Treating breast cancer often requires an approach from several fronts. While surgery to remove a tumor can be effective, sometimes your doctor may also recommend adjuvant therapy to increase the chances of removing all cancerous cells throughout your body.
Adjuvant therapies are additional treatments that help kill any cancer cells remaining in the body after a primary therapy like surgery.
According to the
In some cases, your doctor may recommend neoadjuvant therapy, a type of adjuvant therapy given before the main treatment.
This form of therapy can make the primary treatment more effective and decrease the chances of the cancer coming back, according to
There are different types of adjuvant therapy for breast cancer. Your doctor may recommend one or more of the following at any time during your cancer treatment.
Adjuvant chemotherapy involves using anticancer drugs to kill any remaining cancer cells after surgery.
Because these cells are often difficult to see, even on imaging tests, your doctor may recommend adjuvant chemotherapy to lower the risk of breast cancer returning after surgery, according to the
When used before surgery (neoadjuvant), the goal is to shrink the tumor, so the removal is easier and requires less extensive surgery.
- 5-fluorouracil (5-FU)
Adjuvant radiation therapy helps target cancer cells by using high doses of radiation to kill cancer cells that remain in the breast or lymph nodes after surgery, per the
There are two types of radiation: external beam radiation and internal radiation (brachytherapy).
With external radiation, a machine outside your body aims radiation at cancer cells. Internal radiation places radiation inside your body in or near the cancer.
According to the
However, your doctor will likely wait until the surgery site is healed before starting external beam radiation as adjuvant therapy.
Hormone therapy uses certain mediations to stop hormone production in the body or to alter how they affect the body. According to the
The drugs used for hormone therapy either stop estrogen from helping cells grow or lower estrogen levels in the body.
Drugs that block estrogen receptors include tamoxifen, toremifene, and fulvestrant. Drugs that lower estrogen levels include aromatase inhibitors.
Tamoxifen is appropriate for pre- and postmenopausal people, while toremifene is only approved to
Fulvestrant is also recommended for postmenopausal people with locally advanced breast cancer and metastatic breast cancer.
Aromatase inhibitors (AIs) are better suited for postmenopausal people or premenopausal people with suppressed ovaries. AIs include letrozole, anastrozole, and exemestane.
Immunotherapy is a type of biological therapy sometimes used during breast cancer treatment. According to the
Immune checkpoint inhibitors are the most common type of immunotherapy.
Currently, there are two immune checkpoint inhibitors approved by the FDA for metastatic triple-negative breast cancer and high risk early stage triple-negative breast cancer, respectively:
Your doctor may suggest a targeted therapy to focus on specific abnormalities in the cancer cells. In addition to identifying and destroying cancer cells while leaving other cells undamaged, these drugs also detect and block messages inside the cell that tell it to grow, according to the
HER2-positive breast cancer is one type of cancer that can respond to targeted therapies like monoclonal antibodies, antibody-drug conjugates, and kinase inhibitors.
In general, breast cancer responds well to adjuvant therapy. However, treatment for breast cancer should be individuated and designed to meet your unique needs. That’s why certain treatments, like adjuvant therapy, are better suited for some people.
More specifically, people with a high risk of cancer returning are good candidates for adjuvant therapy. This includes people in later stages of cancer or with cancer that has spread to nearby lymph nodes.
Your doctor will also discuss the side effects of each adjuvant therapy with you so you can decide if the benefits outweigh the risks.
Overall, breast cancer responds well to adjuvant therapy. However, there are some risks to consider before moving forward.
Side effects are generally specific to the type of treatment, dose, and your general health.
- hair loss
- appetite changes
- nausea and vomiting
- hot flashes
- mouth sores
- nail changes
- changes in menstrual periods in younger patients
- nerve damage (rare)
- skin changes in the treated area
- hair loss
- breast swelling
- breast pain
- infection, redness, or bruising at treatment site for brachytherapy
- hot flashes (all hormone therapy drugs)
- menstrual cycle changes (tamoxifen and toremifene)
- vaginal dryness (aromatase inhibitors, tamoxifen, and toremifene)
- bone issues (tamoxifen)
- headache (fulvestrant)
- mild nausea (fulvestrant)
- bone pain (fulvestrant and aromatase inhibitors)
- injection site pain (fulvestrant)
- skin rash
- changes in appetite
- infusion reaction, which is similar to an allergic reaction
- severe diarrhea
- liver problems
- lung problems
- heart issues
- hand-foot syndrome
Adjuvant therapies are additional treatments that help address any cancer remaining in the body after a primary therapy like surgery. Sometimes these therapies may be used before another therapy. In this case, they’re referred to as neoadjuvant therapies.
While adjuvant therapy does not guarantee that cancer won’t recur, it can reduce the risk of it returning.
Examples of adjuvant therapy for breast cancer include chemotherapy, radiation, hormone therapy, immunotherapy, and targeted therapies. The type of breast cancer and stage, along with other factors, will determine the adjuvant therapy that will work best for you.
It’s important to talk with your doctor about your treatment options. They can answer any questions you may have about adjuvant therapy and help you decide the best treatment for you.