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Breast Cancer Medicine: Present and Future
Dr. Larry Norton
Deputy Physician-in-Chief
for Breast Cancer Programs

Adjuvant Therapy

After surgery, some patients will be advised to receive adjuvant systemic therapy. The goal of this treatment is to rid the body of any cancer cells that may have spread outside of the breast and to prevent metastases in the future. Sometimes the treatment is given before the surgery (called neo-adjuvant therapy) in order to help shrink the tumor and make it easier to remove.

Whether or not a woman needs adjuvant therapy and, if so, which type best suits her condition depend on a number of factors. These include the presence or absence of cancer cells in her lymph nodes, the size of the tumor, her menopausal status, and whether her tumor contains hormone receptors or overproduces certain proteins such as HER2/neu. Clinical trials of new treatments for breast cancer are also available.

Treatment might consist of a combination of:

  • Chemotherapy
  • Hormonal therapy
  • Targeted agents

Treatment for Metastatic Disease

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Patients with disease that has spread to other organs (metastatic, or stage 4, disease) may be able to be treated with various systemic therapies -- chemotherapy, hormonal therapy, targeted agents, or combinations of these -- to control the disease. The choice of treatments depends on certain characteristics of the tumor such as hormone receptors, HER2/neu, and the location of the disease. Patients can also inquire whether or not there is an appropriate clinical trial available for them.

Preventive Therapy

Hormonal therapy can also be used to decrease the chance of developing breast cancer. Examples of these therapies include:

Findings from one of the largest breast cancer prevention trials ever conducted -- the Study of Tamoxifen and Raloxifene (STAR) -- showed that tamoxifen and raloxifene were equally effective in preventing invasive breast cancer in women at high risk for the disease, reducing risk by about 50 percent. The study also found that raloxifene was not as effective as tamoxifen for the reduction of noninvasive breast cancer (DCIS), but that tamoxifen was associated with the development of more uterine cancers and blood clots than raloxifene.


Last Updated: Dec. 12, 2008
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