Doctor explains why breast cancer therapies can differ
Dr Santi Christiani Gultom, a Specialist in Internal Medicine with a subspecialty in Haematology and Medical Oncology at MRCCC Siloam Semanggi, explains that breast cancer therapy can differ between one patient and another, even if they share the same type of cancer.
Santi stated that doctors do not determine therapy solely based on the organ where the cancer is found, but also consider a number of disease characteristics and the patient’s overall condition.
“In reality, we do not treat based on the cancer alone, but based on the organ,” Santi said during the MRCCC Siloam Semanggi Media Hospital Tour 2026 in Jakarta on Tuesday.
She explained that the stage and the presence of metastasis are key factors in determining therapy options. Patients with early-stage cancer may receive a different treatment approach compared to patients whose cancer has already spread.
Doctors also assess the aggressiveness of the tumour through molecular profiling, including the status of estrogen receptor (ER), progesterone receptor (US), human epidermal growth factor receptor 2 (HER2), and Ki-67.
According to Santi, these molecular characteristics help doctors identify breast cancer subtypes that require different treatment approaches, such as Luminal A, Luminal B, triple-negative, and HER2-positive.
“There are several types of breast cancer, from Luminal B and Luminal A to Triple Negative or HER2-positive, and each has different treatments,” she noted.
In addition to cancer characteristics, doctors consider each patient’s individual condition, including age, physical condition, organ function, and comorbidities such as heart disease, kidney disorders, and diabetes.
“We cannot administer cancer medication arbitrarily; it must be tailored to each patient and their comorbidities,” said Santi.
She added that the objective of the treatment also determines the therapeutic approach. Patients undergoing curative-intent therapy may receive more aggressive treatment, whereas palliative therapy for certain patients aims to extend life and maintain the patient’s quality of life.
Santi emphasised that these various considerations make cancer therapy increasingly personalised and impossible to standardise based solely on the type of cancer or the affected organ.