Approaches for treatment of common breast cancer
Historically, treatment of breast cancer was purely surgery, however now radiotherapy is generally adjuvant or neoadjuvant, with surgery (mastectomies) being the main part of the treatment.
The general approach is surgery for the local and regional tumor, preceded or followed by a combination of chemotherapy, radiotherapy, endocrine (hormonal) therapy and/or targeted therapy.
Chemotherapeutic methods:
- Cytotoxic drugs
- Methotrexate, 5-fluorouracil, cyclophosphamide (often in combination)
- NB we often use combination therapies due to their synergistic action.
- Hormonal therapy
- Tamoxifen - premenopausal women to inhibit estrogen receptors
- Aromatase inhibitors - postmenopausal women to lower the amount of estrogen in system
- GnRH analogues for ovarian suppression
- Targeted therapy
- Where patient expresses an over-abundance of HER2 protein, trastuzumab, a monoclonal antibody, can be prescribed to slow growth. Alternatively Tamoxifen.
Radiotherapeutic methods
- Covered above, but in essence, can be brachy radiology or external beam radiotherapy, often done in lumpectomies rather than mastectomies in adjuvant therapy.
The exact approach depends on patient status and tumour staging.