A: Women who are under age 40 sometimes receive more aggressive surgery because their breast cancer may be more difficult to treat. However, research now shows that younger women with stage I or stage II disease who choose lumpectomy instead of mastectomy under the advice of their doctors have about the same risk of recurrence as older patients also treated by lumpectomy. The surgery must be followed by radiation.
You and your surgeon should talk fully and openly about your options. Seeking a second opinion often helps with treatment decision-making.
A: Tamoxifen is a hormonal treatment that works by blocking estrogen receptors on breast cancer cells that grow when estrogen is present. This helps lower the risk of developing hormone-sensitive breast cancers.
When tamoxifen was first used, research measured its benefits only in postmenopausal women with hormone-sensitive breast cancers. More recently, studies show it is effective in younger, premenopausal women with lymph-node positive, estrogen-receptor positive (ER+) disease. When those women take tamoxifen for five years after surgery and chemotherapy, they increase the amount of time they remain disease-free. Today, tamoxifen is the standard treatment for hormone-sensitive breast cancer in premenopausal women.
You should not become pregnant while taking tamoxifen because it can damage the developing fetus.
Find out more about tamoxifen and other hormonal treatments by listening to the podcast of Hormonal Therapies: Before, During and After Breast Cancer.
A: About 15 percent of all breast cancers are known as "triple negative," meaning that they don’t test positive for the expression of estrogen or progesterone receptors or the HER2 receptor. Younger women are more likely to have triple-negative breast cancer than older women.
While it’s true that hormonal therapies (which block estrogen or progesterone) and targeted therapies (which attack specific cancer cells) aren’t effective against triple-negative breast cancer, it’s also true that chemotherapy works especially well against triple-negative disease. Ongoing research projects are looking at whether specific chemotherapies, alone or in combination, might increase that effectiveness even more.
In addition, studies are looking at anti-angiogenesis medicines that prevent the growth of new blood vessels, as well as many new targeted therapies, as possible treatments for triple-negative breast cancers.
All FAQs reviewed by Clifford A. Hudis, MD