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Breast Cancer Treatment by Stage

Drawing of a person with a tumor shown in their breast who is surrounded by icons representing different treatments, including chemotherapy, surgery, radiation therapy, immunotherapy, targeted therapy, and hormone therapy.

There are different types of treatment for breast cancer. You and your cancer care team will work together to decide on a treatment plan that’s best for you based on how advanced your cancer is and other factors. This may include one or more types of treatment.

Credit: Created by Nadia Jaber and Linda Wang with Biorender.com

Cancer stage, which is the extent of cancer in the body, is an important factor in determining which breast cancer treatments may work best for you. To learn how breast cancer is staged, visit Breast Cancer Stages.  

Other factors that will be considered when planning your treatment include:

  • the type of breast cancer you have
  • whether you have started menopause
  • whether you are pregnant
  • your age and general health  
  • your preferences  

You and your cancer care team will work together to decide your treatment plan. Most people receive more than one type of treatment.

The information on this page applies to most types of invasive breast cancer. To learn about the treatment of these and other less common types of breast cancer, visit Breast Cancer Treatment

Treatment of stage 0 breast cancer (ductal carcinoma in situ)

Ductal carcinoma in situ (DCIS) is a condition where abnormal cells form in the lining of the milk ducts but have not spread. It's not cancer, but it may develop into invasive cancer.  

Treatment of ductal carcinoma in situ may include lumpectomy with radiation therapy, mastectomy with or without radiation, and hormone therapy if biomarker testing suggests it may be helpful.

To learn more about DCIS and how it is treated, visit Ductal Carcinoma in Situ.

Treatment of stages I to III breast cancer

Treatment of early-stage breast cancer, which includes stages I, IIA, and some stage IIB breast cancers, usually begins with surgery to remove the cancer. Surgery is often followed by additional therapy. If the tumor is large, chemotherapy or targeted therapy may be given before surgery to make the tumor smaller and easier to remove.

Treatment of locally advanced breast cancer, which includes some stage IIB breast cancers and stages IIIA, IIIB, and IIIC, often begins with chemotherapy, followed by surgery and radiation.  

Palliative Care

Palliative care can be given at any stage of disease. It aims to improve quality of life by managing symptoms and providing support to patients and their families. Palliative care can be provided alongside curative treatments, such as chemotherapy, or as the focus of care. Learn more at Palliative Care in Cancer.

Treatment of stages I to III breast cancer may include:

  • Surgery. Lumpectomy (breast-conserving surgery) is often used, but mastectomy may be recommended if the tumor is large or cancer is found in multiple areas of the breast or chest. The surgeon may also remove the underarm lymph node closest to the tumor in a procedure called sentinel lymph node biopsy. Learn more about Breast Cancer Surgery and Sentinel Lymph Node Biopsy.  
  • Radiation therapy. After surgery, you will likely have radiation therapy to the breast or the chest wall where the breast was removed to reduce the chance of breast cancer returning in the breast or the chest wall. However, you may not need radiation therapy if you have a mastectomy. Learn more about Radiation Therapy for Breast Cancer.  
  • Chemotherapy. You are more likely to receive chemotherapy if the tumor is high grade, in the lymph nodes, HER2-positive, or triple-negative. Whether chemotherapy is given before or after surgery depends on the size and location of the tumor and other factors. Learn more about Chemotherapy for Breast Cancer.
  • Hormone therapy. If the cancer tests positive for estrogen receptor and/or progesterone receptor, or when the hormone receptor status of the cancer is unknown, you may receive hormone therapy as part of your treatment. Hormone therapy for breast cancer may begin before or after surgery. If you are premenopausal, you might also have treatment to stop the ovaries from making hormones. Learn more about Hormone Therapy for Breast Cancer.
  • Immunotherapy. This cancer treatment is only used to treat triple-negative breast cancer. Learn about this type of cancer and how it is treated at Triple-Negative Breast Cancer and Immunotherapy for Breast Cancer.
  • Targeted therapy. If biomarker tests suggest that the cancer is HER2-positive, hormone-receptor positive, or has a BRCA1 or BRCA2 mutation, you may receive targeted therapy. Targeted therapy for breast cancer may be given at different times in your treatment. It might be started before or after surgery. It can also be given even if surgery is not recommended for you. Learn more about Targeted Therapy for Breast Cancer.  

Join a Clinical Trial

Joining a clinical trial may be an option. There are different types of clinical trials for people with breast cancer. You can use the clinical trial search to find NCI-supported cancer clinical trials that are accepting participants. You can also review a list of all current NCI-supported Breast Cancer Clinical Trials

Get live help finding a clinical trial at 1-800-4-CANCER. Learn more about clinical trials at Cancer Clinical Trial Information for Patients and Caregivers.

Treatment of locoregional recurrent breast cancer

Sometimes breast cancer comes back after treatment. Locoregional recurrent breast cancer is cancer that has come back in the breast, the chest wall, or nearby lymph nodes after treatment. Learn more about Breast Cancer Recurrence and how it is treated.

Treatment of stage IV (metastatic) breast cancer

Breast cancer that has spread beyond the breast, chest wall, or nearby lymph nodes is called metastatic breast cancer. Treatment of metastatic breast cancer focuses on slowing the spread of the cancer and controlling the symptoms. Some of the treatments used for stages I to III breast cancer may also be used for metastatic breast cancer. The choice of treatments will partly depend on how the cancer responded to the treatments you have already received and what you want from treatment. Learn more about Metastatic Breast Cancer and how it is treated. 

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