Systemic Therapy

Systemic therapy uses medication to treat cancer throughout the whole body. It helps destroy cancer cells that may have spread beyond the breast.

Systemic therapy may be used at different times during treatment:

• Neoadjuvant therapy: Given before surgery to shrink tumours and improve surgical outcomes
• Adjuvant therapy: Given after surgery to destroy remaining cancer cells and reduce risk of recurrence
• Primary therapy: Used alone when surgery isn’t an option, such as in metastatic (stage IV) breast cancer

Types of systemic therapy include:

• Chemotherapy
• Hormone (Endocrine) Therapy
• Targeted Therapy
• Immunotherapy

Understanding biologics and biosimilars

Some breast cancer treatments, like trastuzumab (Herceptin) and pertuzumab (Perjeta), are biologics. These medications are made from living cells (e.g., bacteria, yeast, or animal cells) and are more complex.

Biosimilars are highly similar versions of biologic drugs. While not exact copies, biosimilars are regulated by Health Canada to ensure they are as safe and effective as the original drug.

To learn more about biosimilars, click here.

Access and Coverage

Access to systemic therapy drugs may vary by province or territory. Not all breast cancer treatments are covered by provincial or territorial health plans. Use MedSearch to see what drugs are publicly funded in your province.

If your medication is not covered, speak with your healthcare team about potential financial assistance options. For more information, visit FinancialNavigator.

Support Medications

Support medications help manage treatment side effects, ensuring that patients can continue with their therapy while minimizing discomfort. For more details, visit our side effects management section.

Medical Review by Roochi Arora, MD, FRCPC, August 2025

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