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A transplantation procedure may be used as adjuvant therapy in some women with a high risk of breast cancer recurrence or for treatment of advanced disease.

• Peripheral Blood Stem Cell Transplantation - Before chemotherapy is initiated, a sample of immature blood cells are collected and frozen for later transplantation back into the person. These stem cells are then re-injected after treatment is complete to help the bone marrow recover and continue producing healthy blood cells.

• Bone Marrow Transplantation (BMT) - This technique entails removal of a sample of bone marrow which is then frozen. Following treatment with chemotherapy and/or radiation, the marrow is thawed and re-injected intravenously to help with recovery of healthy blood cells.

Immunotherapy for Breast Cancer

Immunotherapy stimulates the body's own immune system to help fight the caner. Monoclonal antibody (MAb) therapy is a form of passive immunotherapy because it uses antibodies made in the lab rather than by a person's own immune system. Although only monoclonal antibodies have been approved for immunotherapy against breast cancer so far, many other forms of treatment are under study.

• Trastuzumab (Herceptin) is a monoclonal antibody that attaches to a growth-promoting protein known as HER2/nue. Too much of this protein can cause cancer to grow and spread faster. Herceptin can stop the protein from causing this growth as well as help the immune system to attack the cancer more effectively. Trastuzumab is used to treat breast cancer that is HER2-positive and has spread after treatment with other drugs. It is also used with other anticancer drugs to treat HER2-positive breast cancer after surgery.

Bevacizumab (Avastin) is a monoclonal antibody that slows blood vessel growth in tumors and has been shown to be helpful when used along with chemotherapy in some women with advanced breast cancer.

Other forms of immunotherapy under investigation include:

• Interferons and interleukins, usually in conjunction with tumor vaccines or immunotoxins.

• Autologous vaccine therapy has been shown to lengthen remission and survival times of some women with early breast cancer.

• A HER2/neu peptide (a small part of the protein made by the HER2/neu gene), used as the antigen in a vaccine, has been shown to cause an increased immune response against the HER2/neu receptor on cancer cells.

Bisphosphonates

These medications may be used to help prevent fractures and reduce pain in persons whose disease has spread to the bone. Examples of commonly used biphosphonates include:

• Clodronate (Bonefos; Ostac; Clasteon)
• Pamidronate (Aredia)

There have been reports of a few serious side effect from bisphosphonates, including deterioration and pain in the jaw bone. The reason for this is unknown, however, it seems to occur in patients who have had dental work done while on the drugs. Therefore, dental work should be done before starting treatment with biphosphonates.