Approximately 5% to 10% of all breast cancers are hereditary; many of which are caused by pathogenic variants in genes required for homologous recombination, including BRCA1 and BRCA2. Here we discuss systemic treatment for such breast cancers, including approved chemotherapeutic approaches and also targeted treatment approaches using poly-(ADP ribose) polymerase inhibitors. We also discuss experimental approaches to treating hereditary breast cancer, including new small molecule DNA repair inhibitors and also immunomodulatory agents. Finally, we discuss how drug resistance emerges in patients with hereditary breast cancer, how this might be delayed or prevented, and how biomarker-adapted treatment is molding the future management of hereditary breast cancer.

Original languageEnglish
Pages (from-to)203-224
Number of pages22
JournalHematology/Oncology Clinics of North America
Issue number1
Publication statusPublished - Feb 2023


  • Humans
  • Female
  • Breast Neoplasms/drug therapy
  • Genes, BRCA2
  • Poly(ADP-ribose) Polymerase Inhibitors/pharmacology
  • DNA Repair


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