Treatments for hormone receptor-positive (HR+) breast cancer

Breast cancer is always tested to find out if it is hormone receptor-positive or negative. This information helps you and your treating team create the best plan for your situation.

About 70% to 80% of breast cancers are hormone receptor positive (HR+).

Several different types of treatment are available for HR+ breast cancer.

Surgery

Usually, surgery is the first treatment for HR+ breast cancer. The aim is to remove the affected area of the breast.

The type of surgery depends on many factors such as the size, grade and stage of your breast cancer.

The options, which your breast surgeon will discuss with you, may be:

• a lumpectomy (‘breast conserving surgery’ or ‘wide local excision’)
• a mastectomy (removal of the breast, with or without immediate reconstruction).

To understand these options, go to Which breast cancer surgery is right for you.

Hormone-blocking therapy

Hormone-blocking therapy is the most common treatment for HR+ breast cancer. It blocks the growth of cancer cells.

Read about hormone-blocking therapy and the common hormone-blocking therapy drugs.

The choice of hormone-blocking therapy depends on whether you are premenopausal or postmenopausal.

You will need to permanently stop using:

• hormone replacement therapy
• hormonal contraceptives.

Note:

Hormone-blocking therapy is usually not part of treatment if:

• your cancer is hormone receptor negative, as it does not respond to hormone therapies
• you have DCIS, unless you have a very strong family history of breast cancer.

Chemotherapy

People with fast-growing or high-grade tumours are usually also offered chemotherapy.

This may be given:

• before surgery (‘neoadjuvant treatment’)
• after surgery ('adjuvant treatment').

Breast cancer that is HR+ and also HER2-positive is called triple positive breast cancer. In this case, doctors usually recommend chemotherapy combined with a HER2 targeted therapy. You usually finish these treatments before you start hormone-blocking therapy.

For more information go to:

• HER2-positive early breast cancer
• Triple positive breast cancer.

Radiotherapy

If your surgery is a lumpectomy or mastectomy, you will usually be offered radiotherapy treatment. This happens after surgery and when you finish chemotherapy.

The aim of radiotherapy is to kill any cancer cells that may be left in the breast or lymph nodes.

Targeted therapies

Targeted therapies are drugs that attack cancer cells but mostly do not affect normal cells.

Abemaciclib (Verzenio) and and ribociclib (Kisqali) are targeted therapies. They are sometimes given after surgery for patients with a high risk of recurrence.

Verzenio and Kisqali are in a class of drug called 'CDK4/6 inhibitors'. This class of drugs is proven to help stop cancer cells from dividing.

Clinical trials for hormone receptor positive breast cancer

Research and clinical trials are important to identify different drugs and when to give them to patients to achieve the best outcome.

Ask your specialist about any clinical trials that may be suitable for you.