The Role of Radiation and Chemo for Breast Cancer

What Are the Main Types of Breast Cancer Treatment?

Breast cancer treatment generally includes:

• Surgery
• Radiation therapy
• Systemic medications

Treatment recommendations are personalized based on:

• Cancer stage
• Tumor size
• Lymph node involvement
• Hormone receptor status
• HER2 status

What Is Radiation Therapy?

Radiation therapy is a local treatment used to target cancer cells in a specific area.

Radiation may help:

• Reduce the risk of local recurrence
• Treat remaining microscopic cancer cells after surgery

After Lumpectomy

Most patients who undergo breast-conserving surgery (lumpectomy) will also receive radiation therapy.

After Mastectomy

Many mastectomy patients do not require radiation, although radiation may still be recommended if:

• Cancer involves lymph nodes
• The tumor is larger
• Other high-risk features are present

What Is Chemotherapy?

Chemotherapy is a systemic treatment, meaning it works throughout the body.

The goal is to:

• Reduce recurrence risk
• Treat cancer cells that may have spread beyond the breast

Chemotherapy is managed by a medical oncologist and may be given:

• Before surgery
• After surgery
• Alongside other treatments

Not all breast cancer patients require chemotherapy.

What Are Targeted Therapies?

Some breast cancers respond to medications designed to target specific cancer features.

Targeted treatments may include:

• HER2-targeted therapies
• Hormone-blocking medications
• Other biologic treatments

These therapies may be given as:

• Pills
• Intravenous (IV) medications

Treatment depends on the tumor’s biology and receptor status.

Why Would Chemotherapy Be Given Before Surgery?

Some patients receive:

Neoadjuvant Chemotherapy

This means chemotherapy is given before surgery to:

• Shrink the tumor
• Improve surgical options
• Treat aggressive cancers earlier

The surgeon and medical oncologist work together to coordinate care.

How Are Treatment Decisions Made?

Treatment planning is highly individualized and often involves:

• Breast surgeons
• Medical oncologists
• Radiation oncologists
• Radiologists
• Pathologists

The goal is to create a treatment plan tailored to the patient’s cancer type and personal health needs.

About Dr. Danielle Bertoni

Dr. Danielle Bertoni is a breast surgical oncologist at the Gregory Rhodes MD Cancer Center specializing in breast cancer surgery, breast conservation, high-risk breast care, and survivorship.

Video Transcript

Depending on the type of cancer you have, you may need chemotherapy, radiation therapy, or both.

Breast cancer treatment involves three main approaches: surgery, radiation, and medicines.

The medicines are part of what we call systemic treatment, which means treatments that reach all cells in the body to prevent cancer from spreading or coming back elsewhere.

Surgery and radiation are considered local treatments.

If a woman chooses breast conservation, she will generally need radiation afterward, although there are exceptions.

Most women who choose mastectomy typically do not need radiation unless the cancer has spread to the lymph nodes.

Chemotherapy and surgery/radiation decisions are independent of each other.

Some patients may even need chemotherapy before surgery, which can be the best course of action for certain cancers.

In those cases, the medical oncologist and surgeon work together to provide the best treatment plan.

Frequently Asked Questions

Do all breast cancer patients need chemotherapy?

No. Treatment depends on the cancer stage, tumor biology, and overall treatment plan.

Is radiation always needed after lumpectomy?

Radiation is commonly recommended after lumpectomy, although there are exceptions.

What is systemic treatment for breast cancer?

Systemic treatments include chemotherapy, hormone therapy, and targeted medications that work throughout the body.

Why would chemotherapy happen before surgery?

Chemotherapy before surgery may help shrink tumors and improve treatment outcomes in certain cancers.