systemic therapy in breast cancer

Discussions between younger women and clinicians about systemic treatments should include consideration of the individual woman’s underlying risk of recurrence, her treatment preference and the associated toxicities of treatment.


Where there remains a significant risk of distant relapse following local therapy, systemic therapy is frequently given in order to reduce this risk.At present, such adjuvant systemic therapy consists of various cytotoxic chemotherapy regimens and endocrine measures, such as tamoxifen and ovarian suppression. Many clinical trials have been carried out to determine the extent to which giving chemotherapy, or endocrine therapy or both may reduce the risk of recurrence. Five-yearly systematic review and meta-analysis of these trials show that these treatments are effective, although endocrine treatments are only effective where the tumour expresses hormone receptors.1,115,116 The greater the risk of cancer recurrence, the greater the potential benefit from adjuvant therapies. For hormone receptor positive cancers, chemotherapy combined with endocrine therapy is better than either treatment alone.