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Treatment for breast cancer is becoming more personalized. There is ongoing research to tailor therapies to best treat each person’s breast cancer. Factors related to the tumor itself (such as hormone receptor status) can guide treatment. And, factors related to each person (such as genes) may also help in choosing which treatments will work best.
Learn about promising, new treatments for metastatic breast cancer.
Gene expression profiling
Gene expression profiling is a promising tool to help guide breast cancer treatment. These tests do not show genetic information about a person, but rather information about the genes in a tumor. The gene profiles of some tumors may help predict whether the cancer is more likely to recur (when cancer comes back) and metastasize (when cancer spreads to other organs) . Tumors with gene profiles showing a high risk of recurrence or metastasis may be more likely to respond to chemotherapy than tumors with gene profiles showing a low risk of recurrence.
At this time, Oncotype Dx® is the only gene expression profiling tool widely used in the United States. Oncotype Dx can be used to help make chemotherapy treatment decisions in some people with estrogen receptor-positive cancers who are going to have hormone therapy [43-44]. Other gene profiling tools and their use in guiding treatment plans are still under study .
Learn more about Oncotype Dx.
MammaPrint® is a gene expression profiling tool for lymph node-negative breast cancer (it can be used for either hormone receptor-positive or hormone receptor-negative tumors).
MammaPrint is still mostly limited to the research setting in the U.S. because it requires special preparation of the biopsy tissue that is different from what is generally done here. It is more commonly used in Europe.
Subtypes of breast cancer
Molecular and genetic differences in breast cancers may be useful in guiding the development of new targeted therapies. Most studies divide breast cancers into four molecular subtypes: luminal A, luminal B, triple negative/basal-like and HER2 type. Although mainly used in research setting, these subtypes may be useful in tailoring treatment in the future.
Learn more about subtypes of breast cancer.
CYP2D6 and tamoxifen
CYP2D6 is an enzyme that affects how the body metabolizes (breaks down and uses) certain medications. For this reason, researchers were interested in whether certain forms of the gene related to CYP2D6 function affected the hormone therapy tamoxifen. The largest studies to date have found no difference in the risk of breast cancer recurrence in women with gene variations related to less CYP2D6 function compared to risk in women with genes related to normal or high CYP2D6 function [53-54]. There is no role for routine testing of CYP2D6 in women taking tamoxifen.
Certain medications can interfere with CYP2D6 function and probably should be avoided while taking tamoxifen . For example, some antidepressants, such as fluoxetine (Prozac), buproprion (Wellbutrin) and paroxetine (Paxil), can interact with CYP2D6 and may affect how tamoxifen works in the body . If you are considering taking tamoxifen, talk to your health care provider about potential drug interactions.
Learn more about tamoxifen.
Research is ongoing to improve all areas of treatment for breast cancer. New therapies are being studied in clinical trials. The results of these studies will decide whether these therapies become part of standard care. After discussing the benefits and risks with your health care provider, we encourage you to consider joining clinical trials of new therapies.
BreastCancerTrials.org in collaboration with Susan G. Komen® offers a custom matching service that can help you find a clinical trial that fits your health needs.
Learn more about clinical trials.
Our commitment to research
At Susan G. Komen®, we are committed to ending breast cancer forever by energizing science to find the cures and ensuring quality care for all people, everywhere. Our global research grants and scientific programs are essential driving forces for achieving this mission. Many of the world’s leaders in breast cancer research have been supported by Komen’s Research and Scientific Programs – including three Nobel Laureates. Komen’s funding has supported research that has resulted in a better understanding of breast cancer; earlier detection; personalized, less invasive treatments for what was once a “one-treatment-fits-all” disease; and improved survival rates. Learn more about the exciting research we are funding.
*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date at this time.