The oncologist decides on the necessary adjuvant treatment and medication based on the size of the tumour, the patient’s age, whether the axillary lymph nodes are affected, and the biological and microscopic features of the cancer cells. This may involve chemotherapy and/or less arduous hormonal therapy. For very large tumours or in the rare case of inflammatory breast cancer, a course of medication may be necessary before the first operation, to reduce the size of the tumour before the surgery can go ahead.
In most cases, a course of chemotherapy is undertaken using cytostatic agents. Cytostatics stop the cancer cells from dividing and multiplying; thereby inhibiting the growth of the cancerous tumour, as the drugs destroy the malignant, fast-growing cells. Chemotherapy is normally used as an adjuvant/post-operative treatment. The medication is administered for several days in a row. Then, after a break, a new treatment cycle commences. Normally several treatment cycles will be required. The course usually involves an individually determined combination of different medications. Unfortunately, chemotherapy takes its toll on the body and is associated with some unpleasant side effects (hair loss, nausea, fatigue etc.). An increasing number of pharmaceutical companies are currently working on new approaches to cancer research. For example, certain antibody therapies based on monoclonal antibodies provide new treatment options and fewer side effects for a specific group of women.
Hormonal therapy is currently used in some cases as an adjuvant treatment for breast cancer and to treat metastasis. The aim is to inhibit the growth-promoting effect of the female hormone, oestrogen, on the cancer cells. Aromatase inhibitors are also used to treat advanced tumour growth with metastases.