Adjuvant therapy for breast cancer

Adjuvant therapy for breast cancer, a rapidly changing area of management, has made the difference to the breast cancer mortality figures over the last ten years. Initial treatments used hormonal manipulation such as ovarian ablation. This was followed by the development of tamoxifen, an oestrogen receptor antagonist. This has been followed by other hormonal regimes such as aromatase inhibitors, which have been used initially in the metastatic setting but are now being transferred to the adjuvant setting for post-menopausal women. Chemotherapy is used routinely for many breast cancers and is now well tolerated. Newer treatments include the use of taxanes and an antibody against HER-2 receptors; both of these are currently being evaluated in the adjuvant setting. Radiotherapy is a local adjuvant treatment that is given after breast conservation treatment surgery and in some cases is required after a mastectomy to decrease the risk of local recurrence.