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6 treatment settings, 6 with more than one named option. Each section lays out the options the standard of care names, what each is for, the trials behind them with their recorded results, the side effects and cautions on record, and questions to ask. Built from the cancer page's standard-of-care rows; nothing here is advice for your case.
Genomic assay on node-negative and one to three node-positive tumours; chemotherapy for a high recurrence score, for premenopausal women with node-positive disease and a score up to 25, and for clinically high-risk tumours without a low genomic score.
A 21-gene test that tells most women with early hormone-positive breast cancer whether they can safely skip chemotherapy.
A 70-gene test that tells whether an early breast cancer is genomically low or high risk, used to decide who can skip chemotherapy.
Averages across everyone diagnosed, often years ago. A median is the middle of a group: half the people counted lived longer than the figure shown, and some lived far longer. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.
No chemo benefit postmenopausal; iDFS HR 0.60 with chemo premenopausal.
Averages across everyone diagnosed, often years ago. A median is the middle of a group: half the people counted lived longer than the figure shown, and some lived far longer. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.
No side-effect rates or interaction flags are recorded for these options yet. The side-effect lookup and interaction checker cover the products that have them.
Add these to your appointment list, or take the full question set for this cancer.
Aromatase inhibitor for postmenopausal women; tamoxifen, or ovarian function suppression with an aromatase inhibitor for premenopausal women at higher risk (SOFT and TEXT); five years, extended to seven to ten in node-positive disease.
Daily pills that stop the body making oestrogen after menopause, the backbone of hormone therapy for most breast cancers.
Exemestane is a steroidal aromatase inhibitor, the partner of everolimus and the agent tested with ovarian suppression in young women.
The original targeted cancer drug (1977): a pill that blocks oestrogen's effect on breast cancer and halves recurrence, still essential for premenopausal women.
Monthly or 3-monthly injections that switch off the ovaries, letting premenopausal women use aromatase inhibitors and lowering recurrence in higher-risk cases.
Pills that block or remove oestrogen signalling, the mainstay of treatment for hormone-driven breast cancer for 50 years.
Exemestane + OFS: DFS and DRFI improved; no OS difference at 12 years.
Add these to your appointment list, or take the full question set for this cancer.
Abemaciclib for two years (monarchE, node-positive high-risk disease) or ribociclib for three years (NATALEE, stage II to III) alongside the aromatase inhibitor.
Abemaciclib was the first CDK4/6 inhibitor approved after surgery for high-risk hormone-positive breast cancer.
Ribociclib is the CDK4/6 inhibitor with the most consistent survival benefit, approved for a broad population of early breast cancer patients since 2024.
Pills that stop the cell-division engine, added to hormone therapy for the most common type of breast cancer.
iDFS HR 0.68.
iDFS HR 0.75.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Neutropenia · 37-46% any grade; 19-32% grade 3-4 | 42% | 19% |
| Diarrhoea · 81-90% any grade; 8-20% grade 3 across trials | 85% | 8% |
| Infections · monarchE / MONARCH 2 | - | 3% |
| Venous thromboembolism · 2-5% across trials | - | 2% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Neutrophils decreased · NATALEE / MONALEESA-2 | 94% | 45% |
| ALT/AST increased (grade 3-4) · 8-11% across trials | - | 8% |
| Lymphocytes decreased · NATALEE / MONALEESA-2 | 97% | - |
| Leukocytes decreased · NATALEE / MONALEESA-2 | 95% | - |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.
One year of adjuvant olaparib after chemotherapy for high-risk disease (OlympiA).
Olaparib was the first PARP inhibitor, and turned an inherited BRCA mutation from a risk factor into a drug target, including after surgery in breast cancer.
A test of the DNA you were born with, to find inherited risk genes such as BRCA or Lynch syndrome.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Anaemia · OlympiA adjuvant, n=911 | 24% | 9% |
| Neutropenia · OlympiA adjuvant, n=911 | 16% | 5% |
| Leukopenia · OlympiA adjuvant, n=911 | 17% | 3% |
| Fatigue · OlympiA adjuvant, n=911 | 42% | 1.8% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.
Breast-conserving surgery with hypofractionated whole-breast radiotherapy or mastectomy, sentinel node biopsy, and regional nodal irradiation when nodes are involved.
Removing just the first lymph node a tumour drains to, instead of all of them, to check for spread.
Fewer, larger daily doses instead of the classic five to seven weeks of small ones. Large trials in breast and prostate cancer showed the same control with the same or fewer late effects and far less time in hospital.
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
Add these to your appointment list, or take the full question set for this cancer.
Zoledronic acid or denosumab during aromatase inhibitor therapy in postmenopausal women reduces fractures, and bisphosphonates also reduce bone recurrence.
Zoledronic acid (Zometa) is a fifteen-minute infusion given every few weeks or months to strengthen bone and prevent fractures, spinal cord compression and the need for radiotherapy in people with myeloma or cancer that has spread to bone; it also treats dangerously high calcium caused by cancer.
Denosumab is an injection under the skin that blocks the signal driving bone breakdown. As Xgeva it prevents fractures and other bone complications in people whose cancer has spread to bone or who have myeloma; as Prolia it treats osteoporosis, including bone loss caused by hormone therapy for breast and prostate cancer.
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
No side-effect rates or interaction flags are recorded for these options yet. The side-effect lookup and interaction checker cover the products that have them.
Add these to your appointment list, or take the full question set for this cancer.