Breast cancer is one of the most prevalent cancers worldwide, impacting millions of women—and, increasingly, men—every year. While its prevalence can be alarming, the positive news is that breast cancer is very treatable, especially when caught early. Early detection and a personalised treatment plan can greatly improve survival rates and quality of life. 

In this article, we'll explore the stages of breast cancer, the range of treatment options available, and how new advancements are changing the future of care, offering hope and better outcomes for patients around the globe.

What are the stages of breast cancer?

Breast cancer is categorised into stages, ranging from Stage 0 (non-invasive) to Stage IV (advanced). The stage of cancer determines its severity and guides treatment options. Here's an overview of each stage:

Stage 0: Ductal Carcinoma In Situ (DCIS): Stage 0 is a non-invasive cancer where abnormal cells are present in the milk ducts but haven't spread to surrounding tissues. DCIS is often detected early through mammograms, making it highly treatable with a good prognosis. Treatment usually includes surgery to remove the abnormal tissue, followed by radiation therapy in some cases. Hormone therapy may be suggested if the tumour cells are estrogen receptor-positive.

Stage I: Early-Stage Invasive Breast Cancer: At Stage I, cancer cells have begun to invade surrounding tissue but are still localised, usually no larger than 2 centimetres. This stage has a high success rate with treatment, typically involving surgery (lumpectomy or mastectomy) and radiation therapy. Chemotherapy may also be recommended if there's a risk of the cancer spreading.

Stage II: Localized Cancer: Stage II is further classified into IIA and IIB, based on the tumour's size and lymph node involvement. While cancer has spread beyond the breast, it is still localised and hasn't reached distant organs. Treatment may include surgery, chemotherapy, and radiation therapy and also hormone or targeted therapy. Medications may be used to inhibit tumour growth.

Stage III: Locally Advanced Cancer: In Stage III, the cancer has spread to nearby lymph nodes and tissues but hasn't metastasised to distant organs. This stage requires aggressive treatment, usually starting with chemotherapy to shrink the tumour before surgery. Following surgery, radiation therapy and possibly targeted therapies are used. Hormone therapy may also be suggested if the cancer is hormone receptor-positive.

Stage IV: Metastatic Breast Cancer: Stage IV is the most advanced stage, where the cancer has spread to distant areas of the body, such as the bones, liver, lungs, or brain. Though incurable, treatment focuses on managing the disease and prolonging life. This may include chemotherapy, targeted therapies, radiation, and medications that help slow tumour growth by blocking its blood supply. While a cure isn't possible, modern treatments can extend survival and improve quality of life.

What are the treatment options for breast cancer?

Breast cancer treatment has evolved significantly, with advances in medical research offering more targeted, effective options. A personalised treatment plan is designed based on the cancer's stage, type, and molecular characteristics. The primary treatment modalities include surgery, chemotherapy, radiation therapy, targeted therapy, and hormone therapy.

Surgery: The First Line of Defense

Surgery continues to be one of the most effective treatments for early-stage breast cancer. The goal is to remove the tumour or the entire breast if necessary. The two main types of surgery are:

  • Lumpectomy: Removing the tumour along with a small margin of surrounding tissue, typically used for early-stage cancers.
  • Mastectomy: Removing the entire breast is recommended for large tumours or high recurrence risk.

Surgery may be followed by radiation therapy to eliminate any remaining cancer cells.

Chemotherapy: Systemic Treatment for Cancer Cells

Chemotherapy utilises strong medications to target and eliminate rapidly dividing cancer cells. It's often used in advanced stages or when there's a risk of cancer spreading. Chemo can be given before surgery (neoadjuvant) to shrink tumours or after surgery (adjuvant) to eliminate remaining cancer cells. In metastatic breast cancer, chemotherapy is a primary treatment, often combined with targeted therapies for enhanced effectiveness.

Radiation Therapy: Targeting Localized Cancer

Radiation therapy employs high-energy rays to target and kill cancer cells, often following surgery to ensure all cancer cells are eliminated. It's effective for localised cancers and is frequently used alongside chemotherapy for more comprehensive treatment.

Targeted Therapy: Fighting Cancer on a Molecular Level

Targeted therapies are developed to focus on specific molecules that contribute to cancer cell growth. Bevacizumab (brand name Avastin) is one such targeted therapy. It blocks the development of blood vessels that supply tumours, effectively starving them and preventing further growth. This is particularly used in advanced breast cancer, particularly when other treatments have proven less effective.

Hormone Therapy: Blocking Hormone-Driven Growth

Hormone therapy is used to treat hormone receptor-positive breast cancers, where cancer growth is fueled by hormones like estrogen or progesterone. Medications block these hormones or lower their levels in the body, slowing or stopping cancer growth. Standard hormone therapies include selective estrogen receptor modulators (SERMs), aromatase inhibitors, and ovarian suppression treatments. These therapies are often combined with other treatments to reduce recurrence risk.

What are the latest advancements in breast cancer treatment?

Recent advancements in breast cancer treatment have greatly improved outcomes. Key developments include:

  • Immunotherapy: Harnessing the immune system to more effectively target and combat cancer.
  • Genetic Testing and Personalised Medicine: Customised treatments based on individual genetic profiles for greater precision.
  • Targeted Therapies: Treatments that focus on specific cancer-causing molecules, minimising damage to healthy tissue.
  • Improved Early Detection: Enhanced imaging and diagnostic tools for earlier, more accurate detection.
  • Better Supportive Care: Improved strategies for managing side effects and supporting mental well-being during treatment.

These innovations are transforming breast cancer care, resulting in enhanced survival rates and quality of life for patients.

Wrapping up

Breast cancer is a complex disease, with treatment tailored to the stage and characteristics of the tumour. Advances in early detection and personalised treatment offer the best chance for success, whether through chemotherapy, targeted therapies, radiation, or surgery. 

As science evolves, new treatments continue to improve outcomes. With ongoing research, the future of breast cancer care is promising, offering hope to millions worldwide.