Dr. Karishma Kirti

Dr. Jay R Anam

Surgical Oncologist
DNB General Surgery, M.Ch

Understanding Stage 1 Breast Cancer Treatment

Breast cancer is a complex and multifaceted disease, affecting millions of women around the world. Early detection is crucial in ensuring the best possible outcomes for patients.

In today’s blog, we’ll delve into stage 1 breast cancer, its presentation, treatment options, and post-surgery care.

Understanding Breast Cancer

Breast cancer is a malignant growth that begins in the breast tissue. It can be classified into four main stages based on the size of the tumor, the extent of its spread, and other factors.

Stage 1 breast cancer is considered early, with the tumor limited to the breast and measuring less than 2 cm. The cancer has not spread to the axillary (armpit) lymph nodes at this stage.

Cancer cells may sometimes be present in the sentinel axillary nodes, but it is still classified as stage 1 breast cancer.

How Stage 1 Breast Cancer Presents Itself?

Since stage 1 tumors are relatively small, they are generally not visible or observable through physical examination. However, they can be detected through screening mammography, which is recommended for all women above 40 as a routine procedure.

If an abnormality is detected on the mammogram, your doctor might recommend a core biopsy to confirm the presence of cancer. In cases where no nodes are found in the axilla, further imaging such as PET scans may not be necessary, and surgery may be recommended as the first line of treatment.

Understanding the Importance of Screening Mammography:

Screening mammography is a vital tool in detecting breast cancer at its earliest stages, allowing for timely intervention and improved outcomes. In general, we recommend screening mammography once a year for every woman above 40.

 However, women at a higher risk of breast cancer due to factors such as family history or genetic mutations may need to start screening at an earlier age or undergo additional imaging tests, such as breast MRI or ultrasound.

Treatment Options

For stage 1 breast cancer, there are two primary surgical options:

  1. Breast-conserving treatment and radiation: This approach involves removing the tumor while preserving as much healthy breast tissue as possible, followed by radiation therapy to eliminate any remaining cancer cells.

    This option is often preferred by patients who wish to maintain the appearance and shape of their breasts after treatment.

  2. Mastectomy: This procedure involves the complete removal of the breast and axillary lymph nodes. In stage 1 breast cancer, radiation therapy may not be necessary after a mastectomy.

    Some women choose mastectomy for various reasons, such as a strong family history of breast cancer or a desire to reduce the risk of cancer recurrence in the future.

During surgery, we typically perform a sentinel node biopsy to examine the first lymph node where cancer is most likely to spread.

If cancer is detected in this node, axillary clearance (removal of additional lymph nodes) may be necessary. If no cancer is found, the surgery can be concluded.

Must read this blog- Myths About Breast Cancer Biopsy Procedure

Post-Surgery Care

Following surgery, additional treatment may be required, depending on the presence of cancer in the axillary nodes. If cancer is found, chemotherapy may be recommended, though this is more common in higher-stage breast cancer.

A genomic test, such as the Oncotype DX or MammaPrint, may be conducted in selected cases to assess the risk of cancer recurrence. If the risk is high, chemotherapy may be administered to reduce this risk.

Depending on the presence of estrogen and progesterone receptors in the tumor, hormonal therapy may be initiated in stage 1 breast cancer patients.

Hormonal therapy can be administered in the form of medications like tamoxifen or aromatase inhibitors, which work to block the effects of estrogen on cancer cells or lower estrogen levels in the body, respectively.

These treatments can help prevent cancer recurrence and are often prescribed for several years following surgery. If the tumor doesn’t show the presence of any receptors (TNBC – triple-negative breast cancer) then even despite being stage chemotherapy needs to be taken.

Targeted therapy options depend on whether the cancer has a HER2 neu receptor. If present, specialized drugs, such as trastuzumab (Herceptin) or pertuzumab (Perjeta), can be administered to target this specific receptor.

These targeted therapies have shown to be effective in reducing the risk of cancer recurrence and improving overall survival rates in HER2-positive breast cancer patients.

Radiation therapy may also be offered to stage 1 breast cancer patients, particularly in cases where breast-conserving surgery was performed.

Radiation therapy uses high-energy X-rays or particles to destroy cancer cells and is typically administered over several weeks. This additional treatment is vital in minimizing the risk of cancer recurrence in the treated breast.

Also, Read This Blog- Breast Conservation Surgery

Wrapping up

Stage 1 breast cancer, though considered an early stage, requires a comprehensive approach to treatment and care.

Through early detection via routine mammography, appropriate surgical intervention, and post-surgery therapies tailored to each patient’s specific needs, women diagnosed with stage 1 breast cancer can significantly increase their chances of a successful recovery and a cancer-free future.

It is crucial to stay vigilant, maintain regular follow-up care, and adopt a healthy lifestyle to optimize long-term outcomes.