Treatment Options for Recurrent Breast Cancer

Locoregional recurrent breast cancer

Treatment of locoregional recurrent breast cancer (cancer that has come back after treatment in the breast, in the chest wall, or in nearby lymph nodes), may include the following:

  • Chemotherapy
  • Hormone therapy for tumors that are hormone receptor positive
  • Radiation therapy
  • Surgery
  • Targeted therapy (trastuzumab)
  • A clinical trial of a new treatment

See the NCI Metastatic Breast Cancer section for information about treatment options for breast cancer that has spread to parts of the body outside the breast, chest wall, or nearby lymph nodes.

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

Metastatic breast cancer

Treatment options for metastatic breast cancer (cancer that has spread to distant parts of the body) may include the following:

Hormone therapy

In postmenopausal women who have just been diagnosed with metastatic breast cancer that is hormone receptor positive or if the hormone receptor status is not known, treatment may include:

  • Tamoxifen therapy
  • Aromatase inhibitor therapy (anastrozole, letrozole, or exemestane). Sometimes cyclin-dependent kinase inhibitor therapy (palbociclibribociclib, or abemaciclib) is also given

In premenopausal women who have just been diagnosed with metastatic breast cancer that is hormone receptor positive, treatment may include:

  • Tamoxifen, an LHRH agonist, or both
  • Cyclin-dependent kinase inhibitor therapy (ribociclib)

In women whose tumors are hormone receptor positive or hormone receptor unknown, with spread to the bone or soft tissue only, and who have been treated with tamoxifen, treatment may include:

  • Aromatase inhibitor therapy
  • Other hormone therapy such as megestrol acetate, estrogen or androgen therapy, or anti-estrogen therapy such as fulvestrant

Targeted therapy

In women with metastatic breast cancer that is hormone receptor positive and has not responded to other treatments, options may include targeted therapy such as:

  • Trastuzumab, lapatinib, pertuzumab, or mTOR inhibitors
  • Antibody-drug conjugate therapy with ado-trastuzumab emtansine
  • Cyclin-dependent kinase inhibitor therapy (palbociclib, ribociclib, or abemaciclib) which may be combined with hormone therapy

In women with metastatic breast cancer that is HER2/neu positive, treatment may include:

  • Targeted therapy such as trastuzumab, pertuzumab, ado-trastuzumab emtansine, or lapatinib

In women with metastatic breast cancer that is HER2 negative, with mutations in the BRCA1 or BRCA2 genes, and who have been treated with chemotherapy, treatment may include:

  • Targeted therapy with a PARP inhibitor (olaparib or talazoparib)

Chemotherapy

In women with metastatic breast cancer that is hormone receptor negative and HER2 negative, treatment may include:

  • Chemotherapy with one or more drugs

Chemotherapy and immunotherapy

In women with metastatic breast cancer that is hormone receptor negative, has not responded to hormone therapy, has spread to other organs or has caused symptoms, treatment may include:

  • Chemotherapy and immunotherapy (atezolizumab)

Surgery

  • Total mastectomy for women with open or painful breast lesions. Radiation therapy may be given after surgery
  • Surgery to remove cancer that has spread to the brain or spine. Radiation therapy may be given after surgery
  • Surgery to remove cancer that has spread to the lung
  • Surgery to repair or help support weak or broken bones. Radiation therapy may be given after surgery
  • Surgery to remove fluid that has collected around the lungs or heart

Radiation therapy

  • Radiation therapy to the bones, brain, spinal cord, breast, or chest wall to relieve symptoms and improve quality of life
  • Strontium-89 (a radionuclide) to relieve pain from cancer that has spread to bones throughout the body.

Other treatment options

Other treatment options for metastatic breast cancer include:

  • Drug therapy with bisphosphonates or denosumab to reduce bone disease and pain when cancer has spread to the bone. (See the PDQ summary on Cancer Pain for more information about bisphosphonates.)
  • A clinical trial of high-dose chemotherapy with stem cell transplant
  • Clinical trials testing new anticancer drugs, new drug combinations, and new ways of giving treatment

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

 

 

Information provided by National Cancer Institute.