Medical Breast Cancer Treatment

Many factors go into determining the right breast cancer treatment for your condition. These include the size of your tumor, the stage and type of breast cancer you have, an assessment of the genes that may be associated with your cancer, your age, whether cancer has spread to other parts of your body, and your risk for recurrence. Tests will determine if your breast cancer is hormone-receptor-positive, HER2-positive (containing the HER2 protein, which promotes cancer growth), or triple-negative.

The sequence of treatments is determined by your treatment team and can include a lumpectomy or mastectomy, medical treatment, and radiation treatment.  Medical treatments can include chemotherapy, hormone therapy -- which blocks hormones such as estrogen or progesterone that promote the growth of cancer cells -- and targeted therapies, which tell the body’s immune system to target and destroy certain breast cancer cells.

Your medical oncologist will help you weigh the pros and cons of each treatment option to help guide your decision. 

Chemotherapy

Kills breast cancer cells and may reduce the risk of your cancer recurring. Useful for both early stage and advanced cancers, chemotherapy is given intravenously and may cause side effects such as nausea, hair loss, fatigue, and difficulty with concentration and memory. 

Hormone Therapy

Reduces the level of estrogen in the body and/or prevents estrogen from promoting the growth of cancer cells. Used to treat hormone-receptor-positive breast cancers. Typically taken in pill form and used long-term. Common drugs include Tamoxifen and aromatase inhibitors.

Targeted Therapies

Combined with other therapies, these treatments work on specific growth factors in the cancer and boost the immune system’s ability to fight cancer cells. Administered intravenously, these monoclonal antibodies may be effective for fast-growing and aggressive HER2-positive cancers. Common drugs include Herceptin and Perjeta.

Bone-Modifying Drugs

Given primarily to patients undergoing hormone therapy. Helps prevent bone loss and may prevent recurrence of cancer. Common drugs include Zometa and Prolia.

A Team Approach
At Duke, we offer a team approach to breast cancer care. Your medical treatments will be overseen by a board-certified medical oncologist who specializes in breast cancer and works closely with a team of specialists and caregivers, including the infusion therapists who administer your treatments.

Close to Home and Work
Having a cancer center near your work or home will minimize the impact your breast cancer treatment has on your daily life. At our breast cancer centers in Durham and Raleigh, we do everything we can to schedule breast imaging appointments and visits with your breast surgeon, medical oncologist, and radiation oncologist on the same day.

Support for Fertility Preservation
Chemotherapy can affect fertility. Patients who hope to have children in the future may be referred to the Duke Fertility Center to discuss fertility preservation. Women may undergo egg harvesting followed by egg or embryo freezing (cryopreservation) prior to chemotherapy or radiation to preserve their fertility options as they age.

Clinical Trials Access
Clinical trials give eligible patients access to new therapies before they are approved. You may be eligible to participate in our breast cancer clinical trials, which are using new vaccines to treat different types of breast cancer, including early stage breast cancer and HER2-positive breast cancer.