Systemic therapies are drugs that spread throughout the body to eliminate cancer cells. They include chemotherapy and hormonal therapies and molecular based therapies.
After surgery, some patients need systemic therapy to help reduce the risk of breast cancer recurring or spreading. This is called adjuvant chemotherapy. Sometimes the treatment is given before the surgery in order to help shrink the tumor and make it easier to remove surgically. This is called neoadjuvant therapy.
Whether you might need adjuvant systemic therapy and which type will depend on a number of factors including:
- The presence or absence of cancer cells in the lymph nodes.
- The size of the tumor.
- Menopausal status.
- Whether the tumor contains hormone receptors or overproduces certain proteins such as HER2/neu.
- Whether there is a high recurrence score on OncotypeDx-testing.
- Histologic grade.
Neo adjuvant therapy
Neoadjuvant therapy is treatment given before surgery. A woman may receive neoadjuvant chemotherapy for breast cancer to shrink a tumor that is inoperable in its current state, so it can be surgically removed. A woman whose tumor can be removed by mastectomy may instead receive neoadjuvant therapy to shrink the tumor enough to allow breast-conserving surgery.
Neoadjuvant chemotherapy is given in the same manner as adjuvant chemotherapy. If a tumor does not shrink or continues to grow during neoadjuvant chemotherapy, your doctor may stop treatment and try another type of chemotherapy or perform surgery instead, depending on the stage of the cancer.
Patients with metastatic breast cancer may receive a combination of systemic therapies to help control the disease.
The choice of treatments depends on certain characteristics of the tumor such as hormone receptors, HER2/neu status, and the location of the disease.
Patients with metastatic breast cancer may also be eligible to participate in clinical trials of new therapies.