Cancer Genetics and Epigenetics 2017, Vol.5, No.1, 1
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effect a radical cure which is given priority to, and keep the principle of function and appearance’s
complementary.
Radiotherapy
Radiation treatment includes before or after operation for auxiliary radiation therapy, including radical palliative
radiotherapy of advanced breast cancer. Indications: (1) the primary tumor maximum diameter is of 5 cm or more,
or the tumor invades the breast skin or chest wall; (2) the axillary lymph node metastasis are 4 or more; (3) the
lymph node metastasis is of 1 ~ 3 for T/T 2 1, the data also supports the value of postoperative radiotherapy. It
contains at least one of the following factors .The patients are likely to be higher risk of recurrence, and
postoperative radiotherapy is more meaningful: age 40 years old or older, or less number of cleaning axillary
lymph node < 10, transfer rate > 20%, hormone receptor negative, its Her - 2 / neu expression, etc (Budach et al.,
2015). For ILC, radiotherapy and infiltrating ductal carcinoma are same to IDC.
The Chemical Drugs
As an integral part of comprehensive treatment of breast cancer, the purpose of systemic chemotherapy is the
eradication of residual tumor cells within the body, in order to improve the cure rate of surgery. Postoperative
adjuvant chemotherapy of breast cancer improves disease-free survival in patients with breast cancer (DFS) and
overall survival (OS) significantly. But in a retrospective study to evaluate the benefit of chemotherapy and the
interaction between estrogen receptor status, proves that the ER negative breast cancer patients can benefit from
chemotherapy more (Delpech et al., 2013).
Chemotherapy, 4 cycles of AC (doxorubicin and cyclophosphamide) is equivalent to 6 cycles of CMF, and 6
cycles of anthracycline chemotherapy has more advantages. Joining the paclitaxel can improve the curative effect
of chemotherapy, anthracycline plus paclitaxel reduce a third of breast cancer mortality (Sonnenblick et al., 2015).
More and more applied in patients with breast cancer, neoadjuvant chemotherapy will shrink tumors .So that it
can be able to surgery in patients with locally advanced breast cancer, and it’s able to put patients who could not
do brease-conserving surgery. For Her - 2 positive patients, before the application of targeted therapy, which
should be chosen that is associated with paclitaxel of neoadjuvant chemotherapy, can increase the rate of
pathologic complete response (Park et al., 2015). Invasive lobular carcinoma is not sensitive to neoadjuvant
chemotherapy, and can’t increase the probability of breast-conserving surgery, studies have shown that the cut
edge positive rate of ILC’s breast-conserving surgery is 16% higher than that of IDC (Braunstein et al., 2015).
Endocrine Therapy
Breast cancer, a kind of tumors, is closely related to the endocrine, as a result of the ILC immunohistochemical
positive rate of ER and PR are obviously higher than that of other types of breast cancer, so the endocrine therapy
appears especially important. At present, the endocrine therapies for breast cancer include anti-estrogen drugs
such as tamoxifen (TAM), toremifene, aromatase inhibitors (AI) (letrozole, anastrozole, exemestane, etc.),
progesterone (megestrol, medroxyprogesterone) and luteinizing hormone (LH - RH) release antagonists, Clinical
treatment choice is the first and the second above all, and choosing the appropriate drugs should be based on
patients’ menstrual state. General premenopausal patients preferred tamoxifen, oral tamoxifen 5-10 years,
tamoxifen with thromboembolism, and endometrial cancer closely related (Christinat et al., 2013). The
postmenopausal patients preferred the third generation of aromatase inhibitors, reach menopause state by drugs or
surgery can also choose aromatase inhibitors (Davies et al., 2013). Recurrent metastatic breast cancer (MBC)
endocrine therapy can choose fulvestrant.
The Molecular Targeted Drug Therapy
Molecular targeted drugs, a new treatment method is following the surgery, radiotherapy and chemotherapy after
the three traditional modes. Targeted therapy mechanism utilizing the tumor cells can express, and the normal
cells express specific genes or gene products little or not, maximize killing tumor cells molecular targeted drugs
for the treatment of breast cancer are marketed, Trastuzumab, Pertuzumab, Lapatinib, bevacizumab, etc, are
