Breast cancer is categorized into one of several stages. The stage describes how far the disease has spread at the time of diagnosis. The earliest stage is referred to as stage zero (0) breast cancer. The good news is that stage 0 breast cancer is considered pre-cancer. However, if left unmonitored or untreated, the cancer may progress to a more advanced stage, which can mean more therapies and a longer treatment journey.
If you were told you have precancerous breast cancer cells or stage 0 breast cancer, understanding more about how it's treated can give you a clearer idea of what to expect.
What Is Stage 0 Breast Cancer?
If a mass is found and the breast biopsy confirms breast cancer, your oncologist will need to determine how advanced the cancer is, including if and how far it has spread. Breast cancer is staged from 0 to IV, with higher numbers indicating more advanced disease.
Stage 0 breast cancer is known as ductal carcinoma in situ, or DCIS. This is the only type of cancer diagnosed as stage 0. The term "in situ" means the cancer cells are confined to the lining of the milk ducts and have not spread further into the breast or affected the lymph nodes. When the cancer advances, it is classified as either invasive ductal carcinoma or invasive lobular carcinoma, depending on where it originated.
The pathology report from your biopsy will provide additional information about DCIS, including whether hormones fuel its growth. If your breast cancer is listed as hormone-positive, this means estrogen, progesterone, or both are present within the tumor. Your oncologist will use this information to guide your treatment plan.
Treating Stage 0 Breast Cancer
Several treatment options are available for patients with stage 0 breast cancer. Your care team will be led by a breast cancer specialist known as a breast oncologist. They will discuss your options based on various factors, including your age, family history, and the characteristics of DCIS, such as the presence of hormone receptors. Other members of your care team may include a radiation oncologist and a breast cancer surgeon.
Breast Cancer Surgery
Stage 0 breast cancer is typically approached with surgery before any other type of treatment. For most women with DCIS, surgery involves a lumpectomy, which removes the cancerous cells while preserving the rest of the breast. To provide the best possible outcome, the breast surgeon will remove the cancer and a small border of healthy tissue around it. This extra step helps lower the risk of cancer cells being left behind. A mastectomy may be recommended in cases where cancer cells cannot be fully removed by a lumpectomy. Your cancer surgeon will help you understand which type of breast cancer surgery will be most effective for you.
Radiation Therapy for Early-Stage Breast Cancer
Many treatment plans for stage 0 breast cancer include radiation therapy following surgery. Radiation therapy uses high-energy radiation to eliminate cancer cells. If you undergo a lumpectomy, your oncologist will likely recommend at least one of the following types of radiation therapy after surgery:
- External Beam Radiation Therapy (EBRT): This method delivers high-energy beams from a machine outside the body to kill cancer cells. Treatments typically continue five days a week for at least a few weeks.
- Internal Radiation (Brachytherapy): In this approach, high doses of radiation are delivered through small tubes implanted into the breast. Small, radioactive pellets are inserted into the tubes to treat the area. Treatment usually takes place over three to five days. When treatment is complete, the tubes are removed.
Related Read: What Type of Radiation Therapy is Right for Breast Cancer?
Is Hormone Therapy a Treatment Option for Stage 0 Breast Cancer?
Some stage 0 breast cancer patients may receive additional treatments, such as hormone therapy. If Stage 0 breast cancer is hormone receptor-positive, hormone therapy is given to block estrogen and/or progesterone receptors. Hormone therapy may reduce the likelihood of the cancer returning.
Determining the Best Treatment Approach for Stage 0 Cancer
While there is a standard treatment protocol for stage 0 breast cancer, the approach can vary among patients based on individual factors. Your breast cancer specialist will consider the following when determining your best treatment options:
- Overall health: Your age and any existing health conditions can influence the timing, intensity, and frequency of your treatment.
- Genetic and/or family history: A strong family history of breast cancer or inherited mutations may influence treatment decisions.
- DCIS characteristics: The breast cancer doctor will consider the size, extent, grade, and hormone receptor status of the DCIS.
- Possibility of overtreatment: Overtreating Stage 0 breast cancer could result in unnecessary side effects. Active surveillance, if appropriate, helps reduce those risks.
- Personal preference: Your treatment plan should reflect what matters most to you. Your care team will discuss your goals, including preserving your breast, reducing the risk of the cancer returning, and how different treatment options may affect your appearance, daily life, and overall well-being.
Working with a breast cancer team and expressing your preferences is important. Together, you can develop a comprehensive treatment plan that meets both your medical and personal needs.
Personalized Early-Stage Breast Cancer Care at Virginia Oncology Associates
If a mammogram or breast biopsy indicates a small area of cancer, it's important to consult with a breast cancer specialist. The breast cancer doctors at VOA are here to help you every step of the way. They will create a personalized treatment plan using the latest breast cancer therapies. Learn more about what you can expect next.
Our cancer centers are located throughout Virginia and Eastern North Carolina, including Chesapeake, Elizabeth City, Newport News, Norfolk, Suffolk (Obici and Harbour View), Virginia Beach, and Williamsburg. Request an initial consultation or second opinion at the location most convenient for you.
