Most breast cancers, if caught early and treated effectively, can be beaten. And the newest breast cancer drugs are increasingly able to target specific challenges to survival. Knowing your options is an essential step, so read on for a roundup of the major types of drug treatments available.


Aromatase Inhibitors
Breast cancer is fueled by estrogen, a hormone present in three different forms in women’s bodies. Aromatase inhibitors (AIs) prevent the formation of the hormone estradiol in post menopausal women by interfering with the enzyme aromatase, which is necessary for estrogen production. Three FDA-approved AIs available in the U.S. are Arimidex (anastrozole), Aromasin (exemestane) and Femara (letrozole).

Femara has been shown to be effective in women with advanced breast cancer who have completed five years of Tamoxifen (Novaldex), a drug used in the primary treatment of breast cancer and prevention of future breast cancers. One study indicated a breast cancer recurrence reduction of 43% in women taking Femara.

Arimidex has also been shown to be effective in some women by shrinking large breast-cancer tumors to the point where they can opt for lumpectomy instead of more invasive breast cancer surgery such as mastectomy. Arimidex may eventually be shown to be more effective than Tamoxifen in shrinking tumors prior to surgery.

Selective Estrogen Receptor Modulators
SERMs block a tumor’s ability to use estrogen to fuel its growth. Research demonstrates that the SERM Tamoxifen reduces breast cancer recurrence by 48%. Another, Raloxifene (Evista), shows promise of reducing breast cancer recurrence by as much as 66%. Researchers are also attempting to use Tamoxifen to prevent breast cancer in women. The Breast Cancer Prevention Trial tested whether women at high risk for developing breast cancer can reduce risks by using Tamoxifen. Results suggest a 45% breast-cancer-incidence reduction when Tamoxifen is used as a preventative. Overall, the study showed a 49% reduction in invasive breast cancers and a 45% reduction in non-invasive breast cancer incidence.


Anti-angiogenic Drugs
These drugs stop the development of new blood vessels that supply cancerous tumors with oxygen and nutrients for growth. Other terms for this type of drug are antivascular endothelial growth factor (anti-VEGF) or angiogenic inhibitors. A promising drug in this category is Avastin (Bevacizumab). Studies show that when Avastin is combined with chemotherapy, breast-cancer survival is improved by as much as 49%.

This is a major advancement for treatment of patients with metastatic breast cancer, or cancer that has spread to other organs from the original tumor site. This is the most advanced form of breast cancer and accounts for one in 10 of all breast-cancer diagnoses.


Monoclonal Antibody Drugs
Monoclonal antibodies are the proteins produced by your immune-system cells to attack invasive cells. The proteins attach themselves to the cancer cells that the antibodies recognize as abnormal tissue and slow the growth of the tumor cells.

Herceptin (Trastuzumab) slows or stops the growth of cancer cells stimulated by the HER2/neu protein by as much as 52% when compared to women treated with chemotherapy alone. The HER2/neu protein overproduces in approximately 20% of breast cancers. Many experts believe Herceptin is the way of the future for breast-cancer drug development in that it targets a particular protein of the cancer cell. When it successfully prevents the protein from carrying out its action, it slows or stops the growth of the cell.

Leading experts recommend an annual mammogram for women 40 and older—and some local health centers will even provide one for women at no charge on their 40th birthday. The New England Journal of Medicine reports that if you’re 50 or younger, have had no signs or history of breast cancer, aren’t pregnant, and don’t have implants, your best mammogram is a digital one.

In fact, women who have dense breasts or women who are perimenopausal (who have had their last period within a year of the mammogram) get the best outcomes with digital mammography.

For women in general, film and digital mammography are equally effective—unless you fall within this unique age and characteristics category. Then it’s best to go digital.

• Lump in breast (any size)
• Thickening of tissue
• Puckering of the skin
• Change in color
• Swollen lymph node in chest or armpit
• Wrinkling of the skin
• Newly inverted nipple
• Change in nipple direction and height

About the Author: Joan Edwards, RNC, CNS, is an assistant clinical professor at Texas Woman’s University’s Houston campus and the AWHONN 2006 president.