Treatment options for breast cancer

Treatment for breast cancer depends on a number of factors. You might have a choice of treatments, or your medical team might recommend the best treatment for you. The main treatments for breast cancer include:

• surgery

• chemotherapy

• radiotherapy

• hormonal therapy (also called endocrine therapy)

• targeted cancer drugs and immunotherapy

• bone strengthening drugs (bisphosphonates)

You usually have a combination of these treatments, depending on your situation. This is why your treatment may be different from other people with breast cancer.

This page is about treatment options for breast cancer that hasn’t spread to other distant parts of the body. We also have information about treatment options for breast cancer that has spread to other distant parts of the body such as the lungs, liver or bones. This is secondary or advanced breast cancer.

Go to our information about secondary breast cancer

Surgery for breast cancer

Most people begin their breast cancer treatment with surgery. Some people may have chemotherapy or hormonal therapy before surgery. 

There are different types of surgery.

Breast conserving surgery (lumpectomy)

Depending on the size and position of the cancer, you might be able to have just the cancer and a border of normal breast tissue removed. This is also called a lumpectomy or wide local excision.

Find out more about breast conserving surgery

Surgery to remove your breast (mastectomy)

Your surgeon may recommend you have the whole breast removed. This is a mastectomy. You can have a new breast shape made (a breast reconstruction) at the time of surgery, or sometime later.

Find out more about having a mastectomy and breast reconstruction

Surgery to the lymph nodes 

Cancer cells can break away from the breast tissue and go to other parts of the body. If this happens, it usually first spreads to the ​lymph glands (nodes)​ in the armpit (axilla) close to the breast.

You usually have an ultrasound scan to look at the lymph nodes in the armpit. If your doctor sees any changes in the lymph nodes, they might take a ​biopsy​ .

If the lymph nodes look normal on the ultrasound, you usually have a sentinel lymph node biopsy during your breast surgery. This is to make sure that cancer has not spread to the sentinel lymph node. The sentinel node is the first node fluid drains from the breast into the armpit.

Your doctor usually suggests surgery to remove all or some of the lymph nodes in your armpit if the results show that you have cancer cells in the lymph nodes. This is called an axillary lymph node clearance or a targeted axillary dissection. You have the operation on your armpit at the same time as your breast cancer surgery or as a second operation.

Find out more about surgery to remove lymph nodes

Radiotherapy for breast cancer

Radiotherapy uses high energy x-rays to kill cancer cells. You usually have radiotherapy after breast conserving surgery. This is usually between 5 to 15 radiotherapy treatments (​fractions​ ).  

Some people may also have radiotherapy after a mastectomy. For example, if the cancer has spread to the lymph nodes or is bigger than 5cm.

Depending on your situation, you may also have radiotherapy to the lymph nodes in your armpit.

Find out about radiotherapy for breast cancer

Treatment to strengthen the bones (bisphosphonates)

Bisphosphonates are drugs that help prevent or slow down bone thinning (osteoporosis). They can help to strengthen bones and reduce the risk of bones breaking.

You might have bisphosphonates to help prevent or slow down bone thinning. You may also have it to reduce the risk of breast cancer spreading to the bones if you have had the menopause. You usually have a drug called zoledronic acid or sodium clodronate.

Read more about having treatment with bisphosphonates

Getting a second opinion

Treatment decisions can be complicated and confusing. You can ask for a second opinion if you would like to get another doctor's view on your treatment. This means going to see another specialist. They will need to see all your test results. 

Having a second opinion doesn't usually mean that the new doctor takes over your treatment and care. They discuss with you and your current doctor which is the best treatment approach to take.

It can take time to arrange a second opinion and it might mean that your treatment is delayed for a while.

It is worth discussing your treatment again with your current doctor first. Once you have heard why they are suggesting particular treatments, you might feel that you don't need a second opinion.

Write down all your questions before the appointment with your specialist. It can be difficult to remember everything you want to ask once you get there. Writing down your questions beforehand can help you to feel more confident during the discussion.

Read more about getting a second opinion

Having treatment as part of a clinical trial

Doctors are always trying to improve treatments and reduce side effects. Your doctor might ask you to participate in a clinical trial as part of your treatment. This might be to investigate a new test, a new cancer treatment or to look at different combinations of existing treatments.

Your doctor will tell you if there are any trials that you can enter.

Read about research and clinical trials

JoC's breast cancer story

JoC was diagnosed with lobular cancer in 2021.

"I've had the cancer removed and a reconstruction of the breast. I'm awaiting radiotherapy and hormone suppression treatment."

Read JoC's story about her cancer diagnosis, treatment and how she coped