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Updated September 27, 2010

There are two parts to breast cancer treatment: local therapy and systemic therapy.

Local Therapy

The goal of local therapy is to control the disease in the breast and nearby lymph nodes.

Local therapies include surgery and radiation. These therapies are sometimes offered in combination with each other, and other times surgery alone is enough. In most cases, lumpectomy and radiation go together, but each case is unique and so is each treatment plan.

Systemic Therapy

The goal of systemic therapy is to get rid of cancer cells that may have traveled away from the primary tumor to distant sites, such as the bones, liver, lungs or brain. All invasive cancers have the potential to travel from the primary tumor to another part of the body.

Systemic therapies include chemotherapy, hormonal therapy and targeted (biologic) treatment. The choice about which systemic therapies, if any, you receive, depends on the likelihood of the cancer coming back (recurring) either in the breast or somewhere else in your body. Many factors go into the decision about which systemic therapy will be most effective in reducing your risk for distant recurrence.

Treatment Decisions

Your doctors may recommend that you receive some or all of these treatments based on the pathology of the cancer and what your doctors know about the way the tumor behaves. From the pathology report, they will consider the size of the tumor and how fast it is growing. They also will consider whether the cancer has invaded nearby tissues, is present in lymph nodes, grows in response to the hormones estrogen and progesterone or has too many HER2 receptors.

Genomic tests give doctors more detailed and specific information about the biologic traits of the tumor and how effective certain treatments might be. If a genomic test is used, your doctors will talk with you about how the results could impact your treatment.

Treatment recommendations also may take into account other important factors, such as your age, your overall health, your preferences and the likelihood that the breast cancer could recur.

In some cases, you may be given a single treatment option. Or you may have a choice among several equally good options. Sometimes your doctor may recommend a clinical trial, a new approach that is being compared to the standard treatment to see which is more effective.

Learn more about local and systemic treatment options by using the navigation bar on the left.

Learn more about the providers who helped us write this page in our Guide to Understanding Treatment Decisions.