Advanced breast cancer, depending on receptor expression, can be treated with the following drug options.
- Hormone receptor (ER/PR)-positive (Luminal type) breast cancer. Your doctor will usually consider endocrine therapy or chemotherapy. Usually, doctors prefer endocrine therapy to chemotherapy if the disease is slowly progressing, if the metastases are in bone or soft tissue, or if the metastases are small and mild, and if the ER/PR is strongly positive.
- HER-2 (human epidermal growth factor receptor-2)-positive breast cancer. In these patients, the physician’s first choice is an anti-HER-2 therapy-based regimen, usually anti-HER-2 targeted therapy in combination with chemotherapy. In a small number of patients with very slow disease progression and low tumor risk, anti-HER-2 targeted therapy in combination with endocrine therapy will also be considered.
- Triple-negative breast cancer. Chemotherapy is preferred. For patients with visceral metastases who need rapid disease control, rapid disease progression, and significant symptoms, physicians will consider giving a two-drug combination chemotherapy regimen; conversely, patients with relatively slow disease progression, bone or soft tissue metastases, and less significant symptoms, physicians will consider single-drug chemotherapy.
The above is only the usual situation, but clinical conditions vary widely and there is some controversy about which treatment regimen different physicians choose, and the final choice of treatment regimen still needs to be made by the patient and physician after weighing the pros and cons.