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Medical management of breast cancer 

Medical management of breast cancer
Chapter:
Medical management of breast cancer
Author(s):

Tim Crook

, Su Li

, and Peter Harper

DOI:
10.1093/med/9780198746690.003.0051
Page of

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date: 28 February 2021

Most patients with breast cancer are offered surgery, the main options being modified radical mastectomy, with or without immediate or delayed breast reconstruction, or breast-conserving surgery. All patients treated surgically for early breast cancer should be considered for risk-reducing neoadjuvant (before surgery) or adjuvant (after surgery) treatments. Adjuvant radiotherapy should be considered for all patients who have undergone breast-conserving surgery. Adjuvant medical therapies include (1) endocrine therapy—should be given to all oestrogen-receptor positive patients (premenopausal—tamoxifen; postmenopausal—aromatase inhibitors); (2) anti-HER2 targeted therapy (e.g. trastuzumab) in cancers that overexpress the HER2 oncogene; (3) chemotherapy—selection is informed by clinic-pathological parameters and increasingly by molecular genetic platforms such as Oncotype DX; patients with oestrogen-receptor negative, node-positive disease should receive regimens containing sequential anthracyclines and taxanes. Regimens for neoadjuvant treatment are similar to those used in the adjuvant setting.

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