Breast cancer is the most common malignancy among women and the second leading cause of death for women worldwide. It is bracketed into a few chief molecular subtypes according to hormone and growth factor receptor expression. In recent years, significant advancements have been made in the discovery of new medicines for treating breast cancer.

Improved comprehension of the biologic divergency of this cancer has allowed the development of a more effective and personalised approach to treatment. The giant steps in molecular biology and immunology have helped create highly targeted therapies for many forms of breast cancer.

The emergence of novel treatment pathways and medicines represents a paradigm shift towards personalised medicine. It is now established that optimal diagnosis and treatment models customised to address individual patient risk and expected subtypes are critical, supporting precision oncology for breast cancer.

New treatments for breast cancer

Targeted therapy: This approach uses drugs that target specific proteins on or inside cancer cells to halt their growth and spread. Also known as precision medicine, this therapy is used to treat certain types of breast cancer, especially those that are HER2-positive or have other specific mutations.
Immunotherapy: Results in clinical trials show that immunotherapy could potentially be effective against two less common aggressive subtypes, HER2-positive and triple-negative breast cancer.
Bone-directed treatments: Breast cancer is likely to spread to the bones. There are specific drugs which prevent that spread or treat the condition when it happens. These drugs also lessen the risk of fractures in bones weakened by breast cancer.
Liquid biopsy: These tests are used by doctors to look for circulating cancer cells and tumour DNA, very small amounts of DNA from a cancer tumour in the bloodstream. This way, they can watch how the tumour evolves during treatment and better tailor strategy to suit individual patients. These tests can also track mutations in tumours, helping doctors to pivot when they need to.
Advancements in surgery: Recent advancements in breast cancer surgery are aimed at personalisation, minimally invasive techniques, better cosmetic outcomes and improved tumour localisation using oncoplastic surgery, 3D imaging, new fat graft techniques and nipple-sparing mastectomies.
Genetic testing: This test analyses one’s inherited DNA from a blood, saliva or cheek swab sample to identify mutations in genes like BRCA1 and BRCA2 passed down from a parent. This is to determine the person’s inherited risk of developing breast cancer and other cancers later in life. Knowing about such mutation, the doctors might decide on a more extensive surgery, like a bilateral mastectomy, due to the elevated risk of developing a new cancer in either breast.
Genomic test: This test analyses the genes within the tumour tissue to understand its specific characteristics, and its response to specific treatments like chemotherapy and endocrine therapy. It can tell the doctors if chemotherapy is required post-surgery, guides the choice of targeted therapies and helps determine if a patient with early-stage breast cancer can avoid chemotherapy entirely. It can also inform decisions about extending endocrine therapy in certain cases, like the breast cancer index (BCI) test.