Breast Cancer

Breast Cancer

The National Cancer Institute estimates that more than 246,000 people were diagnosed with breast cancer in 2016. Many of these patients will be treated with some form of chemotherapy. At Rational Therapeutics, we know that selecting the right therapy can mean the difference between life and death.

Types of Breast Cancer

Breast cancer is a malignant tumor that is formed from the cells of the breast, primarily in the ducts or lobules. The most common forms of this cancer are:

Ductal carcinoma in situ is a non-invasive form of cancer in which the cancerous cells do not penetrate the lining of the mammary ducts. 

Lobular carcinoma in situ is another non-invasive form of cancer arising in the breast lobules that does not penetrate the basement membrane. 

Invasive ductal carcinoma is the most common invasive type. This cancer starts in a duct and spreads to the breast tissue where it may more easily spread to lymph nodes and other parts of the body. 

Invasive lobular carcinoma is also an invasive type of breast cancer, which starts in a lobule and then spreads to lymph nodes and other parts of the body.

The team at Rational Therapeutics has many years of experience conducting laboratory assays on the invasive forms of breast cancers. The laboratory test, known as a "functional profile," enables us to identify those drugs and combinations most likely to kill your cancer.

Common Treatments for Breast Cancer

Most medical oncologists base their treatment strategy on standard chemotherapy protocols for specific types of cancer. For breast cancer patients there are many established drug combinations.

These include CMF (cyclophosphamide, methotrexate, fluorouracil), CAF (cyclophosphamide, Adriamycin, fluorouracil), CA (cyclophosphamide plus Adriamycin), Taxol (paclitaxel), Taxotere (docetaxel), Xeloda (capecitabine), Navelbine (vinorelbine), Gemzar (gemcitabine), and Paraplatin (carboplatin).

For HER2 positive (abbreviation for human epidermal growth factor receptor 2) patients, Herceptin (traztuzumab) and Tykerb (lapatinib) are used as well.

These treatments have been developed over years of clinical trials, by assigning patients to different drugs and following their progress to determine the best combination. While some progress has been made, there is no single best treatment for every breast cancer.

The fact that at diagnosis all patients with breast cancer have an equal likelihood of response to any given therapy does not mean they will respond equally well. As can be seen from the list above, physicians have many treatment options to choose from. This is why we use functional profiling to select the treatment that is most active for you.

The results on the graph below, published in the Journal of Clinical Oncology, reveal a statistically significant correlation between drug sensitivity and time to progression.

 Cancer Survival Curve

Breast Cancer Patient Stories

Kathy Leach felt a lump in her right breast. After seeking medical advice, a biopsy was performed and her worst fears were confirmed. Kathy, a 45-year-old mother of three, had aggressive breast cancer.  After surgery, the prognosis worsened—she had metastatic disease with documented involvement of the liver. Having known of the work of Robert Nagourney, MD, director of Rational Therapeutics (now Nagourney Cancer Institute), Kathy asked her physicians in Cincinnati to send a sample of her cancer to the California-based laboratory.

— Kathy Leach


From my first meeting with Dr. Nagourney...I felt I was in the best of hands and needed to look no further. He took charge of my treatments, referred me to outstanding surgeons, and guided me through my chemotherapy. Thanks to him I was never really sick . . . in spite of my cancer spreading to 13 lymph nodes.

— Ingrid Ottesen



How We Test Your Cancer

Currently, hundreds of drugs, drug combinations and targeted agents are used to treat cancer patients. With so many choices, how does your oncologist decide which ones are right for you?