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Systemic Therapy

To reach cancer cells that may have spread beyond the breast and nearby tissues, physicians use drugs that can be given orally or by injection, called systemic treatment. Based on the characteristics of your tumor, systemic treatment can include:

  • Chemotherapy: the use of drugs to kill cancer cells
  • Hormonal therapy: uses medicine to reduce the risk of certain types of cancer from developing or recurring
  • Biologic therapy: the use of laboratory-produced substances to control cancer growth by delivering drugs or materials directly to cancer cells
  • Clinical trials: studies that test new therapies to treat breast cancer

Stop Cancer from Spreading

Preventing the breast cancer from metastasizing (spreading to other parts of the body) in the future is one use of systemic treatment. This treatment, called adjuvant therapy, is used to get rid of undetected cancer cells that have traveled from the breast to other parts of the body through the bloodstream.

Shrink the Tumor

Systemic treatment is usually given immediately following surgery. Occasionally it is given before surgery, called neoadjuvant treatment, in order to shrink the tumor enough to allow for surgical removal. This may allow women who would otherwise need mastectomy to have breast-conserving surgery.

Side Effects

Systemic treatment does cause side effects, including hair loss, fatigue, nausea, vomiting, lowered white blood cell count and a corresponding increased risk of infection, mouth sores, hair loss and premature menopause. Many side effects can be treated with drugs that prevent or reduce nausea and vomiting. Growth factors are drugs that stimulate the production of red or white blood cells. They can help bone marrow recover after chemotherapy and prevent problems resulting from low blood counts. The use of these drugs allows doctors to give chemotherapy more frequently.

Many side effects go away once treatment is stopped and are not long-term. However, long-term toxicities, or side effects, may occur including heart damage, nerve damage or secondary cancers. Because of this, many patients find adjuvant treatment difficult to take, but systemic therapy is an important step in the treatment process as it can significantly reduce the risk of cancer recurrence.

Primary Treatment if Cancer has Spread

For women whose cancer has spread to other organs in the body (metastases), surgery may not be an option, so systemic treatment is the main treatment. This may include chemotherapy, hormonal therapy or a combination of both.