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Breast Cancer.org: Treatment and Side effects

Treatment

Sequence of Treatment

 

Your team of doctors will most likely recommend a particular sequence of treatment. Here is the most common "pathway":

  • Usually surgery is first. For some women, surgery to remove the breast cancer and surgery to reconstruct the breast happen during the same operation.
  • If chemotherapy is going to be part of your care, it is often given second.
  • Radiation therapy usually follows surgery and chemotherapy (when chemotherapy is given).
  • A hormonal therapy (such as tamoxifen or an aromatase inhibitor) is often started after the other treatments have been given if the cancer is hormone-receptor positive.

There are many exceptions to this sequence, however, or other treatments given. There are also many other variations in timing and sequence.

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Understanding the risk

How much does your risk of recurrence change?

If you hear that a certain treatment can reduce your risk by 25%, what does that mean?

To understand what the numbers mean about YOUR risk for a breast cancer recurrence, the key terms to know are Relative Risk and Absolute Risk.

Relative Risk is the number that tells you how much something you do, like taking a pill, can change your risk, compared to your risk without taking a pill.

Absolute Risk is the number of percentage points by which your own risk changes if you do something, like taking a pill. The size of your absolute risk depends on what your risk is to begin with.

Example of treatment reducing risk of recurrence

Suppose your risk of breast cancer is 12%, and then you decide to take Drug A, which can lower the risk of breast cancer by 25%.

That means your risk of breast cancer with Drug A could be 25% lower than without Drug A. That's the Relative Risk decrease with Drug A.

But how big a difference does a 25% decrease really mean for you? Lowering your 12% risk by 25% drops your risk by 3%.