Adjuvant Therapy for Breast Cancer

If you've been diagnosed with breast cancer, one of the treatments your doctor may suggest is adjuvant therapy. "Adjuvant" means "to aid." This is treatment that's added to the primary treatment to try to prevent the cancer from recurring.

Primary vs. adjuvant therapy
In breast cancer, primary treatment is usually surgery to take out the cancer. There are two types of surgery. Either the whole breast is removed (mastectomy) or only the tumor and part of the breast around it are removed (lumpectomy). After lumpectomy, radiation is often done to kill any cancer cells that may still be in the breast.

Usually, some of the underarm lymph nodes are taken out during surgery and checked for cancer. Cancer tends to spread first to these nearby lymph nodes. But sometimes cancer cells may break off from the tumor and travel to other parts of the body. These cells may not show up on any tests, but they increase the chance that the cancer will return.

That's where adjuvant therapy comes in. In some cases, following up primary treatment with adjuvant therapy can help stop the growth of cancer cells that may be hiding in the body. With the help of adjuvant therapy, more women are surviving breast cancer and staying cancer-free than ever before.

Types of adjuvant therapy
Adjuvant therapy can either be local or systemic.

• Local. Focuses on one area. Radiation that's done after a mastectomy is local adjuvant therapy. It is used to kill cancer cells that could be in the chest wall or nearby lymph nodes. (Radiation done with lumpectomy is considered part of primary therapy.)
• Systemic. Involves the use of drugs that travel throughout your body and attack the cancer.

There are three basic types of systemic adjuvant therapy for breast cancer:

• Chemotherapy. Slows or stops the growth of cancer cells, using a combination of two or more drugs.
• Hormone therapy. Most breast cancers need the hormone estrogen to grow. Hormone therapy lowers the level of estrogen in the body or blocks its action. The most common hormone therapy drug is tamoxifen.
• Biological therapy (also called targeted therapy). Breast cancers with high levels of a protein called HER2 tend to grow and spread fast. The drug trastuzumab (Herceptin®) can find and bind to this protein, slowing the cancer or stopping it from spreading.

Choosing the right adjuvant therapy
It's not always easy to know which type of adjuvant therapy would be right for you. Doctors base these decisions on many factors, including the size of the tumor, the type and stage of the cancer, and your age and overall health. Your personal preferences also play a role.

Adjuvant therapies can be life-saving, but they can also cause side effects. These can range from short-term and relatively minor (such as nausea, fatigue and hair loss) to more serious (such as blood clots, heart damage and leukemia). Your doctor can help you weigh the risks and benefits so you can make a good decision.

Related Articles Breast Cancer Breast Cancer: Types of Medication A Guide to Cancer Treatment

External Sources American Cancer Society. Detailed guide: Breast cancer. How is breast cancer treated? Accessed September 19, 2007. National Cancer Institute. Fact sheet. Adjuvant therapy for breast cancer: Questions and answers. Accessed September 19, 2007. National Cancer Institute. What you need to know about breast cancer. Accessed September 19, 2007.

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