Early stage disease Standard treatment is surgery with adjuvant chemotherapy and radiotherapy. Surgery is primarily used for early stage disease and may be either a lumpectomy or a mastectomy. Studies have found that the overall survival for lumpectomy and radiotherapy was the same or higher than for a mastectomy for<unk>  patients. Neoadjuvant chemotherapy (before surgery) is very frequently used for<unk> s as they are more susceptible to platinum-based regimen, allowing for a higher rate of<unk> -conserving surgeries. Important details on the individual responsiveness of particular<unk> s can be gained from evaluating the response to this form of chemotherapy. However, the improvement in<unk>  conservation is only 10–15% and the clues to individual responsiveness have conclusively proven to make an improvement in outcomes. Early stage<unk>  is generally very susceptible to chemotherapy and can lead to a pathological complete response (pCR) i.e. no detectable<unk>  cells in the<unk>  or lymph nodes. Although this does not always translate into overall survival. Chemotherapy used to treat early stage<unk> s are: * anthracylines * alkalating agents such as cisplatin and carboplatin. These are particularly effective with BRCA positive cases. These agents cause DNA damage which is unable to be repaired when there are BRCA defects leading to cell death. * taxanes Late stage disease Late stage disease is known as metastatic<unk>  (mTNBC). Treatment depends on whether the tumour tests positive for the programmed death cell ligand 1 (PD-L1) protein or BRCA gene mutation. Also known as immunotherapy the presence of PD-L1 on<unk>  cells mates with an associate PD-1 receptor on the bodies own immune killer T cells which prevents the T cell from further attacking the<unk>  cell. By blocking these receptors the T-cells can attack both<unk>  cells and healthy cells. The following treatment is recommended by the American Society of Clinical Oncology (ASCO) for metastatic<unk> : * mTNBC +PD-L1: 1st line: offered chemo + immune checkpoint inhibitor * mTNBC -PD-L1: 1st line: single-agent chemo; 3rd line: sacituzumab govitecan * mTNBC +BRCA: patients previously treated with chemotherapy in the neoadjuvant, adjuvant, or metastatic disease should be offered PARP inhibitor rather than chemotherapy. Sacituzumab govitecan (Trodelvy ) is an anti-Trop-2 antibody linked to SN-38, developed by Immunomedics Inc. (now Gilead Sciences). It was approved by the FDA on 22 April 2020 for the treatment of metastatic<unk> . Sacituzumab govitecan had previously received FDA priority review,<unk> hrough therapy, and fast track designations.
Triple-negative breast cancer
Hereditary lobular breast cancer
Hormone receptor positive breast tumor
Paget's disease of the breast
Mucinous carcinoma of the breast
Medullary breast carcinoma
Inflammatory breast cancer
Hormone-sensitive cancer