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Female Breast Cancer (Female Breast Carcinoma): Treatments

Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk).

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

Treatments for Female Breast Cancer

There are different types of treatment for patients with breast cancer.

Different types of treatment are available for patients with breast cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Six types of standard treatment are used:

Surgery

Most patients with breast cancer have surgery to remove the cancer from the breast. Some of the lymph nodes under the arm are usually taken out and looked at under a microscope to see if they contain cancer cells... Read more about Female Breast Cancer (Female Breast Carcinoma): Treatments

What works? Research summarized

Evidence reviews

Suspected Cancer: Recognition and Referral

Cancer is an important condition, both in terms of the number of people affected and the impacts on those people and the people close to them. Around one third of a million new cancers are diagnosed annually in the UK, across over 200 different cancer types. Each of these cancer types has different presenting features, though there may be overlap. More than one third of the population will develop a cancer in their lifetime. Although there have been large advances in treatment and survival, with a half of cancer sufferers now living at least ten years after diagnosis, it remains the case that more than a quarter of all people alive now will die of cancer.

Venous Thromboembolism: Reducing the Risk of Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism) in Patients Admitted to Hospital

Venous thromboembolism (VTE) is a term used to include the formation of a blood clot (a thrombus) in a vein which may dislodge from its site of origin to travel in the blood, a phenomenon called embolism. A thrombus most commonly occurs in the deep veins of the legs; this is called deep vein thrombosis. A dislodged thrombus that travels to the lungs is known as a pulmonary embolism.

Treatments targeting blood vessels for metastatic breast cancer

Angiogenesis refers to the development of new blood vessels from the pre‐existing beds containing the normal supply of blood vessels. Tumours are dependent on the formation of new blood vessels for their growth. Vascular‐endothelial‐growth‐factor (VEGF) is a key molecule in promoting blood vessel growth. VEGF‐targeting therapies are a new class of drugs designed to target a specific molecule. One of these drugs is bevacizumab (Avastin) which has been studied in clinical trials in metastatic breast cancer. Trials with other drugs are ongoing. Data are available from seven randomised trials, which evaluated the effect of bevacizumab on the primary endpoint in a total of 4032 patients with metastatic breast cancer. These patients were either‐hormone receptor negative or had progressed on hormonal treatment. The primary end point was progression‐free survival and secondary end points included overall survival, response rate measuring the change in size of the tumour, quality of life and toxicity of the treatment.  Progression‐free survival is considered a surrogate end point, i.e. a substitute for overall survival as an end point. The addition of bevacizumab to chemotherapy significantly prolongs progression‐free survival and response rates in patients who have had previous chemotherapy and those who have not had previous chemotherapy for metastatic disease. The magnitude of this benefit is dependent on the type of chemotherapy used. Best results have been observed for the combination of weekly paclitaxel and bevacizumab in patients without prior chemotherapy for metastatic disease. Although progression‐free survival was significantly longer with bevacizumab, there was no significant effect observed on either overall survival or quality of life. Quality of life is a direct measure of benefit to the patient. Adverse effects of bevacizumab in breast cancer are generally manageable, but may be serious and include increased frequencies of high blood pressure, blood clots in arteries and bowel perforations. However, overall rates of treatment‐related deaths were lower in patients treated with bevacizumab. Because of the lack of effect on overall survival and quality of life, it is regarded as controversial whether bevacizumab is associated with a true patient benefit in spite of the increase in progression‐free survival.

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Summaries for consumers

Treatments targeting blood vessels for metastatic breast cancer

Angiogenesis refers to the development of new blood vessels from the pre‐existing beds containing the normal supply of blood vessels. Tumours are dependent on the formation of new blood vessels for their growth. Vascular‐endothelial‐growth‐factor (VEGF) is a key molecule in promoting blood vessel growth. VEGF‐targeting therapies are a new class of drugs designed to target a specific molecule. One of these drugs is bevacizumab (Avastin) which has been studied in clinical trials in metastatic breast cancer. Trials with other drugs are ongoing. Data are available from seven randomised trials, which evaluated the effect of bevacizumab on the primary endpoint in a total of 4032 patients with metastatic breast cancer. These patients were either‐hormone receptor negative or had progressed on hormonal treatment. The primary end point was progression‐free survival and secondary end points included overall survival, response rate measuring the change in size of the tumour, quality of life and toxicity of the treatment.  Progression‐free survival is considered a surrogate end point, i.e. a substitute for overall survival as an end point. The addition of bevacizumab to chemotherapy significantly prolongs progression‐free survival and response rates in patients who have had previous chemotherapy and those who have not had previous chemotherapy for metastatic disease. The magnitude of this benefit is dependent on the type of chemotherapy used. Best results have been observed for the combination of weekly paclitaxel and bevacizumab in patients without prior chemotherapy for metastatic disease. Although progression‐free survival was significantly longer with bevacizumab, there was no significant effect observed on either overall survival or quality of life. Quality of life is a direct measure of benefit to the patient. Adverse effects of bevacizumab in breast cancer are generally manageable, but may be serious and include increased frequencies of high blood pressure, blood clots in arteries and bowel perforations. However, overall rates of treatment‐related deaths were lower in patients treated with bevacizumab. Because of the lack of effect on overall survival and quality of life, it is regarded as controversial whether bevacizumab is associated with a true patient benefit in spite of the increase in progression‐free survival.

Mammography followed by ultrasonography compared to mammography alone for breast cancer screening in women at average risk of breast cancer

Worldwide, breast cancer is the most common malignancy in women. Evidence shows that mammography in healthy women 50 to 70 years of age can detect breast cancer early and reduce the risk of dying from breast cancer. Mammography, however, is not a perfect tool to detect breast cancer and misses some tumours in some women, particularly in women who have dense breasts. In women with dense breasts, the normal breast tissue and the tumour are difficult to distinguish from each other on the mammogram. Because of this, some supporters feel that the addition of ultrasonography screening of these women in addition to the mammography screening will detect those tumours that are missed by mammography alone. Others feel that this will increase the rate of false positive tumours and increase the number of biopsies and unnecessary treatment.

It is not yet clear whether adding chemotherapy (anti‐cancer drugs) to another treatment for a recurrence of breast cancer in the same area improves survival

Early breast cancer can be removed by surgery, and for most women the chance of the cancer returning (recurrence) is small. In some women however, the cancer returns in the same area. Chemotherapy (anti‐cancer drugs) can be used together with other treatments, such as surgery or radiation therapy, to try to treat recurring cancer and improve survival. The review found that few trials have been performed to investigate its effectiveness. There is currently not enough evidence that adding chemotherapy to other treatments helps to treat the recurring cancer or to improve survival. However, chemotherapy may be an option, and further trials are underway.

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Terms to know

Breast
Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue.
Clinical Trial
A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.
Duct
In medicine, a tube or vessel of the body through which fluids pass.
Lobule
A small lobe or a subdivision of a lobe.
Lymph Nodes
A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.
Nipples
In anatomy, the small raised area in the center of the breast.
Surgery (Surgical Procedure)
A procedure to remove or repair a part of the body or to find out whether disease is present.

More about Female Breast Cancer (Female Breast Carcinoma): Treatments

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Other terms to know: See all 7
Breast, Clinical Trial, Duct

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