In most cases, the standard treatment for stage IV—advanced or metastatic breast cancer—involves systemic treatment. This treatment approach typically involves a combined use of chemotherapy, hormone therapy, and targeted therapy. Radiation therapy or surgery may also be recommended to control the symptoms.
Advanced breast cancer is a stage in which the tumour has spread to surrounding tissues outside the breast, such as the lymph nodes. In a majority of cases, when breast cancer metastasizes, it reaches into the lungs, liver, and bones. However, it can also spread to distant organs such as the brain.
Advanced Breast Cancer Treatment
For patients with advanced breast cancer, the primary method of treatment includes systemic medications through chemotherapy, targeted therapy, or hormone therapy. A combination of two or more of these methods can also be used.
These therapies work by shrinking cancerous cells or impeding their growth rate. Some of them also relieve symptoms and prolong patients’ lives. That said, stage IV breast cancer is incurable; it can only be treated to enhance patients’ quality of life.
Systemic Therapies as Advanced Breast Cancer Treatment
Oncologists determine the most suitable drugs according to the patient’s breast cancer type in relation to its HER2 status and hormone receptor status.
ER-positive or PR-positive Cancers
Using hormone therapy that is comprised of either an aromatase inhibitor or tamoxifen is usually the first course of action for patients with hormone receptor-positive tumours. In some cases, this form of therapy may be used in conjunction with a targeted therapy medication such as abemaciclib or palbociclib.
ER-negative or PR-negative Cancers
Chemotherapy is the primary therapy for patients with hormone-receptor-negative cancers as hormone therapy does not work in fighting this particular type of cancer.
The primary approach to treatment for HER2-positive cancers involves the use of the medication trastuzumab. In fact, trastuzumab is typically taken in conjunction with chemotherapy or hormone therapy drugs. It can also be taken with anti-HER2 medications.
HER2-negative cancer patients prefer chemotherapy as the most viable option. In the case of ER-positive or PR-positive cancers, chemotherapy may be used in conjunction with hormone therapy. Following a course of chemotherapy, some patients are placed on a targeted agent known as a PARP inhibitor.
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