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Research into treatment for early breast cancer

Researchers around the world are looking at better ways to treat early breast cancer Open a glossary item and manage treatment side effects.

Go to Cancer Research UK’s clinical trials database if you are looking for a trial for early breast cancer in the UK. You need to talk to your specialist if there are any trials that you think you might be able to take part in.

Some of the trials on this page have now stopped recruiting people. It takes time before the results are available. This is because the trial team follow the patients for a period of time and collect and analyse the results. We have included this ongoing research to give examples of the type of research being carried out in early breast cancer.

Click on the ‘recruiting’, ‘closed’ and ‘results’ tabs to make sure you see all the trials.

Surgery

Doctors usually remove early breast cancer with surgery. Researchers are looking at new ways to improve surgery. 

New devices to help surgeons remove the cancer

Surgeons are looking at ways to improve breast conserving surgery. For this type of surgery they only remove the cancer and a border (margin) of surrounding tissue.

Some women need further surgery if the margin is not clear of cancer. To avoid this, surgeons are researching new devices to use in surgery. The devices check whether they have removed all the breast cancer. They include the MarginProbe, Intelligent Knife and magnetic markers. 

Treatment of the lymph nodes in your armpit

Researchers are comparing women who have treatment to the lymph nodes in their armpit with women who don’t. They want to find out if treatment to the armpit is necessary.

Appearance after surgery

To help prepare women for their surgery, they can look at pictures of other women who have had the same operation surgery. These are usually standard two dimensional (2D) photographs.

Researchers in one hospital are using three dimensional (3D) digital photography. This provides a predicted image of what their breast is likely to look like. They hope this will help women feel better prepared and more pleased with their outcome. They also hope this is something that can be used in the future for all people before breast cancer surgery. 

Chemotherapy

We know from research that most breast cancers respond well to chemotherapy, but unfortunately some don’t. If doctors could tell whether chemotherapy was working at an earlier stage, some people could avoid having treatment that wouldn't help them.

Doctors are looking at new types of scans and blood tests to monitor how well chemotherapy is working. Researchers are looking at:

  • PET scans to show up cancer cell death after chemotherapy
  • MRI scans, to see how well chemotherapy is working
  • samples of your cancer and blood tests to find out which cancers respond to chemotherapy and to check how well chemotherapy is working

Researchers are also looking at chemotherapy side effects. There are studies looking at:

  • reducing side effects such as heart problems
  • predicting who might have side effects
  • coping with side effects
  • how chemotherapy might affect memory

Radiotherapy

Doctors often treat early stage breast cancer with surgery followed by daily radiotherapy to help stop the cancer from coming back. Researchers are looking at simpler, quicker ways to give radiotherapy. This includes research into:

  • giving radiotherapy to women during their breast cancer surgery
  • changing the dose and timing of radiotherapy
  • whether women at very low risk need radiotherapy

Research is also looking at a type of radiotherapy called intensity modulated radiotherapy (IMRT). This type changes the radiotherapy dose, depending on the thickness of breast tissue. It means doctors can give higher dose of radiotherapy to the area of the breast where the cancer was. And give a lower dose to the rest of the breast. Doctors hope this can reduce the risk of side effects. The trial is now closed and we're waiting for the results. 

Hormone therapy

Many women with early breast cancer take hormone therapy to lower the risk of the cancer coming back.

Researchers have looked at:

  • how long women should take hormone therapy for
  • the timing of treatment
  • comparing how well different hormone therapies work
  • taking hormone therapy before surgery
  • taking hormone therapy with biological therapy

There are several types of hormone therapy which work in different ways. Aromatase inhibitors are a type used for postmenopausal women. Research has found that these drugs can help premenopausal women if they take them alongside treatment to switch off their ovaries.

Doctors are looking at new hormone therapy drugs for early breast cancer such as enzalutamide.

Targeted drugs and immunotherapy

Targeted drugs change the way that cells work. For example, they can block signals that tell cells to grow. Immunotherapies can boost the body’s own immune system to fight off or kill cancer cells.

The most commonly used targeted drug for early breast cancer is trastuzumab.

In early breast cancer, researchers are looking at targeted drugs:

  • before surgery or chemotherapy, to see what effect they have on breast cancer
  • after surgery, to prevent breast cancer coming back or spreading
  • in combination with other treatments such as hormone therapy or chemotherapy, to prevent breast cancer coming back
  • with immunotherapy to see if they can improve treatment for breast cancer

There are many types of targeted drugs and immunotherapies. For early breast cancer, researchers are looking at:

  • monoclonal antibodies, such as trastuzumab (Herceptin), atezolizumab or durvalumab
  • cancer growth blockers, such as Ipatasertib everolimus or AZD5363
  • parp-1 inhibitors, such as olaparib or rucaparib
  • vaccines, such as Neuvax
  • targeted drugs joined to chemotherapy, such as TDM1

Some clinical trials are looking at how well these drugs work for particular types of breast cancer. This includes triple negative breast cancer, or people with inherited breast cancer.

Gene tests to decide on treatment

We know that two people with breast cancer may have differences in their cancer cells. The differences mean that the cancers will respond to different types of treatment. If your cancer doesn’t have a particular cell change, the medicine that targets that change won’t work.

Clinical trials are looking at the genetic makeup of breast cancer cells before or during treatment. Researchers want to know if particular genes affect how well treatment works. And they want to know whether genetic testing can help doctors decide who should have particular types of treatment after surgery.

Other treatment to stop breast cancer coming back

Doctors are researching treatment that might lower the risk of breast cancer coming back or help women live longer. Researchers are looking at:

  • aspirin
  • metformin, which is a type of drug used to treat diabetes
  • taking pro biotic capsules to see if they can stimulate the immune system to kill cancer cells
  • giving a type of immunotherapy called atezolizumab with chemotherapy to see if it will improve treatment

Research into different types of early breast cancer

Triple negative breast cancer

Triple negative breast cancers don’t have receptors for oestrogen, progesterone or Her2. Treatments such as hormone therapy or trastuzumab don’t work. Doctors are looking at ways to improve treatment.

For triple negative early breast cancer, researchers are looking at:

  • a hormone drug called enzulatamide for breast cancer with androgen receptors – androgens are hormones made in both men and women, and some triple negative breast cancers have androgen receptors
  • targeted cancer drugs to prevent breast cancer coming back, such as olaparib and rucaparib
  • giving targeted cancer drugs and or immunotherapy before surgery. The aim is to see if this treatment can shrink the cancer and make surgery more successful

Ductal carcinoma insitu (DCIS)

Ductal carcinoma in situ (DCIS) means that cells inside some of the ducts of your breast have started to turn into cancer cells. These cells are all inside the ducts and have not started to spread into the surrounding breast tissue.

Doctors are not sure that low risk DCIS would ever become invasive cancer. So researchers are comparing surgery with monitoring by having yearly mammograms. This is for women with low risk DCIS.

Researchers are also looking at comparing different ways to give radiotherapy treatment. The aim is to find out: 

  • the best number of radiotherapy treatments to give
  • if a radiotherapy boost to the area of the cancer helps to prevent it coming back
  • about the side effects

Inherited breast cancer

A small number of women have breast cancer because they inherited a faulty gene. Doctors do not know if treatment works in the same way for these women as for women who do not have an inherited faulty gene.

Trials are looking at a targeted cancer drug called rucaparib in women with breast cancer who have a faulty BRCA1 or BRCA2 gene. This drug is a type of targeted cancer drug called a PARP-1 inhibitor. This means it stops the PARP-1 enzyme from repairing damaged cancer cells.

Side effects

Researchers are looking into better ways of people reporting side effects. They want to find out if reporting them online or through your mobile phone works better than reporting them in the usual way. 

Researchers are looking at whether:

  • acupuncture can help with nerve damage from treatment (this nerve damage can make it difficult to do things, such as doing up buttons)
  • art therapy can help people cope with pain after treatment for breast cancer

Treatment for breast cancer can put women into a menopause. Coping with the symptoms can be difficult. Researchers are investigating whether cognitive behavioural therapy can help control hot flushes and night sweats.  

Research into living with breast cancer

Researchers want to find better ways to cope with the emotional, psychological and physical effects of breast cancer. They are keen to improve people’s quality of life with breast cancer.