Abstract:
The prognosis of breast cancer remains unpredictable despite of frequent change in treatment protocol since last few decades. As we understand the heterogenous nature of the disease, complex tumor biology etc. the treatment protocols have changed. There is an unprecedented transformation in breast cancer management, driven by parallel advances in targeted therapies, immunomodulation, drug-delivery technologies, and molecular diagnostic tools. Breast cancer management has shifted from a "one-size-fits-all" approach to highly personalized, biology-driven medicine. Surgical management has progressed from radical mastectomy with routine axillary dissection to breast-conserving surgery with sentinel-node biopsy, targeted nodal dissection, and, in some cases, omission of axillary surgery. Similarly Systemic therapy has likewise moved from universal chemotherapy to risk-adapted approaches.
Recent advances include the routine incorporation of genomic profiling and the widespread adoption of targeted therapies such as HER2-directed agents, CDK4/6 inhibitors, PARP inhibitors, and antibody–drug conjugates, as well as an expanding role for immunotherapy, particularly in triple-negative disease. There is change in HER2 classification due to improvements in targeted treatments. Neoadjuvant systemic therapy has gained prominence in facilitating tumor downstaging and to achieve pathological complete response and enabling response-guided treatment strategies.
This review summarizes evolving concepts and recent advances in breast cancer diagnosis and treatment, with emphasis on precision oncology, multidisciplinary care, and personalized treatment planning.
