Tailoring Your Treatment Plan
Before a healthcare professional recommends a treatment plan, theyll collect and test a tumor sample to learn what type of breast cancer you have.
Some types of breast cancers are:
- Estrogen receptor-positive. This type of breast cancer grows more quickly in the presence of the hormone estrogen.
- Progesterone receptor-positive. This type of breast cancer grows more quickly in the presence of the hormone progesterone.
- Human epidermal growth factor receptor 2 -positive. These cancers produce an overabundance of the HER2 protein, which drives the growth of the cancer cells.
Other types of breast cancers are:
- estrogen receptor-negative
- HER2-negative
These are known as triple-negative breast cancers.
If you have breast cancer thats estrogen receptor-positive, progesterone receptor-positive, or HER2-positive, your doctor may recommend hormone therapy or targeted therapy.
Fewer treatments are available for triple-negative breast cancer.
The Importance Of Self
Menopause symptoms can be incredibly disruptive, taking a toll on your work, sleep, daily mood, and relationships. Researchers have acknowledged this fact, stating that the physical and financial cost of VMS is âimmense.â
But despite the magnitude of the problem, only a minority of patients actually receive treatment for VMS from their healthcare team.
In fact, a recent survey of cancer healthcare providers found that many are unsure which VMS treatments are effective and arenât confident in their ability to manage VMS. This lack of decisive, high-quality care may be heightened among breast cancer survivors.
âThe clinicians focused on your cancer journey may not be thinking about side-effects like menopausal symptoms. But as the patient, you have the right to speak up and ask for help,â says Dr. Leah Millheiser. âThese are serious concerns with a very real impact on your quality of life, and itâs important to be open about that with your clinician.â
In other words, the more communicative you are about menopause symptoms, the more your healthcare team can do to help you. For tips on self-advocacy during the cancer journey, check out the National Coalition for Cancer Survivorship.
Reviewed by Dr. Leah Millheiser, MD, Evernow Chief Medical Officer, May 2022
Chemo Drugs For Breast Cancer That Has Spread
- Taxanes: Paclitaxel , docetaxel , and albumin-bound paclitaxel
- Ixabepilone
- Gemcitabine
- Antibody drug conjugates
Although drug combinations are often used to treat early breast cancer, advanced breast cancer often is treated with single chemo drugs. Still, some combinations, such as paclitaxel plus gemcitabine, are commonly used to treat metastatic breast cancer.
For cancers that are HER2-positive, one or more drugs that target HER2 may be used with chemo.
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New Treatments For Breast Cancer
These advances in treating breast cancer aren’t on the horizon. They’re here, right now.
While some promising new treatments for breast cancer are years away from regular treatment regimens, others are on the market or just around the corner.
Still on the horizon for treating breast cancer are anti-angiogenesis drugs. They block the formation of new blood vessels that feed tumors and help them grow. These drugs have shown promise in treating colon cancer and are now being studied in patients with advanced breast cancer. But it may be some time before these drugs have been studied enough to make the leap to treating early-stage breast cancer.
Even so, new breast cancer treatments are available now. Over the past year, doctors have learned a lot more about many targeted therapies that very soon may be helping millions of women live longer and healthier lives after learning they have breast cancer.
Clinical Evidence For Cam Is Limited
While CAM therapies are becoming increasingly popular, its important to recognize the limited clinical evidence that these alternative therapies are as effective as conventional treatment. In a 10-year study, CAM therapy was shown to be associated with disease progression and increased risk of reoccurrence and death when conventional treatment, such as surgery, is delayed or refused.
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Genetics And Family History
Treatment for breast cancer may depend partly on having a close relative with a history of breast cancer or testing positive for a gene that increases the risk of developing breast cancer.
Patients with these factors may choose a preventive surgical option, such as a bilateral mastectomy.
Clinical trials are studies in which patients volunteer to try new drugs, combinations of drugs, and methods of treatment under the careful supervision of doctors and researchers. Clinical trials are a crucial step in discovering new breast cancer treatment methods.
Emerging treatments for breast cancer being studied in clinical trials include:
- PARP inhibitors that block protein used to repair DNA damage that occurs during cell division are being used and tested for TNBC.
- Drugs that or prevent androgen production are being used and tested for TNBC.
If youre interested, ask your oncologist for information about available trials.
The Tnm System The Grading System And Biomarker Status Are Combined To Find Out The Breast Cancer Stage
Here are 3 examples that combine the TNM system, the grading system, and the biomarker status to find out the Pathological Prognostic breast cancer stage for a woman whose first treatment was surgery:
If the tumor size is 30 millimeters , has not spread to nearby lymph nodes , has not spread to distant parts of the body , and is:
- Grade 1
- PR-
The cancer is stage IV .
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If Cancer Is Found Tests Are Done To Study The Cancer Cells
- how quickly the cancer may grow.
- how likely it is that the cancer will spread through the body.
- how well certain treatments might work.
- how likely the cancer is to recur .
Tests include the following:
Based on these tests, breast cancer is described as one of the following types:
- HER2/neu positive or HER2/neu negative.
- Triple negative .
This information helps the doctor decide which treatments will work best for your cancer.
What Are Breast Cancer Treatment Options
Breast cancer treatments depend upon the type of breast cancer that is present as well as the stage of the tumor.
- Treatment for early breast cancer typically involves surgery to remove the tumor.
- After surgery, medical professionals may administer radiation therapy, chemotherapy, or targeted therapy.
- Doctors then perform tests on the surgically removed tissue to determine what type of cancer is present to help determine the optimum treatment.
- Treatment for metastatic breast cancer usually involves chemotherapy, targeted therapy, and/or advanced hormone therapies.
Overall, patients with breast cancer have many treatment options. These treatment options undergo frequent adjustments, and your health care provider will have the information on the current standard of care available. Discuss treatment options with a health care team. The following are the basic treatment modalities used in the treatment of breast cancer.
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The best way to cite this PDQ summary is:
PDQ® Adult Treatment Editorial Board. PDQ Breast Cancer Treatment . Bethesda, MD: National Cancer Institute. Updated < MM/DD/YYYY> . Available at: . Accessed < MM/DD/YYYY> .
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Which Treatment Is Right For Me
Choosing the treatment that is right for you may be hard. Talk to your cancer doctor about the treatment options available for your type and stage of cancer. Your doctor can explain the risks and benefits of each treatment and their side effects. Side effects are how your body reacts to drugs or other treatments.
Sometimes people get an opinion from more than one cancer doctor. This is called a second opinion. Getting a second opinionexternal icon may help you choose the treatment that is right for you.
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Taking Part In A Trial
As part of your treatment you may be interested in, or may be asked if youd like to take part in, a clinical trial. Your specialist will talk with you about this, or you can ask if there are any trials that are appropriate for you.
Taking part in a clinical trial may give you access to a new treatment or a new way of receiving treatment that may otherwise not be available to you.
All clinical trials are regulated to make sure everyone receives at least the standard of treatment that would have been recommended if they hadnt been taking part in the trial.
Breast Cancer Is Sometimes Caused By Inherited Gene Mutations
The genes in cells carry the hereditary information that is received from a persons parents. Hereditary breast cancer makes up about 5% to 10% of all breast cancer. Some mutated genes related to breast cancer are more common in certain ethnic groups.
Women who have certain gene mutations, such as a BRCA1 or BRCA2 mutation, have an increased risk of breast cancer. These women also have an increased risk of ovarian cancer, and may have an increased risk of other cancers. Men who have a mutated gene related to breast cancer also have an increased risk of breast cancer. For more information, see the PDQ summary onMale Breast Cancer Treatment.
There are tests that can detect mutated genes. Thesegenetic tests are sometimes done for members of families with a high risk of cancer. See the PDQ summary on Genetics of Breast and Gynecologic Cancers for more information.
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Targeted Therapy To Treat Metastatic Breast Cancer
Targeted therapies are treatments that target specific characteristics of cancer cells, such as a protein that allows the cancer cells to grow in a rapid or abnormal way. Targeted therapies are generally less likely than chemotherapy to harm normal, healthy cells. Some targeted therapies are antibodies that work like the antibodies made naturally by our immune systems. Because of this, they are sometimes called immune-targeted therapies.
Learn more about targeted therapies used to treat metastatic breast cancer.
Treatment Of Ductal Carcinoma In Situ
For information about the treatments listed below, see the Treatment Option Overview section.
- Breast-conserving surgery and radiation therapy, with or without tamoxifen.
- Total mastectomy with or without tamoxifen. Radiation therapy may also be given.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
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Who Will Treat And Care For Me
Youll be looked after by a team led by a cancer specialist .
Everyone diagnosed with breast cancer should have access to a specialist breast care nurse whos there to provide them with information and support. Some people will have a secondary breast cancer nurse specialist.
Other people who may be involved in your care include:
- GP has overall responsibility for your health when youre at home
- district or community nurse coordinates and delivers nursing care when youre at home
- palliative and supportive care team helps with managing symptoms
- occupational therapist can assess what aids and adaptations you may need
- social worker assess what welfare benefits you may be entitled to
- social services can provide practical information and support, such as home carers
- benefits and finance adviser gives specialist information on benefits, tax credits, grants and loans
- hospice supports you and your family and helps you live with secondary breast cancer
- provides hands-on care for people with secondary cancer in their own homes
Alternative Vs Complementary Medicine
Alternative medicine is used instead of standard medical treatment. Complementary medicine is used along with standard medical treatment but is not considered by itself to be standard treatment.
CAM is the term for medical products and practices that are not part of standard medical care. CAM may be used for:
- Alleviating side effects of cancer treatments, such as nausea, pain, and fatigue
- Reducing cancer and cancer treatment-related stress
- Feeling empowered that they are doing something to help with their own care
- Attempting to treat or cure their cancer
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Systemic Treatments For Breast Cancer
Systemic treatments are intended to kill cancer cells that may have left the original tumor location and be elsewhere in the body. These treatments affect all cells in the body, not just cancer cells. So make sure you discuss possible side effects with your healthcare provider.
Chemotherapy
Chemotherapy uses powerful drugs to kill all rapidly dividing cells in the body. There are many different chemotherapy drugs that can be used alone or in combination. Chemo may be prescribed adjuvantly or neoadjuvantly . It is typically given intravenously , although some types may be in pill form. Chemo is given on a regular interval, typically once every three weeks or every two weeks . Dose dense is a more aggressive treatment schedule. But it may be recommended for young adults.
Hormonal Therapy
Hormonal therapy helps the body fight hormone-receptor-positive breast cancer by reducing or blocking the hormones that help these cancers grow.
- Tamoxifen is typically recommended for five to 10 years for premenopausal women.
- Aromatase inhibitors may be prescribed to postmenopausal women.
- Ovarian suppression is an injection that temporarily stops your ovaries from functioning and simulates menopause.
Recent study results show that taking Tamoxifen or an aromatase inhibitor along with ovarian suppression may be recommended for young women at higher risk of recurrence .
Targeted Therapy
What Are The Types Of Breast Cancer Treatment
Some treatments remove or destroy the disease within the breast and nearby tissues, such as lymph nodes. These include:
Surgery. For most people, the first step is to take out the tumor. An operation called lumpectomy removes only the part of your breast that has cancer. Itâs sometimes called breast-conserving surgery. In a mastectomy, doctors remove the whole breast. There are different types of mastectomies and lumpectomies.
Radiation therapy. This treatment uses high-energy waves to kill cancer cells. Most women under age 70 who have a lumpectomy get radiation, too. Doctors also might recommend this method if the disease has spread. It helps destroy any cancer cells that the surgeon couldnât remove. Radiation can come from a machine outside your body, or you might have tiny seeds that give off radiation placed inside your breast where the tumor was.
Other treatments destroy or control cancer cells all over your body:
Chemotherapy uses drugs to kill cancer cells. You take the medicines as pills or through an IV. Most people get it after surgery to kill any cancer cells left behind. Doctors also prescribe it before surgery to make tumors smaller. Chemo works well against cancer, but it also can harm healthy cells.
Immunotherapy uses your own immune system to target cancer. The drugs atezolizumab and sacituzumab govitecan-hziy have been approved to treat triple-negative breast cancer that has spread.
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Treatment For Breast Cancer Stages 13
People with stage 1 breast cancer will usually undergo surgery first and then receive radiation therapy. If the cancer is at stage 2 or 3, a doctor will prescribe some drug therapies before surgery.
If a person starts any therapy before surgery, doctors call it neoadjuvant therapy. Any therapy that comes after surgery is called adjuvant therapy.
affect what treatment a person receives. These include:
- hormone receptors on the cancer cells
- HER2 proteins on the cancer cells
- cancer progression
Drug therapies before and after surgery include:
- chemotherapy
- targeted therapy that targets HER2 proteins
- hormone therapy
A healthcare professional may recommend a combination of the above treatments.
Immunotherapy In Breast Cancer
Immunotherapy is a type of cancer treatment that uses the bodys immune system to fight against cancer. Immunotherapy may slow the growth and spread of cancer by helping the immune system destroy existing cancer cells. Rarely, immunotherapies may also cause other severe, potentially life-threatening reactions.
In Australia, immunotherapies have been approved for some cancers but not yet for breast cancer. However, immunotherapies are currently being tested in clinical trials for breast cancer in Australia. This includes two groundbreaking clinical trials from NBCF-funded researcher and Endowed Chair, Professor Sherene Loi. These trials will hopefully lead to regulatory approval and ultimately, impact the future of breast cancer treatment.
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