Breast Cancer Management and Treatment Strategies

Breast cancer management encompasses a multidisciplinary approach that integrates early detection, surgery, radiation, systemic therapies and survivorship care. Surgical options range from breast-conserving lumpectomy to mastectomy, often accompanied by sentinel lymph-node biopsy or axillary dissection. Radiation therapy targets residual microscopic disease and reduces local recurrence. Systemic treatments include cytotoxic chemotherapy, endocrine therapy for hormone-receptor-positive tumours, targeted agents for HER2-positive disease and emerging immunotherapies for selected subtypes. Molecular profiling has refined risk stratification, guiding the choice and duration of adjuvant therapies. Ongoing efforts aim to personalise treatment according to tumour biology, minimise toxicity, preserve quality of life and address disparities in access to care worldwide.

Research from Nature Portfolio

Recent studies have explored immunotherapy combinations and molecular determinants of endocrine resistance. In metastatic invasive lobular carcinoma, weekly carboplatin followed by PD-L1 blockade induced a clinical benefit rate of over 25%, with evidence of enhanced CD8+ T-cell infiltration and immune-checkpoint expression. This trial underscores the feasibility of subtype-specific immunotherapy approaches. Concurrent work on postmenopausal oestrogen-receptor-positive, HER2-negative breast cancers used short-term biomarker changes to distinguish poor responders to aromatase inhibitors. Poor response associated with low ESR1 expression, high proliferation signals and non-luminal subtypes, while high immune infiltration and TP53 mutations marked a subgroup with divergent biology. These findings offer molecular handles for predicting resistance and tailoring endocrine strategies.

Breast Cancer Management and Treatment Strategies publication trend

The graph below shows the total number of articles in breast cancer management and treatment strategies across all publications each year (not limited to Nature Index journals).

Technical terms

Adjuvant therapy: Treatment given after primary surgery to eradicate residual disease and reduce recurrence risk.

Neoadjuvant therapy: Treatment administered before surgery to shrink tumours and assess in vivo response.

Immune checkpoint blockade: Immunotherapy that inhibits regulatory pathways (e.g. PD-1/PD-L1) to enhance antitumour T-cell activity.

Aromatase inhibitor: Endocrine agent that suppresses oestrogen synthesis by inhibiting the aromatase enzyme in postmenopausal patients.

Tumour-infiltrating lymphocytes: Immune cells within the tumour microenvironment that reflect host antitumour immune responses.

References

1. Anthracycline-containing and taxane-containing chemotherapy for early-stage operable breast cancer: a patient-level meta-analysis of 100 000 women from 86 randomised trials. The Lancet (2023).
2. Accelerated versus standard epirubicin followed by cyclophosphamide, methotrexate, and fluorouracil or capecitabine as adjuvant therapy for breast cancer (UK TACT2; CRUK/05/19): quality of life results from a multicentre, phase 3, open-label, randomised, controlled trial. The Lancet Oncology (2023).
3. PD-L1 blockade in combination with carboplatin as immune induction in metastatic lobular breast cancer: the GELATO trial. Nature Cancer (2023).
4. Molecular profiling of aromatase inhibitor sensitive and resistant ER+HER2- postmenopausal breast cancers. Nature Communications (2023).