Breast Cancer Treatment Options

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There are more treatment options today than ever before to control breast cancer or put it into remission, even if you have metastatic disease (cancer that has spread to another part of the body).

At Fred Hutch Cancer Center, our breast cancer specialists work closely with you, your family and each other to get you back to health and fully recovered. We provide all standard therapies for breast cancer and offer you access to the latest innovations through clinical trials.

People with breast cancer are living longer, healthier lives.

Breast Cancer Care Tailored to You

You and your family are our top priority. At Fred Hutch Cancer Center, we offer comprehensive and compassionate care — personalized to you. You'll have access to the latest treatment options, clinical trials and supportive care services. 

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How We Treat Breast Cancer at Fred Hutch

Different breast cancers start, progress and respond to treatments in different ways. We choose, combine and schedule your treatments based on what works for your situation. Your care team will make sure you understand each type of treatment and all of your choices.

Surgery

As a patient at Fred Hutch, you’ll have surgery done by a UW Medicine breast surgeon. Your surgeon will be specially trained in breast surgery/surgical oncology. They will recommend the best procedure to match your needs.

Breast Reconstruction

We offer reconstruction, if you want it, using implants and natural tissue for those having surgery to remove breast cancer. Meeting with a breast reconstruction plastic surgeon can help you learn about the options and decide what’s right for you.

Radiation Therapy

Radiation therapy uses high-energy rays to kill cancer cells. Often, it is done to lower the chance of breast cancer coming back after a lumpectomy or mastectomy or to relieve symptoms in people with metastatic disease.

Chemotherapy

Chemotherapy helps to destroy cancer cells wherever they may be in your body. Usually, it means you get anti-cancer medicine through an intravenous (IV) line. Then the medicine travels throughout your body through your bloodstream. 

Hormone Therapy

Hormone therapy is important if your breast cancer cells have receptors for estrogen or progesterone. These hormones help the cancer cells multiply quickly. The therapy may reduce or block the hormone levels or effects.

Immunotherapy

Immunotherapies, like immune checkpoint inhibitors, use the power of your immune system to find and fight breast cancer cells. Another option, cellular immunotherapy, may be available through a clinical trial.

Targeted Therapy

For some cancer subtypes, you may get targeted therapies — newer treatments that work more selectively than standard chemotherapy. There are many options for both early-stage and advanced or metastatic breast cancer.

Where You Will Be Seen

At the Sloan Clinic, we have several clinics for people with breast cancer. When you start care here, we will match you with the best place to meet your current needs.

Breast Cancer Specialty Clinic 

The Breast Cancer Specialty Clinic (BCSC) is a multidisciplinary center for people with non-metastatic invasive breast cancer that is either a more advanced stage or biology and requires up-front treatment coordination between members of the team, including a nurse navigator, breast surgeon, medical oncologist and radiation oncologist. These experts will work together, listening to your needs and preferences, to make a treatment plan that is right for you.

A BCSC visit takes about half a day. A nurse navigator will meet with you first to go over the plan for the day, give you educational and support materials and answer your questions. A resident or fellow (a physician who is doing extra training to specialize in cancer) will examine you and talk with you about your medical history. Then, while you take a break, Fred Hutch’s full team of breast cancer specialists will meet to talk about your treatment options.

Next, your physicians will come to see you in an exam room. Often, they will examine you together to make sure they agree about the best therapies to treat your disease. Then each physician will meet with you one-on-one. They will explain the specific treatment they recommend and what will happen next. This is also a time for you to ask any questions you may have. 

Dr.  Jennifer M. Specht explains what to expect at a first appointment with the Breast Cancer Specialty Clinic.

Breast Health Program/Surgery Clinic

The Breast Health Program serves people with breast health concerns, those at higher risk for breast cancer and those with stage 0, stage I (1) or stage II (2) invasive breast cancer. The clinic also serves women seeking medical or surgical breast cancer risk-reduction strategies.

The Breast Health team diagnoses and treats a full range of breast concerns. Our advanced practice providers see patients with a breast lump, another symptom or a family history of breast cancer. They also order diagnostic imaging tests and genetic counseling and perform clinical breast exams.

If you have a higher risk of breast cancer, our team can make a screening and follow-up plan just for you. We will design your plan to give you and your health care team the best chance of finding breast cancer early, when it is easier to treat. We will also help you reduce your risk and connect you with other Fred Hutch services.

UW Medicine surgeons are also part of our Breast Health Program. They provide the most up-to-date and comprehensive surgical care for our patients.  

Breast Medical Oncology Clinic

This clinic focuses on medicine-based treatments, like chemotherapy, hormone therapy, targeted therapy and immunotherapy. Most people with breast cancer will get one or more of these. If you have metastatic breast cancer, it is likely that all your treatment will be medicine-based.

Specialized Services

People with breast cancer have a range of needs based on their disease stage, their age and other factors. Fred Hutch has many specialized services to provide the care and support that are right for you.

For Those With Metastatic Breast Cancer

If cancer has spread from your breast to distant parts of your body, you have options. New treatments at Fred Hutch may put your cancer into remission and give you a good quality of life for decades. Many people who started treatment somewhere else come to Fred Hutch if their breast cancer comes back or spreads. They come here because of our experts and our focus on research to improve outcomes. Our ASSIST Program helps people with metastatic breast cancer. ASSIST stands for Advanced Stage Support Information Symptoms Trials.

For Younger People With Breast Cancer (Age 18-40)

Some forms of cancer treatment may affect fertility. If you would like to know about options for preserving your fertility, talk with your care team and ask about our Oncoreproduction Clinic.

We also offer a support group for young adults, ages 18–40, who are in active treatment at Fred Hutch. The group gives you a place to talk with people who understand what you are going through. You can share your experiences and connect with others who are living with a cancer diagnosis.

For Older People With Breast Cancer (65 or older)

Fred Hutch uses a special risk-assessment tool to help plan care for older patients with breast cancer. If you are 65 or older with non-metastatic disease, your team may give you this tool to fill out. We may ask you to do this before you visit the Breast Cancer Specialty Clinic. This way, your care team can use your answers to understand your exact needs and personalize your care.

For Breast Cancer Survivors

After cancer treatment, we are still here for you. In fact, it is important to keep getting care from experts who can guide your full recovery. Fred Hutch has teams to support you.

  • For ductal carcinoma in situ (DCIS) or atypia (atypical hyperplasia) on a biopsy, the team at our Breast Health Program will provide follow-up care related to breast health.
  • For invasive breast cancer, you will get follow-up care from the same physicians who treated your cancer. For most people, this means seeing your medical oncologist for five years after treatment ends.
  • For wellness-focused follow-up, the Fred Hutch Women’s Wellness Program serves people who are at least five years out from treatment. You can get routine checkups, a wellness plan, help with any lasting side effects and more.

Monitoring Your Health

While you’re in active treatment, your breast cancer care team will see you regularly for exams and tests to check:

  • How well your treatment is working
  • If there’s any reason to change your treatment
  • If you need help with side effects or supportive care services, like nutrition care or mental health counseling

We update your treatment plan based on the best scientific evidence as well as how your disease responds and what you prefer.

Possible Results of Treatment

Throughout treatment, your care team looks for signs of:

  • Remission: Fewer signs and symptoms of cancer. Partial remission means some signs and symptoms remain. Complete remission means there are no signs or symptoms.
  • Disease progression: The disease is getting worse or spreading.
  • Relapse: The disease, signs or symptoms have come back after they had improved.
  • Refractory disease: The disease does not respond to treatment.

What about “cured”? Sometimes physicians use the word “cured” if you have been in complete remission for at least five years. After five years, cancer is less likely to come back (recur), but recurrence is still possible. 

Managing Side Effects

You might be wondering about possible side effects from treatment, like lymphedema after surgery or hair loss from chemotherapy. 

You are always at the center of everything we do. Our breast cancer physicians, nurses and advanced practice providers are here to help prevent or manage the side effects of treatment. 

Get Help with Side Effects

Before you begin treatment, we talk with you in advance about what to expect, based on your treatment plan, and what can help if you do have side effects.

At your appointments, we want you to tell us about any side effects you are having. If you have questions or concerns between appointments, you can call or email us. We will make sure you know how to reach care providers at Fred Hutch after hours, if that’s when you need us. 

We have many tools to help you feel better, such as:

  • Antibiotics, vaccines and antiviral drugs to prevent or treat infections
  • Transfusions, steroids and medicines that help the immune system treat low levels of blood cells (low blood counts)
  • Nutrition care and medicines to help with digestive problems
  • Conventional and integrative therapies for pain

Common Side Effects

Side effects are different depending on which treatment you get. They also depend on other factors, like how strong your immune system is. These are some of the common side effects of breast cancer treatment:

  • Lymphedema
  • Swelling and sunburn-like skin changes in areas treated with radiation therapy
  • Unusual tiredness (fatigue)
  • Low blood cell counts, which can raise your risk for infection, easy bleeding and bruising, and fatigue 
  • Nausea and vomiting
  • Diarrhea
  • Loss of appetite
  • Mouth sores
  • Hair loss
  • Changes in menstrual periods or early menopause
  • Loss of fertility
  • Numbness, pain, tingling or other nerve symptoms

Continuing Care

When your breast cancer is in remission and your active treatment ends, it is still important to get follow-up care on a regular basis. At follow-up visits, you will see Fred Hutch breast health experts. They will check your overall health and look for signs that your cancer has come back (signs of recurrence).

Your team will also help with any long-term side effects (which go on after treatment ends) or late effects (which may start after treatment is over).

Schedule For Follow-up Visits

Just like we personalize your treatment plan for you, we personalize your follow-up schedule, too. Your breast cancer team will base your schedule on many things, including:

  • Your breast cancer subtype
  • Which treatments you had and how your disease responded 
  • How the disease and treatments affected you 
  • How long it has been since your treatment ended

Most patients are followed for at least five years. It is common to have visits more often in the first months and years after active treatment ends and less often as time goes on. This will depend on your exact needs.

What Happens at Follow-up Visits

Follow-up for breast cancer usually means seeing your medical oncologist for a physical exam and having a mammogram. If there is any cause for concern, you might have other tests or scans. Together, you and your physician will talk about the benefits and risks of any follow-up options and decide what is right for you.

 

Why Choose Fred Hutch for Breast Cancer Treatment

At Fred Hutch, we understand this may be one of the most intense and challenging experiences you and your family ever go through. We are here to provide the care you need.  

Team-Based Care from Specialists

Fred Hutch has surgeons, medical oncologists and radiation oncologists who specialize in breast cancer. We offer the most advanced diagnostic, treatment and recovery programs. 

Along with treating your cancer, we also offer a range of services to support you and your caregiver. This is part of how we take care of you — not just your disease. From registered dietitians to chaplains to social workers, our experts know how to care for people with breast cancer.

Treatment Tailored to You

We view treatment as a collaborative effort. Your Fred Hutch physicians will explain all your options. We’ll recommend a treatment plan to get you the best results based on the stage and size of your cancer, where it is and your overall health.

Twice a week, our breast cancer experts gather in a meeting called a tumor board to get ready for the Breast Cancer Specialty Clinic. Together, team members from different areas of breast cancer care discuss their patients’ treatment plans. We also have a monthly advanced molecular tumor board, a meeting where Fred Hutch physicians review advanced genomic testing on breast cancer to figure out the best ways to treat people who have the most challenging metastatic breast cancers.

Clinical Trials to Improve Outcomes

Many of our patients receive promising therapies by taking part in breast cancer clinical trials. These research studies are done by physician-scientists from Fred Hutch and UW Medicine. They test new treatments or new ways to use current treatments. 

Every advance in cancer treatment in recent years has come out of clinical trials. Through the Fred Hutch/University of Washington/Seattle Children’s Cancer Consortium, we typically have more than 750 active clinical trials, which means more treatment options for people like you.