Breast cancer systemic treatment

The exact treatment prescribed for you will be based on the stage and characteristics of your breast cancer. It’s important to talk to your oncology team if you have any specific questions about your particular treatment. 

Treatment is often classified into local therapy or systemic therapy. Local therapy means that it only treats the breast, and not any other parts of the body. Systemic therapy is treatment that goes around your entire body, treating cancer cells that may be present outside of the breast. A combination of local and systemic therapy may be given for breast cancer. 

This article will focus on the systemic therapy options for breast cancer – chemotherapy, hormone therapy, and HER2 therapy. 


Chemotherapy is medication that is used to stop the division of cells, causing cell death. Because cancer cells are abnormal and usually grow out of control, they are killed by chemotherapy. Unfortunately, chemotherapy can cause side effects because healthy cells are affected as well. 

Chemotherapy can be given before surgery (called neoadjuvant chemo) or after surgery (adjuvant chemo). 

Some examples of chemotherapy used to treat breast cancer include:

  • Anthracyclines (Adriamycin)
  • Taxanes (Taxol, Taxotere)
  • Carboplatin
  • Cyclophosphamide

The specific side effects of chemotherapy can differ for each medication, as well as the dose that is given. 

Hormone Therapy

When breast cancer is ER+ and/or PR+, hormonal, or endocrine, therapy is given to prevent the growth of breast cancer cells. Some of these medications work by blocking the hormone receptors, while others work at decreasing levels of estrogen in the body. These medications are usually given for years to reduce the risk of breast cancer coming back. Some examples of hormone therapy include:

  • Tamoxifen
  • Aromatase inhibitors (Femara, Arimidex, Aromasin)
  • Faslodex
  • Zoladex
  • Lupron

Side effects can differ for each medication, but are generally related to low levels of estrogen (ex: hot flashes, vaginal dryness, decreased bone density).

HER2 Therapy

If breast cancer is HER2+, systemic therapy to target the HER2 receptors specifically is given to treat the breast cancer. These are usually used in combination with chemotherapy, and multiple HER2 medications may be used together. Some examples of HER2 targeted therapy used for early stage breast cancer include Herceptin and Perjeta. 


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