Although it can’t usually be cured, secondary breast cancer can usually be effectively controlled for a long time.

The treatments available include hormonal therapy, chemotherapy, radiotherapy, bisphosphonates, and biological therapy.

There are many different factors which doctors need to consider when deciding which may be the best treatment for you.

One of the most important factors will be which part of your body is affected by the secondary cancer cells.

Many breast cancer cells contain proteins known as oestrogen receptors. A cancer which contains a certain proportion of these proteins is described as oestrogen-receptor positive (ER+). About 6 out of 10 (60%) of breast cancers are oestrogen-receptor positive. The more oestrogen-receptors a cancer cell has, the more likely it is to be controlled by hormonal therapy.

If a cancer cell has very few or no oestrogen-receptors, it is called an oestrogen-receptor negative (ER-) cancer. Hormonal therapies do not work for ER negative breast cancers. Oestrogen-receptors are known as ER because of the American spelling of oestrogen as estrogen.

Whether or not you have had the menopause (change of life) is an important factor in deciding on treatment. Before the menopause, women have high levels of female hormones circulating in their bodies, whereas afterwards the levels of these hormones are lower.

In women who have had their menopause, most of the female hormones are produced by converting androgens from the adrenal glands into oestrogen. This influences which hormonal treatment will control the secondary breast cancer cells best.

Your cancer cells may also be tested to see if they have receptors for particular proteins, known as growth factors, on their surface. The cancer cells will be tested for a type of growth factor receptor known as HER2.

Women with a high number of HER2 receptors are known as being HER2-positive (HER2+), and they may benefit from treatment with a type of biological therapy called trastuzumab (Herceptin®).

About 1 in 5 women (20%) have HER2+ breast cancer. These women may also benefit from a newer type of biological therapy called lapatinib (Tyverb®), which inhibits both the HER2 receptor, and another similar receptor called EGFR.

Other factors your doctor will take into consideration include your age and general health, whether the secondary cancer is slow growing (low-grade) or more faster-growing (high-grade) and which treatment, if any, you have had in the past.

The staging and grading of breast cancer is explained in our section about primary breast cancer.

Chemotherapy drugs, hormonal therapies and biological therapy drugs are carried round the body in the bloodstream so can treat cancer cells wherever they are in the body. This is known as systemic therapy.

Radiotherapy or surgery treats one area at a time and can be very helpful in treating individual areas of cancer, particularly in the bones or parts of the brain or the skin.

Doctors try to treat women with secondary breast cancer with the treatment that is most likely to control the breast cancer and cause the fewest side effects.