The Status of Chemotherapy in Metastatic Breast Cancer: Insights for the Advanced Practitioner

© 2021 HarborsideTM Breast cancer is the most frequently diagnosed cancer in the United States and ranks second as the most common cause of cancerrelated death among women (Siegel et al., 2020). According to American Cancer Society (ACS) estimates, approximately 276,480 new cases of breast cancer would have been diagnosed in 2020, and greater than 42,000 deaths would be attributed to breast cancer (ACS, 2020). Although only 7% of all cancer-related deaths are from breast cancer every year, it is the leading cause of death among women between the ages of 40 and 49 years (Siegel et al., 2020). The death rate associated with breast cancer, however, has decreased by 1.3% annually from 2013 to 2017. While improvements in treatment and management coupled with early detection have accounted for the decreased death rate, as of January 2020, there were more than 3.5 million women with a history of breast cancer in the United States (ACS, 2020). Indeed, a vast majority of women with newly diagnosed breast cancer have localized or regional disease that is associated with almost 99% to 85.7% 5-year survival rates, respectively (ACS, 2020). The primary treatment goal for patients with early-stage disease is to reduce the probability of recurrence and spread with primary surgery (lumpectomy or mastectomy) of the breast and regional nodes, with or without radiation therapy and/or in conjunction with neoadjuvant and adjuvant systemic therapy. Despite the successes of these approaches, up to 30% of women with early-stage, nonmetastatic breast cancer will eventually develop distant metastatic disease, and almost 6% of newly diagnosed women have metastatic breast cancer (MBC) at diagnosis (ACS, 2020; Early Breast Cancer Trialists’ Collaborative Group, 2005). It has been estimated that more than 150,000 women are living with MBC, among whom 3 in 4 patients were initially diagnosed with earlier stage disease (Mariotto et al., 2017). Unfortunately for these women, MBC is not curable, and while meaningful improvements have been reported due to the introducJ Adv Pract Oncol 2021;12(suppl 2):3–5 Th is ar tic le is dis tri bu te d u nd er th e t er m s o f t he Cr ea tiv e C om m on s A ttr ibu tio n N on -C om m er cia l N on -D er iva tiv e L ice ns e, wh ich pe rm its un re str ict ed