Welcome To Brest Cancer Info
Drugs used in addition to surgery are called adjuvant therapy. There are currently 3 main groups of medications used for adjuvant breast cancer treatment:
Hormone Blocking Therapy
Chemotherapy
Monoclonal Antibodies
One or all of these groups can be used.
Hormone Blocking Therapy: Some breast cancers require estrogen to continue growing. They can be identified by the presence of estrogen receptors (ER+) and progesterone receptors (PR+) on their surface (sometimes referred to together as hormone receptors, HR+). These ER+ cancers can be treated with drugs that block the production of estrogen or block the receptors, such as tamoxifen or an aromatase inhibitor).
Chemotherapy: Usually used for stage 2-4 disease. They are given in combinations. One of the most common treatments is cyclophosphamide plus doxorubicin (Adriamycin), known as CA; these drugs damage DNA in the cancer, but also in fast-growing normal cells where they cause serious side effects. Damage to the heart muscle is the most dangerous complication of doxorubicin. Sometimes a taxane drug, such as docetaxel, is added, and the regime is then known as CAT; taxane attacks the microtubules in cancer cells. Another common treatment, which produces equivalent results, is cyclophosphamide, methotrexate, and fluorouracil (CMF). (Chemotherapy can literally refer to any drug, but it is usually used to refer to traditional non-hormone treatments for cancer.)
Monoclonal antibodies: A relatively recent and very exciting development in HER2+ breast cancer treatment. Cancer cells have a receptor called HER2 on their surface. This receptor is normally stimulated by a growth factor which causes the cell to divide, however in the absence of the growth factor, the cell will normally stop growing. In approx 20% of invasive breast cancers, the HER2 receptor is stuck in the "on" position. The cell divides without stopping, producing an aggressive form of cancer. Trastuzumab (Herceptin), a monoclonal antibody to HER2, has dramatically improved the 5yr disease free survival of 'early' (stages 1-3) HER2+ breast cancers to about 87%. Trastuzumab, however, is expensive, and approx 2% of patients suffer significant heart damage; it is otherwise well tolerated with far milder side effects than conventional chemotherapy. Other monoclonal antibodies are also being trialled.
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