Breast Cancer medications & treatments

Medically reviewed by  Jamie Winn, PharmD

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Breast cancer is the 2nd most common cancer behind skin cancer among women in the U.S. It accounts for about 30% of all new cancer cases in women each year, according to the American Cancer Society. It is estimated that 1 in 8 American women will develop invasive breast cancer in their lifetime. Male breast cancer is much less common, with a man’s lifetime risk being about 1 in 833.

In 2022, there are expected to be approximately 287,850 new cases of invasive breast cancer and 51,400 of non-invasive breast cancer in U.S. women. About 43,250 women in the United States will die from breast cancer in 2022.

What is breast cancer?

Breast cancer begins when healthy cells begin to grow out of control. It can start in one or both breasts. Breast cancer typically starts in the milk glands (lobules) or breast ducts that drain milk to the nipple. It less commonly begins in the fat and connective tissue (stroma) that surround the lobules and ducts.

Breast cancer causes

Developing breast cancer is due to a combination of risk factors such as:

• Age. Your risk increases as you get older, with most cases occurring after age 50.
• Genetic mutations. If you have certain inherited gene mutations (BRCA1 or BRCA2) you are at a higher risk of breast cancer.
• Gender. Females are much more likely to develop breast cancer than males.
• Personal history of breast cancer. If you have had breast cancer before, you are at an increased risk of getting it again.
• Family history of breast cancer. If you have a mother, sister, or daughter (first-degree relative) who has had breast or ovarian cancer, you are at an increased risk.
• Reproductive history. If you start your menstrual period before age 12, have your first live birth after age 30, or start menopause after age 55 you will have an increased breast cancer risk.
• Hormone therapy. If you have taken hormone replacement therapy with both estrogen and progestin, it increases the risk of breast cancer.
• Previous radiation therapy. If you have received radiation therapy on your chest at a young age, you have an increased risk of breast cancer.
• Lifestyle factors. Certain factors such as obesity, smoking, and lack of regular physical activity can increase your risk.

Breast cancer types

There are many types and subtypes of breast cancer that are typically classified based on where in the breast they begin to grow, how much they grow or spread, and what they look like under a microscope.

• Ductal carcinoma in situ (DCIS). DCIS is a non-invasive cancer where the cancer cells stay in the duct.
• Infiltrating or Invasive ductal carcinoma (IDC). IDC is the most common type of breast cancer. It is cancer that has spread outside your milk ducts and into nearby tissues and organs.
• Lobular carcinoma in situ (LCIS). LCIS is a non-invasive cancer that is in the milk-producing glands (lobules) of your breast.
• Invasive lobular carcinoma (ILC). ILC is a cancer that started in your lobules and spread to your lymph nodes and other parts of the body.
• HER2-positive breast cancer. Between 10% to 20% of breast cancers are dependent on a gene called human epidermal growth factor receptor 2 (HER2) to divide and grow. This type of invasive breast cancer is very aggressive but is susceptible to many medications.
• Hormone receptor-positive breast cancer. Breast cancers usually have high numbers of female hormone receptors that can fuel cancer growth. About 66% of breast cancers have estrogen and/or progesterone receptors. This type of cancer is usually treated with hormone therapy.
• Triple-negative breast cancer. This type of invasive breast cancer doesn’t have estrogen receptors, progesterone receptors, or HER2 receptors present in the breast tumor. Between 10% and 20% of breast cancers are triple-negative.
• Inflammatory breast cancer (IBC). This aggressive type of invasive cancer causes the breast to become swollen and inflamed. It is a rare type that only accounts for 1% to 5% of all breast cancers.
• Paget disease of the breast. This rare, non-invasive type of breast cancer starts in the ducts of the nipple, then spreads to the areola and the surface of the nipple.
• Phyllodes tumor. This is a very rare type that grows in the connective tissue (sarcoma) of your breast.
• Angiosarcoma. This rare sarcoma grows on the blood vessels or lymph vessels in your breast.

How is breast cancer diagnosed?

To confirm a breast cancer diagnosis, your doctor or healthcare professional may review your medical history, perform a physical exam and run some imaging tests such as a mammogram, ultrasound, and MRI.

Breast cancer symptoms

Many patients are diagnosed without having any symptoms of breast cancer. If you develop any of the following signs of breast cancer, you should discuss them with your doctor.

• Lump in your breast or underarm (armpit)
• Skin irritation or dimpling
• Breast pain
• Nipple pain
• Nipple discharge (other than breastmilk)
• Change in the size or shape of your breast
• Nipple turning inward
• Red, dry, or flaking skin of the nipple or breast

Imaging tests

If a suspicious area is found in your breast during screening, your doctor may run the following tests to confirm or rule out breast cancer:

• Diagnostic mammogram. This procedure uses low-dose x-rays to take pictures of your breast. It is often used if you already have symptoms such as a lump or nipple discharge.
• Breast ultrasound. Ultrasound uses high-frequency sound waves through your breast to look at abnormalities seen on a mammograph or felt by a physical exam. It can tell you if the mass is a fluid-filled cyst which is usually not cancer or a solid mass that may be cancer.
• Magnetic resonance imaging (MRI). MRI uses magnets and radio waves to produce detailed images of your breast. It is typically used to screen high-risk women or to determine the size and specific location of a tumor within your breast.

Breast biopsy

A breast biopsy is a procedure where your doctor will remove a small amount of breast tissue or fluid for microscopic examination by a pathologist. Biopsies are the only test that can confirm that the abnormal area is cancer.

What are some breast cancer treatment options?

Surgery is typically the first-line treatment of breast cancer. Radiation therapy and medications are also used along with surgery to help shrink tumors before surgery or kill any remaining breast cancer cells after surgery.

Surgery

Surgery is the most common treatment for breast cancer. There are different types of surgery that can be performed, depending on the situation.

• Mastectomy. A mastectomy is the surgical removal of the entire breast as well as the neighboring lymph nodes. Your doctor may remove both breasts in a double mastectomy.
• Lumpectomy. This procedure, which is also called breast-conserving surgery, is used to remove the tumor along with a margin of healthy tissue around it. A lumpectomy helps to preserve as much of your breast as possible.
• Breast reconstruction. If you have had a mastectomy or lumpectomy, you may consider having breast reconstructive therapy. A plastic surgeon will recreate your breast(s) using tissue from another part of your body or synthetic materials.
• Sentinel lymph node biopsy. This is a procedure where a surgeon uses injected dye to find and remove 1 to 3 lymph nodes under your arm that cancer might have spread to. The lymph nodes are then examined for evidence of cancer cells.
• Axillary lymph node dissection. In this procedure, your surgeon will remove many lymph nodes from under your arm to be examined for cancer cells. It is not used as often as it once was because it causes more side effects such as lymphedema than a sentinel lymph node biopsy.

Medications 

• Chemotherapy. Neoadjuvant chemotherapy is used before surgery to shrink tumors to make them easier to remove. Adjuvant chemotherapy is also given after surgery to kill any cancer cells that remain in the body. Some chemotherapy drugs used to treat breast cancer include Adriamycin (doxorubicin), Taxol (paclitaxel), Trexall (methotrexate), and Paraplatin (carboplatin).
• Hormone therapy. Also called endocrine therapy, it is an effective treatment for tumors that test positive for estrogen or progesterone receptors. These tumors need these hormones to grow. By blocking the hormones, it can help prevent cancer recurrence and death.
• Radiation therapy. Radiation therapy uses high-energy x-rays or other particles to destroy cancer cells or slow their growth. This procedure is usually performed by a radiation oncologist. Radiation therapy is often used as the primary treatment if surgery is not an option or you cannot take chemotherapy. In some cases, it is used after a mastectomy to treat the chest wall and neighboring lymph nodes.
• Immunotherapy. Immunotherapy helps your immune system recognize and attack cancer cells. It is typically used in advanced breast cancer. Some systemic therapy options include immune checkpoint inhibitors such as Keytruda (pembrolizumab) and Tecentriq (atezolizumab).
• Targeted therapy. Medications such as Perjeta (pertuzumab) and Herceptin (trastuzumab) target proteins, genes, and other factors specific to your cancer to stop its growth. Your doctor may run genetic tests to identify these specific factors to help determine the most effective treatment. Targeted therapy typically causes less damage to healthy tissue than chemotherapy or radiation.

What is the best medication for breast cancer? 

The best medication for the treatment of breast cancer will depend on the individual’s specific medical condition, medical history, medications that the individual is already taking that may potentially interact with breast cancer medications, and the individual’s potential response to the treatment. It is advisable to always speak with your healthcare provider about the best treatment plan for you. The table below includes a list of the most prescribed or over-the-counter breast cancer medications approved by the Food and Drug Administration (FDA).

Best medications for breast cancer

Your healthcare provider will determine the right dosage based on your response to the treatment, medical condition, weight, and age. Other possible side effects may exist; this is not a complete list.

What are the most common side effects of breast cancer medications?

As with all medicines, those used for breast cancer will have some side effects, depending on the class you are taking:

• Chemotherapy drugs can cause you to have low white blood cell counts which increases your risk of infections. Some other common side effects include nausea, vomiting, hair loss, fatigue, stomach pain, headache, and weakness.
• Immunotherapy medications can cause joint and muscle pain, fatigue, rash, diarrhea, cough, nausea, vomiting, constipation, and itching.
• Targeted therapy medications can commonly cause fatigue, nausea, pain, diarrhea, headache, high blood sugar, chills, and fever.
• Hormone therapy can cause hot flashes, menstrual changes, nausea, bone pain, vaginal discharge, and fatigue.

What are some home remedies for breast cancer?

There are no home remedies or natural ways to treat or cure breast cancer. A combination of surgery, medications, and radiation are treatments you may need to treat this condition. After completing treatment, it’s very important to go to all of your follow-up appointments.

Some lifestyle changes and self-care measures that can help improve your quality of life, reduce your risk and detect breast cancer early which will increase your chance of survival include:

• Get regular breast cancer screenings from your doctor.
• Perform regular self-exams and notify your doctor of any new breast lumps or other changes.
• Get 30 minutes of exercise most days of the week.
• Maintain a healthy weight.
• Eat a healthy diet.
• Limit your alcohol intake.
• Stop smoking.

Frequently asked questions about breast cancer

Can breast cancer be cured?

While surgery and other treatments can remove your breast cancer, you are at a higher risk of developing it again. Regular screening is essential to catch it early if you have a recurrence.

What is the life expectancy of someone with breast cancer?

The 5-year survival rate for someone with breast cancer is 99% if it’s a localized tumor and 29% for metastatic breast cancer.

Which medications increase your risk of breast cancer?

If you have taken estrogen or progesterone to reduce menopausal symptoms, you are at a higher risk of breast cancer. You also have a relatively small increased risk if you have taken oral contraceptives for more than 5 years.

How often should you do a self-exam of your breasts?

You should perform a breast exam once a month. Be sure to notify your doctor if you notice any breast changes such as new lumps, dimpling of your breast, nipple inversion, red or scaly breast skin, or nipple discharge.

Where can I find info about clinical trials?

Breast cancer research is always looking for new treatments. Go to the National Cancer Institute for more information.

Related resources for breast cancer

• Breast cancer practice essentials. MedScape
• Risk factors for breast cancer. StatPearls, National Library of Medicine
• About breast cancer. Breastcancer.org
• What is breast cancer? Cancer.org
• Breast cancer symptoms and causes. MayoClinic
• What is breast cancer? Centers for Disease Control and Prevention