Types of Treatment for Early Breast Cancer

The goal of treating early and locally advanced breast cancers (stages I, II and III) is to get rid of the cancer and keep it from coming back. These breast cancers include invasive ductal carcinomas and invasive lobular carcinomas.

Learn about treatment for ductal carcinoma in situ (DCIS).

Learn about treatment for metastatic breast cancer.

Making treatment decisions

Together, you and your health care team make breast cancer treatment decisions.

After you get a recommended treatment plan from your health care team, take time to study your treatment options. Each treatment option has risks and benefits to consider. Talk with your health care team about your values and lifestyle. Talk to those closest to you. Make thoughtful, informed decisions that are best for you. If you’re unsure, consider getting a second opinion.

Early breast cancer treatment can be divided into local therapy and systemic therapy.

Local therapy

Local therapy removes the cancer from a limited (local) area, such as the breast, chest wall and lymph nodes in the underarm area. It also helps make sure the cancer doesn’t come back to that area.

Local therapy involves surgery, with or without radiation therapy to the breast and nearby lymph nodes.

Learn about factors that affect treatment options.

The goal of breast cancer surgery is to remove the entire tumor from the breast.

Some of the lymph nodes from the underarm area (axillary lymph nodes) may also be removed to see if they contain cancer cells.

Types of breast cancer surgery

There are 2 basic types of breast cancer surgery:

Lumpectomy (also called breast-conserving surgery, partial mastectomy or wide excision). The tumor and a small rim of normal tissue around the tumor are removed. The rest of the breast remains intact.
Mastectomy. The entire breast is removed.

Learn about deciding between lumpectomy and mastectomy.

Learn about breast reconstruction.

The goal of radiation therapy is to kill any cancer cells that might be left in or around the breast after surgery. These cells are too small to see on scans or to be measured with lab tests.

Learn about going through radiation therapy.

Learn about side effects of radiation therapy.

Learn about emerging areas in radiation therapy.

Systemic therapy (neoadjuvant therapy and adjuvant therapy)

The goal of systemic therapy is to get rid of cancer cells that may have spread from the breast to other parts of the body. These cells are too small to be seen on scans or to be measured with lab tests.

Systemic therapy uses drug therapies that travel throughout the body to get rid of cancer cells. Some drug therapies are given by vein (through an IV) or injection, and some are pills.

Systemic therapy is used in addition to (an adjunct to) breast surgery. So, these treatments are often called adjuvant therapy when given after surgery. When they are given before surgery, they are often called neoadjuvant therapy.

Learn about factors that affect treatment options.

Chemotherapy drugs kill or disable cancer cells.

For people with early breast cancer, chemotherapy may be given before or after breast surgery. Chemotherapy is usually given before radiation therapy.

Neoadjuvant (before surgery) chemotherapy

In people with large tumors who need a mastectomy, chemotherapy may be used before surgery. This is called neoadjuvant chemotherapy. Neoadjuvant chemotherapy may shrink the tumor enough so a lumpectomy becomes an option.

Neoadjuvant chemotherapy may also be given to people who have enlarged lymph nodes in the underarm area due to breast cancer. Neoadjuvant chemotherapy may shrink the tumors in the lymph nodes and make it easier to remove these nodes during surgery.

In some cases, response to neoadjuvant therapy can help guide treatment after breast cancer surgery.

People with locally-advanced or inflammatory breast cancer usually begin treatment with neoadjuvant chemotherapy.

Learn about chemotherapy drugs.

Learn about going through chemotherapy.

Learn about short-term side effects of chemotherapy.

Learn about long-term side effects of chemotherapy.

Learn about emerging areas in chemotherapy.

Some breast cancer cells need estrogen and/or progesterone (hormones in the body) to grow. Hormone therapy slows or stops the growth of these tumors by preventing the cancer cells from getting the hormones they need to grow.

Hormone therapy is usually given after surgery.

In some postmenopausal women, hormone therapy may be used before surgery with the goal to shrink a tumor enough so a lumpectomy becomes an option to a mastectomy. This is called neoadjuvant hormone therapy.

Learn more about hormone therapies, including tamoxifen, aromatase inhibitors and ovarian suppression.

Learn about side effects of tamoxifen.

Learn about side effects of aromatase inhibitors.

Learn about side effects of ovarian suppression.

Learn about emerging areas in hormone therapy.

Some breast cancers have high amounts of a protein called HER2 on the surface of their cells. These are called HER2-positive breast cancers. The HER2 protein is an important driver of cell growth and cell survival.

HER2-targeted therapies are used to treat HER2-positive breast cancers. Unlike chemotherapy, HER2-targeted therapies only kill HER2-positive cancer cells, with little harm to healthy cells.

Learn about side effects of HER2-targeted therapies for early breast cancer.

Learn about emerging areas in HER2-targeted therapies.

Cyclin-dependent kinase 4 and 6 (CDK4 and CDK6) are enzymes important in cell division. CDK4/6 inhibitors are drugs designed to interrupt the growth of cancer cells.

The CDK4/6 inhibitor abemaciclib (Verzenio) is used in combination with hormone therapy to treat some early hormone receptor-positive breast cancers at high risk of recurrence.

Learn about abemaciclib, including its side effects.

Learn about emerging areas in drug therapies for early breast cancer.

Immunotherapy drugs help the body’s immune system attack cancer cells.

Pembrolizumab (Keytruda) is a checkpoint inhibitor immunotherapy drug used to treat some early triple negative breast cancers at high risk of recurrence.

Learn more about pembrolizumab, including its side effects.

Learn about emerging areas in drug therapies for early breast cancer.

PARP inhibitors are drugs that try to keep cancer cells from repairing damaged tumor DNA.

Olaparib (Lynparza) is a PARP inhibitor used to treat some HER2-negative early breast cancers at high risk of recurrence in people who have a BRCA1 or BRCA2 inherited gene mutation.

Learn more about olaparib, including its side effects.

Learn about emerging areas in drug therapies for early breast cancer.

Learn about factors that affect treatment options.

Learn more about side effects of breast cancer treatments.

Learn about financial issues related to treatment.

Learn more about the importance of following your breast cancer treatment plan.

Treatment guidelines

Although the exact treatment for breast cancer varies from person to person, evidence-based guidelines help ensure high-quality care. These guidelines are based on the latest research and agreement among experts.

The National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology (ASCO) are respected organizations that regularly review and update their guidelines.

In addition, the National Cancer Institute (NCI) has treatment overviews.

Talk with your health care team about which treatment guidelines they use.

After you get a recommended treatment plan from your health care team, study your treatment options. Together with your health care team, make thoughtful, informed decisions that are best for you. Each treatment option has risks and benefits to consider along with your own values and lifestyle.

Updated 08/25/23

Types of Treatment for Early Breast Cancer

Making treatment decisions

Local therapy

Types of breast cancer surgery

Systemic therapy (neoadjuvant therapy and adjuvant therapy)

Neoadjuvant (before surgery) chemotherapy

Treatment guidelines

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