Local Treatment

"Local" treatment refers to anything that is targeted to a specific area of the body—such as the breast, the lymph nodes, the lungs—as opposed to the whole body. Treatment to the lymph nodes near the breast is also sometimes referred to as "regional" treatment, because the nodes lie in the region surrounding the breast.

A diagnosis of breast cancer is usually made on the basis of some type of surgery (biopsy, lumpectomy). The surgery may turn out to be only "diagnostic," telling you and your doctor what's there and what next steps might be needed. A fine needle aspiration and core biopsy are examples of such diagnostic surgery. Or the initial surgery might turn out to be diagnostic AND therapeutic, removing all of the cancer that can be detected in the breast. A lumpectomy that removes the entire cancer is an example of this type of therapeutic surgery. If no further surgery is required, other local treatments may be added.

The whole breast can be treated by mastectomy or breast preservation therapy:

• Mastectomy involves removal of the entire breast. Mastectomy may be followed by radiation to the area where the breast used to be.
• Breast preservation therapy removes the breast cancer by lumpectomy (also called "wide resection," "partial mastectomy," or "quadrantectomy") and is also followed by radiation to the remainder of the breast tissue.

These two options are considered equally effective for women with a breast cancer measuring about four centimeters or less. For women with a single tumor larger than about four centimeters, breast preservation therapy may still be an option if chemotherapy is able to shrink the cancer substantially BEFORE surgery.