Research into treatment for early breast cancer
Researchers around the world are looking at better ways to treat 
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.
When looking at the trials database, click on the ‘recruiting’, ‘closed’ and ‘results’ tabs to make sure you see all the trials.
Surgery
Surgery is one of the main treatments for early breast cancer. Researchers are looking at new ways to further 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 and Intelligent Knife.
Treatment of the lymph nodes in your armpit
Researchers are comparing women who have treatment such as surgery to remove the or radiotherapy to the lymph nodes in their armpit with women who don’t. They want to find out if treatment to the armpit is necessary.
Other researchers want to find out whether the lymph glands in the armpit need further treatment once you have had chemotherapy followed by surgery.
Comparing different ways to remove cancer
A study is comparing vacuum assisted excision with surgery for women with a small breast cancer.
Vacuum assisted excision (VAE) means the surgeon puts a needle into the breast. Attached to the needle is a vacuum device that sucks out the cancer.
Researchers think that vacuum assisted excision might be as good as surgery.
Treating lymphoedema with surgery
Breast cancer treatment can cause a build up of lymph fluid. This is called lymphoedema. The for lymphoedema is exercises and compression bandages or garments to the arm.
In one study researchers are looking at surgery to change the route of the before treatment. They will then compare this with people who go onto have standard treatment. The researchers want to see if this helps prevent or lessen the amount of fluid that drains into the arm.
Appearance after surgery
To help prepare women for their surgery, they can look at pictures of other women who have had the same operation. 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. Researchers want to find out if it’s possible to predict how well chemotherapy will work. This could mean that some people would avoid having treatment that wouldn’t help them. Doctors in one study are collecting samples of cancer and blood in women before and during chemotherapy. They will look at the and proteins to see if they can work out early on if chemotherapy is working.
Doctors are also 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
- samples of cancer and blood tests to find out which cancers respond to chemotherapy and to check how well chemotherapy is working
- gut bacteria. Researchers in Scotland want to find patterns that could help doctors pick up which people will respond better to chemotherapy treatment
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
- if exercise 24 hours before treatment with
taxane chemotherapy can help lessen the symptoms of peripheral neuropathy - a new app to help manage symptoms and side effects of chemotherapy
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 timing of when you have radiotherapy
- whether women at very low risk need radiotherapy
Researchers are also looking at a type of radiotherapy called intensity modulated radiotherapy (IMRT). This type changes the radiotherapy amount (dose), depending on the thickness of breast tissue. It means doctors can give a 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.
Other radiotherapy research includes:
- looking at whether hydrogen peroxide that is contained in a gel can make breast cancer more sensitive to radiotherapy
- comparing the use of permanent and non permanent marks during radiotherapy treatment
Hormone therapy
Many women with early breast cancer take hormone therapy to lower the risk of the cancer coming back.
Researchers are looking at:
- the timing of treatment
- comparing how well different hormone therapies work
- taking hormone therapy before surgery
- taking hormone therapy with targeted cancer drugs
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 atezolizumab or durvalumab- cancer growth blockers, such as ipatasertib or AZD5363
parp-1 inhibitors , such as olaparib or rucaparib- a new combination made up of trastuzumab emtansine with atezolizumab after surgery for people with a large number of
HER2 positive proteins
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.
Research into different types of early breast cancer
Triple negative breast cancer
Triple negative breast cancers don’t have 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
Other research into triple negative breast cancer treatment includes using to assess how well a new treatment is working.
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.
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 or 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.
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
-
giving less treatment to people with early HER2 positive breast cancer who have a low risk of it coming back
Side effects
Researchers are looking into better ways of people coping with side effects. One study is looking at whether art therapy can help people cope with pain after treatment for breast cancer.
Other researchers are looking at a type of radiotherapy called . They want to see if this is better at lowering the amount of radiotherapy to the heart compared to standard radiotherapy treatment. They hope that by giving proton beam therapy it will lower the risk of long term heart problems.
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.
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