Breast Cancer. Sarah Khan


The treatment of breast cancer depends on several factors, including the type and stage of cancer, hormone receptor status, HER2 status. I specialise in the use of systemic treatments for all stages of breast cancer including neoadjuvant ( before surgery), adjuvant (after surgery) and palliative treatment for patients with advanced disease.
These are some of the systemic therapies used for the treatment of breast cancer
Used for hormone receptor-positive (ER+/PR+) cancers:

  • Tamoxifen: For premenopausal and postmenopausal women.
  • Aromatase Inhibitors (Anastrozole, Letrozole, Exemestane): Mainly for postmenopausal women
  • Ovarian Suppression: For premenopausal women (e.g., with goserelin or surgery).
  • Targeted therapy– alpelisib, capivarsertib, elacestrant


Chemotherapy

Used if the cancer is:

  • Triple-negative (ER-/PR-/HER2-)
  • Her 2+ve
  • High-grade or aggressive
  • Lymph node-positive
  • Recurring or metastatic

Targeted Therapy


For HER2-positive cancers:

  • Trastuzumab (Herceptin) and Pertuzumab
  • T-DM1 (ado-trastuzumab emtansine)
  • Enhertu ( traztuzumab deruxetecan)
  • Tucatanib

Immunotherapy

For some triple-negative breast cancers (especially with PD-L1 expression):

  • Atezolizumab or Pembrolizumab, often combined with chemotherapy.


Bone-Modifying Agents


Used in metastatic disease to bones:

  • Bisphosphonates (Zoledronic acid)
  • Denosumab