Stage I breast cancer has not spread beyond the breast or has only spread in very small amounts to the lymph nodes. The prognosis for stage I breast cancer is better than for other stages, and if detected early, stage I breast cancer can be cured.
1. Stage I breast cancer
In stage I breast cancer, the cancer is still considered early-stage breast cancer. Stage I describes invasive breast cancer (cancer cells are invading or infiltrating surrounding normal breast tissue). This stage is divided into two branches: IA and IB.
Stage IA describes invasive breast cancer in which: the tumor measures up to 2 cm and has not spread outside the breast; there are no lymph nodes involved.
Stage IB describes invasive breast cancer in which: there is no tumor in the breast but instead small clusters of cancer cells. These clusters are larger than 0.2 mm but not larger than 2 mm. They are found in the lymph nodes. Alternatively, there may be a tumor in the breast no larger than 2 cm and a small cluster of cancer cells that may be larger than 0.2 mm but not larger than 2 mm. These are also found in the lymph nodes.
However, if the cancer is positive for estrogen or progesterone receptors, it may have the potential to be classified as stage IA.
Microscopic invasion may be present in stage 1 breast cancer. In this invasion, cancer cells begin to invade the tissue outside the lining of the duct or lobe, but the invasive cancer cells cannot be measured and are smaller than 1mm.
2. Treatment Options for Stage I Breast Cancer
2.1 Surgery
Surgery is the standard treatment for stage 1 breast cancer. Because the tumor is still small at this time, the surgeon can remove the tumor (the tumor itself and some surrounding tissue). However, in specific cases, some women may undergo mastectomy, in which the entire breast is removed.
Factors determining the choice of this method include: the size of the primary tumor, genetic factors, and lymph node biopsy may also be performed.
In both cases, the surgeon will be able to remove one or more lymph nodes. After mastectomy, patients may choose breast reconstruction surgery.
2.2 Radiation Therapy
Radiation therapy can destroy any remaining cancer cells. It is often administered after tumor removal. Women with stage 1 breast cancer who have undergone mastectomy may still need to use radiation therapy as the next treatment step.
This method may not be necessary for women over 70 years old, especially those who have been treated with hormone therapy.
2.3 Chemotherapy
Post-surgery chemotherapy can reduce the risk of cancer recurrence. These drugs will attack cancer cells. Women with larger breast tumors are more likely to require chemotherapy treatment. Chemotherapy can be administered in several ways, such as taking pills or liquids containing chemicals. However, it is usually delivered directly into the patient’s vein. This treatment method typically occurs in cycles, and patients may have breaks between cycles.
This method may not be necessary for patients who have already been treated with hormone therapy.
2.4 Hormone therapy
Hormone therapy is a good option after surgery for women with hormone receptor-positive (HR) tumors. The medication can help prevent the tumor from receiving hormones. These drugs include: tamoxifen (for all women), and anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara) (for postmenopausal women).
Premenopausal women may consider having their ovaries removed to stop producing hormones that promote cancer growth.
2.5 Targeted therapy
Targeted therapy is the latest treatment method. About 20% of women with breast cancer have too much HER2 protein, which can sometimes cause the cancer to spread quickly. Trastuzumab (Herceptin) is a drug approved for the treatment of women with HER2-positive breast cancer. It works by blocking the HER2 protein to prevent cancer growth and making some chemotherapy treatments more effective. Other medications used in this approach include pertuzumab (Perjeta) and neratinib (Nerlynx).
2.6 Clinical trials
These are studies that show experimental treatments that are not yet available to everyone to see how effective the treatment is and if it is safe for patients. Clinical trials are also one of the selected methods that can help treating physicians discover new effective treatment regimens. At the same time, women with stage 1 breast cancer may gain access to advanced methods to achieve the best treatment results.
Breast cancer is a common cancer among females. Accordingly, if breast cancer is detected early, the prognosis for treatment is very high, and it can even be completely cured and not relapse. Therefore, breast cancer screening is a necessary action, especially for those at high risk of developing breast cancer.
