From the Guidelines
TADs are not directly related to breast cancer treatment, and breast cancer is treated through various approaches including surgery, radiation therapy, chemotherapy, hormone therapy, targeted therapy, and immunotherapy. The specific treatment plan depends on the cancer stage, tumor characteristics, and patient factors. According to the most recent guideline update 1, patients with triple-negative, programmed cell death ligand-1–positive metastatic breast cancer (MBC) may be offered the addition of immune checkpoint inhibitor to chemotherapy as first-line therapy.
- Key considerations in breast cancer treatment include:
- Cancer stage and tumor characteristics
- Patient factors such as age, menopausal status, and overall health
- Multidisciplinary approach involving oncologists, surgeons, and radiation oncologists
- Common treatment approaches include:
- Surgery (lumpectomy or mastectomy)
- Radiation therapy
- Chemotherapy (e.g. AC-T, TC, or CMF)
- Hormone therapy (e.g. tamoxifen or aromatase inhibitors) for hormone receptor-positive cancers
- Targeted therapy (e.g. trastuzumab) for HER2-positive cancers
- The diagnosis of breast cancer is based on clinical examination, imaging, and pathological assessment, and should be carried out in specialized breast units with a multidisciplinary team 1.
- Pathological diagnosis should be based on core needle biopsy, and the pathological report should include histological type, grade, ER status, and HER2 status 1.
- The treatment plan should be individualized based on the patient's specific circumstances and cancer characteristics, and should involve a multidisciplinary approach with ongoing assessment and adjustment as needed 1.
From the Research
Breast Cancer Overview
- Breast cancer is one of the most frequent malignancies among women worldwide 2
- It has various subtypes, including HER2-positive breast cancer, which accounts for approximately 14% to 20% of all breast cancer cases 3, 4, 5
HER2-Positive Breast Cancer
- HER2-positive breast cancer is a distinct subtype that expresses estrogen and progesterone receptors with an overexpression of HER2 3
- It has a higher risk of local recurrence and metastases, and a poorer overall prognosis compared to other subtypes 4
- Treatment with targeted monoclonal antibody therapies, such as trastuzumab and pertuzumab, provides better local-regional control and improved survival outcome 4, 5
Imaging and Diagnosis
- Imaging modalities, such as mammography, ultrasound, and MRI, are used to diagnose and assess the extent of HER2-positive breast cancer 4, 6
- MRI findings are the best predictor of pathologic response to neoadjuvant treatment 4
- The presence of calcifications at mammography can be difficult to correlate with pathologic analysis after chemotherapy 4
Treatment and Management
- Treatment strategies for HER2-positive breast cancer include hormone therapy, anti-HER2 treatment, and neoadjuvant chemotherapy 3
- The emergence of patterns of resistance to trastuzumab has led to the discovery of new monoclonal antibodies and other targeted agents aimed at overcoming resistance and improving survival 5