💊 NHS & WHO sourced

Breast Cancer Treatment Options

Surgery, radiotherapy, chemotherapy, hormone therapy, targeted drugs and immunotherapy — what each treatment does, when it's used, and how the multidisciplinary team decides.

Reviewed against NHS & WHO guidelines Last reviewed: January 2025 For educational purposes — not medical advice
✓ Most people with breast cancer have a combination of treatments
✓ 70–80% of breast cancers are hormone receptor-positive and respond to hormone therapy
✓ Trastuzumab (Herceptin) is highly effective for HER2-positive breast cancer
✓ Treatment plans are decided by a multidisciplinary team (MDT)

Surgery

Surgery is usually the first treatment for early breast cancer. The main options are lumpectomy (breast-conserving surgery, removing the tumour and a margin of surrounding tissue) and mastectomy (removal of the whole breast). Both are followed by radiotherapy in most cases. The choice depends on tumour size relative to breast size, location, and personal preference. Breast reconstruction can be offered at the same time as or after mastectomy.

Radiotherapy

High-energy X-rays used to destroy any remaining cancer cells after surgery. Typically given over 3–5 weeks (or, increasingly, in a shorter course of 1–3 weeks). It significantly reduces the risk of the cancer coming back in the breast.

Chemotherapy

Drugs that kill cancer cells throughout the body. Used when there is a risk that cancer cells may have spread, when the tumour is large (to shrink it before surgery), or when the cancer is high-grade or has specific features (e.g. triple-negative). Given as cycles of treatment, usually over 3–6 months, with recovery time between cycles.

Hormone therapy (endocrine therapy)

Used for hormone receptor-positive (ER+ or PR+) breast cancers, which account for around 70–80% of all cases. These cancers are fuelled by oestrogen. Hormone therapy blocks this. The most common drugs are tamoxifen (suitable pre- and post-menopause) and aromatase inhibitors such as letrozole (post-menopause only). Typically taken for 5–10 years after surgery.

Targeted therapies

Drugs designed to target specific characteristics of cancer cells. The most widely used is trastuzumab (Herceptin) for HER2-positive breast cancer. Other targeted drugs include pertuzumab, ado-trastuzumab emtansine (T-DM1), CDK4/6 inhibitors (e.g. palbociclib), and PARP inhibitors (e.g. olaparib) for BRCA-associated cancers.

Immunotherapy

Drugs that help the immune system fight cancer. Pembrolizumab (Keytruda) is now used alongside chemotherapy for early-stage, high-risk triple-negative breast cancer. Immunotherapy is a rapidly expanding field in breast cancer treatment.

The Multidisciplinary Team (MDT)

All treatment decisions at NHS hospitals are made by a multidisciplinary team — typically including a breast surgeon, oncologist, radiologist, pathologist, breast care nurse and other specialists. The MDT considers your full situation: tumour type, grade, stage, receptor status, your general health, and your personal preferences.

Frequently asked questions

Is breast cancer curable if caught early? +
Yes. The NHS five-year survival rate for Stage 1 breast cancer is approximately 98%, and for Stage 2 around 90%. When caught early, treatment is more effective, less extensive and more likely to result in long-term cure. This is why NHS screening and acting promptly on any new symptom are so important.
What is the first treatment for breast cancer? +
For most people, surgery is the first treatment — either a lumpectomy (removing the tumour and a margin of surrounding tissue) or a mastectomy (removing the whole breast). The choice depends on tumour size, location, type and patient preference. Surgery is usually followed by radiotherapy and drug treatments (hormone therapy, chemotherapy or targeted therapy) to reduce the risk of recurrence.
What is the most effective breast cancer treatment? +
Most people have a combination of treatments decided by a multidisciplinary team. For hormone receptor-positive breast cancer (around 70–80% of cases), surgery combined with radiotherapy and 5–10 years of hormone therapy (tamoxifen or an aromatase inhibitor) is highly effective. For HER2-positive cancer, trastuzumab (Herceptin) alongside chemotherapy has transformed outcomes.
Does breast cancer treatment always include chemotherapy? +
Not always. Chemotherapy is used when there is a risk that cancer cells may have spread, when the tumour is large, or when the cancer is high-grade or triple-negative. Many women with small, low-grade, hormone receptor-positive cancers are treated with surgery, radiotherapy and hormone therapy — without chemotherapy.
How long does breast cancer treatment last? +
This depends on the type and stage of cancer. Surgery and radiotherapy are completed within a few months. Chemotherapy typically runs over 3–6 months. Hormone therapy (e.g. tamoxifen or letrozole) is usually taken for 5–10 years after surgery. Targeted therapies such as trastuzumab (Herceptin) are given for one year.
What happens after breast cancer surgery? +
After surgery, most patients have radiotherapy to the treated breast (if a lumpectomy was performed) to reduce the risk of local recurrence. Depending on cancer type, chemotherapy, hormone therapy or targeted therapy may follow. Hormone therapy is typically taken daily for 5–10 years. Regular follow-up appointments — initially every few months, then annually — monitor for any signs of recurrence.
What is immunotherapy for breast cancer? +
Immunotherapy uses drugs to help the immune system recognise and attack cancer cells. Pembrolizumab (Keytruda) is now approved for early-stage, high-risk triple-negative breast cancer — the first immunotherapy approved for early (non-metastatic) breast cancer — and for metastatic triple-negative disease. Antibody-drug conjugates such as trastuzumab deruxtecan (Enhertu) are also transforming outcomes in HER2-low and HER2-positive metastatic breast cancer. This is the fastest-growing area of breast cancer treatment.

Clinical sources

  • NHS — www.nhs.uk
  • World Health Organization — www.who.int

This content is for educational purposes and does not constitute medical advice. Always consult a qualified healthcare professional for personal medical guidance.

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