op checklist

The Day of Surgery

On the day of surgery, you will be cared for in the operating room by our surgeons, anesthesiologists, physician assistants, and nurses who specialize in breast cancer surgery. After surgery, you will recover in the post-surgical care unit where you will receive comprehensive care by our experienced surgical and nursing staff. Your hospital stay will depend on the type of surgery you have.