Locally advanced breast cancer patients include everyone at stage 3 of the disease. In this article, we discuss the treatment options for locally advanced breast cancer.
- Neoadjuvant systemic therapy
- Surgery
- Radiotherapy
- Hormonal treatment (depending on hormone receptor status)
- Trastuzumab
Neoadjuvant systemic therapy
Firstly, neoadjuvant systemic therapy is the standard in current practice. It reduces the size of the tumor, and controls the local growth of the tumor and makes the tumor operable. Moreover, optimal chemotherapy regimens in locally advanced breast cancer are anthracyclines and taxane-based. Generally, doctors advise 4 to 6 cycles of chemo and surgical assessment.
Treatment for HER2 positive locally advanced breast cancer patients
In HER2 positive patients, Trastuzumab goes along with neoadjuvant chemotherapy. Furthermore, doctors do not advise Anthracycline-based chemotherapy regimens as they increase the cardiotoxicity.
Surgery for locally advanced breast cancer patients
Decisions about surgical intervention in cases of locally advanced breast cancer, are depend on the patients’ response to neo-adjuvant chemotherapy or systemic treatment. Usually, surgical options include either mastectomy or lumpectomy.
Treatment after surgery for locally advanced breast cancer patients
After surgery, all patients must receive chemotherapy. The treating doctor or multidisciplinary panel plan the cycles and duration depending on the patient’s overall health.
Adjuvant radiotherapy after surgery for locally advanced breast cancer patients
Generally, all patients with locally advanced breast cancer must receive post surgical radiotherapy to reduce the chances of local recurrence.
Additional treatments
In HER2 positive patients, doctors advise chemotherapy with Trastuzumab for an additional year, to significantly improve the chances of disease free survival, and overall survival.
Adjuvant endocrine therapy after surgery for locally advanced breast cancer patients
Moreover, post and premenopausal women with hormone receptor positive breast cancer are treated with adjuvant endocrine therapy, similar to the treatment of early breast cancer.