Types of secondary breast cancer treatment

Your specialist will take a number of different factors into account when deciding which treatment is best for you, including

• The part of your body affected
• Any treatment you have already had
• Your general health
• Whether you have pre or post menopausal breast cancer

Secondary breast cancer may respond to several types of treatment. Doctors try to start with treatment that has as few side effects as possible.

Remember that secondary breast cancer can often be kept under control for a long time with treatment. Scientists and doctors are working constantly to develop new treatments through research. If you are interested in finding out more about clinical trials, you may want to look at our

• Pages about breast cancer research
• Information explaining clinical trials
• Database of clinical trials

All our information on trials is written in plain English. To find trials, you can go to the clinical trials database or just click on the breast cancer trials button in the left hand menu of any page in the breast cancer section.

For most people, finding out they have secondary cancer and need more treatment comes as a great shock. Even if you thought the cancer had come back, you may be shocked at your feelings when your fears are confirmed. Don't feel shy about asking how the treatment works or may affect you. You may want to talk over the aims and side effects of your treatment with your family and friends. Or with a counsellor or your breast care nurse. You may find that being involved in the decision about your treatment helps you feel more in control over the cancer and your feelings.

Your doctor will understand if you don't want to decide about treatment straight away. You may want to find out about other treatment options. Or you may just need more time to come to terms with your new situation. It can be hard to take in a lot of information about treatment, especially if you have just learned that the cancer has spread and are feeling shocked and upset. You can take some time to decide what to do.

Hormone therapy is a common treatment for secondary breast cancer. It can often shrink and control the cancer wherever it is in the body. If one hormone therapy stops working so well, another may then help.

Your doctor may arrange for particular tests on your cancer cells. Many breast cancer cells have proteins called oestrogen receptors. A cancer with oestrogen receptors is called oestrogen receptor positive or ER positive. The more oestrogen receptor positive cells a cancer has, the more likely it is that hormone therapy will work. Progesterone receptors can also be measured. A breast cancer with cells with many progesterone receptors is called PGR positive. Hormone receptor negative cancers do not respond as well to hormone treatments.

The Cochrane Collaboration has looked at all the research comparing hormone therapy with chemotherapy for secondary breast cancer. They found that both treatments are as good as each other, but hormone therapy has fewer unpleasant and harmful side effects. Doctors may try hormone therapy first if the cancer is ER positive. Or for cancer in the liver or lungs they may give chemotherapy first and then hormone therapy.

If your cancer is hormone receptor negative, your specialist may suggest chemotherapy. Chemotherapy drugs treat cancer cells all over the body. It is often the best treatment for breast cancer that has spread to the liver or lungs.

Your doctor may suggest that you have treatment with a biological therapy such as the monoclonal antibody Herceptin. Herceptin works by targeting and blocking a protein that stimulates breast cancer cells to grow and multiply. Not everyone with breast cancer will benefit from this treatment. It only works if your breast cancer cells make too much of a protein called HER2. Up to 3 out of 10 women with secondary breast cancer (30%) are HER2 positive and so may benefit from Herceptin. Sometimes Herceptin is combined with other treatments. 

You can find out more about treatment with Herceptin for secondary breast cancer in this section of CancerHelp UK.

Radiotherapy treats one area of the body at a time. So it is good for treating individual spots of cancer. Radiotherapy works well against secondary breast cancer cells in

• The bones
• The brain
• The skin near the breast or on the mastectomy scar

Whether or not you have had the menopause is also important in deciding the best treatment

• Premenopausal women have high levels of female hormones
• Postmenopausal women have low levels of these hormones

The hormone levels influence which treatment the secondary breast cancer cells will respond to best. If you are premenopausal with secondary breast cancer, your doctor may suggest that you have radiotherapy or hormone therapy to stop the ovaries making hormones. Some women have surgery to remove their ovaries. Any of these treatments can help to control your breast cancer. 

Your doctor also considers

• Whether the secondary cancer is growing slowly or more quickly
• Which treatment, if any, you had along with your original surgery

You can get another medical opinion if you want. It may help you decide about your treatment. Most doctors are happy to refer you to another specialist for a second opinion. On the other hand, you may already have enough on your mind – making decisions about treatments could make it even harder. In this case, don't feel you have to get involved in treatment decisions. Each woman has her own way of coping. Doctors will respect your wishes.

If the treatment you are having is not mentioned here it may be because it is a newer type of treatment. You might find it in the clinical trial database, if it is currently being tested in the UK. Or on our breast cancer research pages.