Stage 1 breast cancer is typically treated with surgery and radiation therapy. Other treatments may be necessary for specific types of breast cancer or if there’s a high chance of cancer’s spread or recurrence.
Understanding the details of your diagnosis might be challenging at the start, but your diagnosis informs your treatment process. Learning as much as you can about the type and stage of your breast cancer can help you plan ahead and manage feelings of anxiety or concern.
In the first stage of breast cancer, the cancer is still considered local, and breast-conserving surgery or mastectomy, along with radiation therapy, are the mainstays of treatment.
Breast cancer in clinical stage 1 is divided into two categories:
- Stage 1A: Cancer is smaller than 2 centimeters and has not spread to the lymph nodes.
- Stage 1B: Cancer is still local but with lymph node involvement, or cancer is only found within the lymph nodes close to the breast.
The size of the tumor and the spread of the cancer, both to nearby lymph nodes and other areas of the body, are what indicate the pathological stage in a breast cancer diagnosis.
Pathological staging is done when your doctor has more detailed information on your diagnosis, gained from assessing the tissues of your breast during surgery and evaluating tumor cells under a microscope.
In general, your doctor assigns stage 1 when the cancer is still local to its site of origin and has little to no lymph node involvement.
Outlook and survival rates
The 5-year survival rates for stage 1 breast cancer are excellent at
Every breast cancer treatment plan is individualized. Your doctor considers your diagnosis as well as factors like your age, overall health, lifestyle, and personal preferences.
Surgery
Surgery is the first-line treatment for
Your doctor will discuss a breast-conserving surgery like a lumpectomy (also known as a partial mastectomy), or if you’re at an increased risk for cancer’s spread or recurrence, a whole breast removal (mastectomy) may be recommended.
Surgery will include a sentinel lymph node biopsy or an axillary lymph node dissection to verify the extent of lymph node involvement.
Breast reconstruction surgery, if desired, is sometimes done immediately after a lumpectomy or mastectomy, but your doctor may suggest waiting if you’re receiving additional treatments with radiation.
Radiation can impact healing and affect surrounding tissues, which may complicate the success of breast reconstruction.
Radiation
Radiation for stage 1 breast cancer is typically administered using external beam radiation therapy (EBRT) after you’ve had surgery. In EBRT, a machine focuses a high-energy radiation beam at your surgical site, and any lymph node areas involved.
EBRT occurs after your surgical site is healed because of how radiation can impact the healing process. It may be a
Not everyone with stage 1 breast cancer receives radiation. Older people with very small tumors, for example, may only require surgical removal. Or, if breast cancer is ER- or PR-positive, hormone therapy may be preferred.
Systemic therapies
Systemic therapies are those that travel throughout your body. In breast cancer, they include treatments like chemotherapy and hormone therapy.
The goal after surgery is always to “catch” any cancer cells that might have been missed through surgical removal. Your doctor selects the method that will have the highest success rate, and in certain cases, that will be hormone therapy or chemotherapy.
Some cancers, like ER- and PR-positive cancers, are highly responsive to hormone therapy. If this is the case for your diagnosis, your doctor will recommend systemic hormone treatments
If you’ve been diagnosed with an aggressive form of breast cancer or have other risk factors that make it likely cancer will return or spread, chemotherapy may be recommended.
Even when breast cancer stage 1 treatment goes exactly as planned, side effects can happen.
What to expect
If you’ve just had surgery, some pain is expected. Everyone’s pain tolerance is different, and your doctor will have in-hospital pain medication for you as well as a prescription to use at home.
Other common side effects soon after surgery include:
- incision site pain, soreness, or irritation
- minor swelling at the surgical site or under the arm
- bruising
- site numbness or sensation changes
- drainage (you may have a drainage tube for a couple of weeks post-surgery)
After you’ve healed and moved on in your treatment plan, other side effects are possible. Post-EBRT, common side effects include:
- swelling at the site
- skin changes (redness, peeling, or darkening)
- fatigue
After chemotherapy, common side effects can include:
- fatigue
- hair and skin changes
- appetite and weight loss
- gastrointestinal upset
- hot flashes
Some of the most common side effects of hormone therapy include:
- hot flashes
- vaginal dryness or discharge
- menstrual cycle changes
What to flag
Your doctor will go over signs to watch out for that might indicate infection or other post-surgical complications.
Common experiences that may warrant immediate medical attention include:
- increased redness or heat around the surgical site
- extreme pain
- fever
- pus draining from the incision
- body-wide sensation of sickness or being unwell
How long you recover in the hospital varies depending on the duration and complexity of your surgery. Many people are able to go home the same day from stage 1 breast cancer surgery.
Once home, you’ll have activity and lifting guidelines to follow. Your doctor will go over how to check and gently clean your incision site daily.
Medications and follow-up care
Most people go home with prescriptions for pain relievers to help relieve discomfort and inflammation, as well as antibiotics to help prevent post-surgical infection.
Other prescriptions can include antiemetics to prevent nausea, laxatives to ward off constipation, or blood thinners if you have certain risk factors for blood clots after surgery.
Although they might not be started immediately, you may also have oral pills to take for hormone therapy or chemotherapy.
Your doctor will schedule a follow-up appointment a few weeks after surgery to check your progress and remove any surgical drains.
Stage 1 breast cancer refers to cancer that’s localized with little or no lymph node involvement. While treatment typically involves surgery followed by radiation therapy, systemic treatments may be indicated in certain circumstances.
Your doctor stages your diagnosis based on its clinical presentation and pathological characteristics. These details are used to inform your comprehensive treatment plan.