About breast cancer
When normal cell division in the breast becomes uncontrolled, extra cells can form a mass called a tumor, which can be noncancerous (benign) or cancerous (malignant). Cancerous or malignant breast tumors can often be removed, but can grow back, invade surrounding tissues and organs, and spread to other parts of the body.
Treatment for breast cancer is based on the stage of the patient’s disease and can include surgery, chemotherapy and radiation. Targeted therapies have also become part of the standard treatment process.
Novartis Oncology is committed to developing innovative new cancer drugs for breast cancer and other tumor types, and improving access to them through patient assistance and cancer resource programs.
Advanced Breast Cancer
"Advanced breast cancer" usually refers to metastatic breast cancer, also referred to as Stage IV breast cancer. Breast cancer that has spread locally in the area of the breast, but not too distant organs and tissues, is often referred to as "locally advanced breast cancer," also referred to as Stage III breast cancer. Given these various and sometimes inconsistent terms, if you or a loved one is diagnosed with advanced breast cancer, it is important to discuss with your doctor specifically what stage it is and its other characteristics such as hormone receptor status and where the cancer has spread that can be important for making treatment decisions.
Advanced breast cancer is usually treated with systemic therapy, which means drugs that travel through the bloodstream, reaching and affecting cells all over the body. Systemic therapy includes hormonal treatment, chemotherapy, and targeted therapy.
Women living with Advanced breast cancer have unique needs and challenges. The mindset for most women with early stage breast cancer is short-term with both treatment and an end to cancer being in sight. The goal is to "beat" cancer and become a survivor. Women living with advanced disease will never "beat" cancer, so the mindset isn't about being a survivor, but more about making every day count. They experience the uncertainty of how many days, weeks, months and years they have left and how long a particular treatment will work.
Treatment of HR-positive breast cancer
Hormone receptor-positive (HR+) breast cancer is characterized by hormone receptor-positive tumors, a group of cancers that express receptors for certain hormones such as estrogen and progesterone. Cancer cell growth can be driven by these hormones.1 The presence of estrogen receptor (ER) and/or progesterone receptor (PgR) is one of the most important predictive and prognostic markers in human breast cancers, and is collectively referred to as hormone receptor-positive.2
For patients whose initial diagnosis is advanced breast cancer, and to help prevent recurrence in postmenopausal women with hormone-sensitive early breast cancer, aromatase inhibitors are frequently prescribed by physicians. Aromatase inhibitors are a medication that reduces the amount of hormones such as estrogen in the body, and are a form of endocrine therapy. They are an important advancement in breast cancer treatment in women with an HR+ tumor who have undergone surgery as they have been shown to reduce the risk of recurrence.
While endocrine therapy remains the cornerstone of treatment for women with HR+ breast cancer, most women will eventually develop treatment resistance.3 Therapeutic resistance has been associated with overactivation of the PI3K/AKT/mTOR pathway.3
One type of medication, called an mTOR inhibitor, may be used to help treat some women with HR+/HER2-negative advanced breast cancer and works differently than aromatase inhibitors. This type of medication targets the mTOR pathway, which is hyperactivated in many types of cancer cells and acts as an important regulator of tumor cell division, blood vessel growth and cell metabolism.3
Questions to ask your doctor
When you are diagnosed with breast cancer, you may want to ask your doctor questions like these about your diagnosis and treatment plan:
- What type of breast cancer do I have?
- What stage is my breast cancer?
- What cell markers does my cancer have?
- What are my treatment choices?
- What are the expected benefits of each kind of treatment?
- What are the risks of each treatment?
- What are the side effects of each treatment?
- How will we know if this is working?
- How will each treatment affect my daily life?
- Are there new treatments or clinical trials that I should consider?
- What You Need to Know About Breast Cancer (National Cancer Institute) Web site. Available at http://www.cancer.gov/cancertopics/wyntk/breast. Accessed October 1, 2013.
- Osin, PP, Lakhani, SR. The Pathology of Familial Breast Cancer. Immunohistochemistry and Molecular Analysis. Breast Cancer Research. October 1999;1(1):36-40.
- Baselga, J. Everolimus in Postmenopausal Hormone-Receptor-Positive Advanced Breast Cancer. New England Journal of Medicine. 2012;1-10.