Breast Cancer Care: From Uniform Treatments to Personalized Solutions

Breakthroughs in research have shifted breast cancer treatment from a one-size-fits-all approach to highly personalized strategies, including advanced breast cancer medicine options. With survival rates soaring and new therapies emerging, patients now have more options — and more hope — than ever before.

New treatments for breast cancer

Recent advances have transformed a one-size-fits-all approach into a personalized treatment management strategy.

Though, some things never change: a breast cancer diagnosis still evokes a storm of anxiety — just as it did decades ago — despite the fact that survival rates have soared. Indeed, while more than two million women worldwide receive a breast cancer diagnosis each year, the average risk of dying in the following five years has dropped from 14% to 5% since just the 1990s, according to a June 2023 study involving more than a half-million women.

"For many women, a breast cancer diagnosis is particularly unsettling because we often don't know why a patient developed it," says Dr. Harold Burstein, a medical oncologist at Harvard-affiliated Dana-Farber Cancer Institute. "But the good news is, outcomes are getting better and better."

There's good reason for this survival swing. While breast cancer was once believed to be a single disease requiring a single treatment approach, scientists can now categorize breast tumors by cell type, opening the door for treatment combinations tailored toward each.

Nowadays, surgery is still de rigueur for most types of breast cancer. But once-mainstay chemotherapy may be used in smaller amounts or skipped entirely. Meanwhile, newer drugs have enabled doctors to personalize each woman's arsenal of options. These include immunotherapy — which harnesses the power of the immune system to kill cancer cells — and targeted therapies aimed at gene mutations or proteins active in cancer growth.

"As we recognize these important subsets of breast cancer, we're tailoring treatment to the individual and the special characteristics of each breast cancer," Dr. Burstein says. "There isn't an infinite number of treatments, but the toolbox keeps getting bigger."

Why treatments are improving

Even the past 10 years brought marked shifts in treatment approach, thanks to extensive research that clarifies how genes and cells behave in various cancer subtypes. This, in turn, fueled the development of groundbreaking tests. Some can identify women with BRCA gene mutations that drastically raise their risk of developing breast cancer, while other tests help predict the likelihood a tumor will grow or spread to better pinpoint treatment needs.

These efforts have revealed that some types of breast cancer may respond to less intensive chemotherapy, while one especially aggressive type needs more.

Preparing for your first treatment

No one wants to hear the words, "You have cancer," or to be facing down an unknown path of cancer treatment. But take heart: for some people, the hardest part of a cancer diagnosis is just after diagnosis, before there's a treatment plan in place. By the time you're headed to your first cancer treatment, you should know the type of cancer you're dealing with, its stage, and have a care team and treatment plan in place. That can be reassuring, as can the thought that you're actually doing something about the problem you've probably been wholly focused on since going in for your first test or biopsy.

But even if you are one of those people who thrives on having a plan of action in place, you'll still be facing down some unknowns. Some common treatment options for cancer include chemotherapy, radiation therapy, immunotherapy, and other oral or intravenous treatments. Your oncologist or another person on your care team should meet with you in advance to prepare you for the treatment you'll receive, but you can also take some steps at home to make sure you arrive feeling prepared and calm on your first day of treatment.

Assembling your breast cancer care team

A breast cancer diagnosis can feel like your world has been turned upside down, but it's important to remember that modern treatments are highly effective, and you have many options. Today, people diagnosed with breast cancer have more than a 95% chance of surviving at least five years, thanks to advancements in detection and care. Take a moment to process this news and focus on the path ahead.

Your next step is assembling a strong support network and medical team to guide you through treatment. Surround yourself with loved ones who can provide emotional and practical support — whether it's your partner, children, parents, or close friends. Equally important is building a trusted medical team that understands your needs and helps you feel confident in your treatment plan. Knowing who will be by your side on this journey can make the road ahead feel more manageable.

Your primary care doctor or gynecologist may have been the one who delivered the news about your cancer after a routine mammogram, or after you noticed a lump in your breast. Once you have a diagnosis, you will want to be under the care of a team of doctors who specialize in the treatment of cancer, including breast cancer. There are three types of doctors who treat breast cancer.

• Medical oncologists specialize in treating breast cancer with medications such as chemotherapy and hormone therapy.
• Surgeons or surgical oncologists treat breast cancer with surgical procedures.
• Radiation oncologists are experts in radiation therapy.
• Depending on your cancer stage and treatment plan, you may see just one or all three of these specialists. There are many ways to find an oncologist. You can ask your primary care doctor or gynecologist for a referral, contact your local medical society, or call a nearby cancer center or medical school.
• Be thoughtful and diligent when choosing a doctor. Carefully consider your options, so you can find the treatment team that is most experienced and that most closely meets your needs. It is perfectly acceptable to get an opinion from more than one doctor — in fact, it is expected. The following are five characteristics to look for in a breast cancer doctor:
• Expertise. If possible, you want a doctor who specializes in breast cancer, not just cancer in general. The doctor you choose should be up to date on the latest breast cancer treatments and research advances (clues include working at a major cancer center, having conducted medical research, or both).
• Credentials. Your doctors should be board-certified and affiliated with a reputable cancer center or hospital. Ideally, they will have conducted research in their breast cancer specialty. If you are looking for a surgeon, you want someone who has performed hundreds, if not thousands, of the procedure you will have. Your surgeon also should be willing to share results with you, including how many procedures were successful and how often complications or side effects occurred.
• Rapport. The doctor should make you feel comfortable enough to share your personal information.
• Good communication. The doctor should take the time to explain things to you in a way that you understand and should listen to you and respect your concerns and preferences.
• Responsive office staff. You should be able to set up an appointment and reach the doctor with questions quickly and easily. The staff should be professional, courteous, and compassionate every time you call or come in. Rude front-office staff are a big red flag.
• Along with one or more oncologists, expect to work with some or all of these medical professionals during your treatment:
• Breast radiologist. This professional reads the results of your mammogram and other imaging scans to diagnose your cancer and determine whether treatment is working.
• Nurse practitioners and physician assistants. They work with your doctors to manage your care.
• Genetic counselor. This specialist will help you understand the results of any genetic tests you might have, including whether breast cancer runs in your family and if your children or other loved ones could be at risk.
• Oncology nurse navigator or patient navigator. This professional may help to coordinate your medical appointments, help you overcome any barriers to care, such as transportation to your appointments or the ability to pay for your treatment, and serve as the first line for questions and concerns when you contact your oncology team.
• Plastic or reconstructive surgeon. If you decide to have your breasts reconstructed after a mastectomy or partial mastectomy warranting additional surgery for cosmetic purposes, one of these doctors will perform the procedure.
• Social worker. This support person can help you understand your diagnosis, provide emotional support resources and tools for you and your loved ones as you go through breast cancer and can help connect you with financial resources if you need help paying for your treatment.
• Dietitian. A nutritionist can ensure that you eat a balanced diet to prevent nutritional deficiencies or unwarranted weight loss or weight gain.

A breast cancer diagnosis is never easy, but knowledge and preparation can make the journey less daunting. With cutting-edge breast cancer treatments by stage and a strong support network, you have the tools to navigate this challenge and look forward to a brighter future.

This article is part of our collaboration with Harvard Health Publishing, a trusted source of medical expertise from Harvard Medical School. Content has been adapted for local audiences.

Copyright © 2025 by Harvard University. Original work prepared by Harvard Health Publishing. This content is for informational purposes only and does not replace professional medical advice, and do not represent the views of Manulife (Singapore) Pte. Ltd.