Treatment of locally recurrent and advanced breast cancer

Abstract

The incidence of breast cancer continues to rise, however mortality rates have fortunately been declining. This can be attributed to earlier detection, increased and better use of imaging modalities as well as advancing systemic therapy and radiotherapy options. Breast cancer is primarily subtyped according to the hormone and HER2 receptor status of the tumour. In locally advanced and metastatic breast cancer, this subtyping influences first line and subsequent systemic treatments and helps with prognostication. Systemic anti-cancer treatments such as endocrine therapy, chemotherapy, immunotherapy or targeted therapy form the main treatment backbone in metastatic disease. Bone metastases are commonly seen in breast cancer and bisphosphonates can be given in this setting to reduce skeletal related events. Brain metastases in breast cancer can be treated with surgery, radiotherapy or systemic treatments. In the advent of increasing effective cancer treatment options, it is important to be aware that breast cancer patients can have a very good prognosis with many years of good quality life.