Three different types of systemic therapy or body wide therapy are useful in women with breast cancer. These types of therapies are 1) Hormone therapy, 2) Chemotherapy, 3) targeted therapy using the monoclonal antibody Herceptin ®. To choose any one of these three therapy’s or a combination is dependent upon whether a woman’s breast cancer is hormone-response, and whether it makes a protein called HER2. Chemotherapy is recommended for women whose breast cancer is ER/PR-negative. (Estrogen or progesterone receptors.) In contrast to chemotherapy hormone therapy is used for women with ER/PP-positive breast cancer. Chemotherapy may also be recommended in addition to hormone therapy for women with ER/PR-positive breast cancer particularly if they have node-positive disease a large tumor size or other features which suggest a much higher rise for breast cancer recurrence.
The goal of systemic therapy is to prevent breast cancer cells from receiving stimulation from Estrogen. Breast cancer cells thrive on estrogen, and feed upon this hormone thus making the tumor larger. Several choices in treatment are available. For hormone therapy in postmenopausal women with early breast cancer include the drug tamoxifen. Tamoxifen blocks the hormone receptors on breast cancer cells thus preventing the body’s estrogen from interacting with the hormone receptors. Also this group of women can also be given a class of drugs called aromatase inhibitors or AIs.
For those women who are premenopausal, those that are menstruating, women are not offered AIs. Premenopausal women’s ovaries are still functioning and making hormones and AIs will cause the ovaries to produce more male rather than female hormones. This is not desirable and causes other problems. The available options for hormone therapy in premenopausal women include the drug tamoxifen and disruption of the ovaries’ ability to make estrogen thus giving the term as ovarian function suppression.
Tamoxifen is the drug of choice for systemic therapy. The drug helps reduce the chance of a breast cancer reoccurrence and death from breast cancer. The standard duration of the Tamoxifen drug therapy is five years. Taking tamoxifen for more than five years does not add any further benefits, and sometimes the side effect is a uterine cancer.
No matter whether your doctor chooses Chemotherapy, Hormone Therapy, targeted therapy, or a combination of the two, all of these are considered systemic therapy for breast cancer. The important aspect of breast cancer is to prevent it and/or catch it early. Have self examinations monthly, have your partner check as well, and by all means get a mammogram.