Systematic treatment (therapy) of breast cancer

Systemic treatment (therapy) means treatment in the form of medication. Most treatments can be prescribed and/or administered through the day hospital or through the consultation. For more information, please contact your treating physician.

The type of medication given depends on the type of breast cancer, the stage and the age/general condition of the patient. A combination may sometimes be recommended.

The medication can be administered on three moments:

  1. before the operation of the breast (neo-adjuvant): aims to reduce the size of the tumour and gives us an idea how the tumour reacts to the medication;
  2. after surgery of the breast (adjuvant): aims to reduce the risk of disease relapse;
  3. or in case of metastasis.

In case of metastases, medication can also be given with the aim of reducing or controlling the malignant tumour.

We distinguish 4 groups chemotherapy, antihormone therapy, targeted therapy and immunotherapy.


Chemotherapy inhibits cell division and cell growth. In addition to cancer cells, healthy cells will also be inhibited, which may lead to side effects.

Chemotherapy is usually administered in a day hospital, which means that patients can go home the same day and hospitalisation is usually not necessary. Depending on the type of chemotherapy, it may be decided that it is safer to place a port catheter.

Antihormone therapy

Antihormone therapy is a treatment directed against tumours sensitive to hormones (oestrogen or progesterone). These tumours contain the so-called "receptors" for these hormones.

Tumours sensitive to oestrogen or progesterone grow faster when the receptors in the tumours come into contact with these hormones. Antihormone treatment stops these hormones from stimulating the tumour.

Sometimes the tumour can become insensitive to these drugs; this is known as "resistance". In recent years, a number of drugs have been developed that counteract this resistance.

Targeted therapy

In addition to hormonal receptors, the HER2 receptor can also be present on the breast cancer cell. This receptor receives signals, which stimulate the growth of breast cancer cells. Medication targeting this receptor will stop the growth and destroy the breast cancer cell.

In healthy cells, the Her2neu receptor plays a less important role, which also results in fewer side effects . Moreover, tumours in which the Her2neu receptor is not abnormal will not respond (or respond less) to the medication directed against the Her2neu receptor. Hence the name 'targeted' therapy.

Targeted therapy is usually administered at the day hospital this means that patients can go home on the same day and hospitalisation is usually not necessary.

In metastatic breast cancer (metastasised), it may be decided to carry out genetic testing of the tumour (NGS = next generation sequencing). This technique has been developed in recent years and detects abnormalities in the tumour genes (mutations). This may require a new biopsy. On the basis of the results, a treatment can be chosen that specifically acts on this abnormality in the tumour.


Immunotherapy is a treatment in which the own immune system is activated to attack the cancer cells.

Last modified on 5 July 2022


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