Breast Cancer
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Breast Cancer
NIH - Medical Encyclopedia Breast cancer
"There are several different types of breast cancer. Ductal carcinoma begins in the cells lining the ducts that bring milk to the nipple and accounts for more than 75% of breast cancers. Lobular carcinoma begins in the milk-secreting glands of the breast but is otherwise fairly similar in its behavior to ductal carcinoma. Other varieties of breast cancer can arise from the skin, fat, connective tissues, and other cells present in the breast. … Some women have what is known as HER2-positive breast cancer. HER2, short for human epidermal growth factor receptor-2, is a gene that helps control cell growth, division, and repair. When cells have too many copies of this gene, cell growth speeds up. It’s believed that HER2 plays a key role in turning healthy cells into cancerous ones. Some women with breast cancer have too much HER2, and are therefore considered HER2-positive. … Some families appear to have a genetic tendency for breast cancer. Two variant genes have been found that appear to account for this: BRCA1 and BRCA2. … The body's reduced ability to get rid of abnormal cells leads to damage that gradually accumulates. Women carrying mutated BRCA1 and/or BRCA2 genes start with pre-existing dysfunction of this system and have a "head start" in this damaging process. Hormones are important because they encourage cell growth. High levels of hormones during a woman's reproductive years, especially when they are not interrupted by the hormonal changes of pregnancy, appear to increase the chances that genetically damaged cells will grow and cause cancer."
Breast lumps: Types of lumps and what they mean
Highlighted Articles
Mammographic Breast Density as a General Marker of Breast Cancer Risk (Cancer Epidemiology Biomarkers & Prevention 2007)
"Overall mammographic density seems to represent a general marker of breast cancer risk that is not specific to breast side or location of the eventual cancer."
Lifetime physical activity and the risk of breast cancer: A case-control study. (Cancer Detect Prev. 2007)
"Conclusions: These data are in concordance with the hypothesis that lifetime total physical activity is associated with decreased breast cancer risk. They also suggest that recreational physical activity at ages 14-20 years is the most beneficial. In addition, these findings confirm the majority of previous reports which implicated physical inactivity as important risk factor for breast cancer."
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Notes
The 2007 Treatment Guidelines section will contain the 2007 published guidelines. To view Guidelines from previous years, view year 2006 Treatment Guidelines and 2005 InfoMedlinks (Articles section) or our Monthly Online Newsletter (under the Guidelines section).
Breast Cancer
Daily Treatment Report
Cognitive Therapy-CBT-Psychotherapy
Device Therapy
Drug Side-Effects and Interactions
Safety of aromatase inhibitors in the adjuvant setting (Breast Cancer Res Treat. 2007) "Generally, adverse events with AIs are predictable and manageable, whereas tamoxifen may be associated with life-threatening events in a minority of patients. Overall, the benefits of AIs over tamoxifen are achieved without compromising overall quality of life."
Recognition and management of treatment-related side effects for breast cancer patients receiving adjuvant endocrine therapy. (Breast Cancer Res Treat. 2007) "Across all adjuvant endocrine trials, regardless of the treatment received, vasomotor symptoms such as hot flashes are the most common side effects. Other frequently reported side effects, such as vaginal discharge, vaginal dryness, dyspareunia, and arthralgia, vary in prevalence between tamoxifen and AIs."
Prevalence of joint symptoms in postmenopausal women taking aromatase inhibitors for early-stage breast cancer. (J Clin Oncol. 2007)
Strategies for the prevention of treatment-related bone loss in women receiving adjuvant hormonal therapy. (Clin Breast Cancer. 2007) "More than 220,000 women will be diagnosed with breast cancer this year, and approximately 75% of these women will be long-term survivors of this disease. Survival has improved largely because of advances in adjuvant hormone therapy and chemotherapy, as well as early detection strategies. Because most women will receive adjuvant treatment, and the majority will survive cancer, it is increasingly important to understand the resultant toxicities and to devise monitoring and treatment strategies to avoid adverse long-term effects. Loss of bone mineral density leading to osteoporosis and increased risk of fracture as well as other morbidities is a well known complication of estrogen suppression associated with use of aromatase inhibitors (AIs) in postmenopausal women, and ovarian suppression with GnRH agonists or chemotherapy in premenopausal women."
Breast Cancer Therapies Appear to Advance Cognitive Decline "New data link estrogen deficiency and cognitive decline — a connection that may explain in part why many breast cancer survivors report mental deficits after treatment. Researchers are promoting awareness of the potential dangers of combining endocrine treatments with chemotherapy, which has been poorly studied in the past."
Adjuvant chemotherapy in breast cancer patients induces temporary salivary gland hypofunction. (Oral Oncol. 2007) "Thus, the results suggest that acinar and ductal cell functions are affected by adjuvant CT. These adverse drug reactions are temporary, as salivary findings generally returned to baseline values within one year following treatment."
The DNA-damaging potential of tamoxifen in breast cancer and normal cells. (Arch Toxicol. 2007)
Herceptin Heart Danger Stays Same After Five Years "When added to standard chemotherapy, Herceptin (trastuzumab) reduces the risk of breast cancer recurrence by 52 percent after three years. The compound has proven to be effective in the 20 percent to 25 percent of breast cancer cases that test positive for the HER2/neu receptor. But this benefit comes at a cost: 4.1 percent of people taking Herceptin developed heart failure over a three-year period, vs. 0.8 percent of patients who only received chemotherapy. This latest study, reported Sunday at the American Society for Clinical Oncology meeting in Chicago, found that after five years, the incidence of heart failure was 3.8 percent."
Tamoxifen treatment and new-onset depression in breast cancer patients. (Psychosomatics. 2007) "A post-hoc analysis revealed that chemotherapy and ER+ status were significantly and independently associated with an increased risk for developing depression."
Aromatase inhibitor-associated arthralgia syndrome. (Breast. 2007)
Aromatase inhibitors: a safety comparison. (Expert Opin Drug Saf. 2007)
Tamoxifen Linked to Swelling Within the Eye "The researchers recommend that the optic nerve head be examined biomorphometrically for tamoxifen users reporting visual change that cannot be attributed to non–drug-related causes."
Do endocrine treatments for breast cancer have a negative impact on lipid profiles and cardiovascular risk in postmenopausal women? (Am Heart J. 2007)
Many Breast Cancer Patients Quit Tamoxifen Early " Nearly one-quarter of breast cancer patients stop taking the drug tamoxifen within the first year of a standard five-year regimen, a new Irish study reveals. Doctors routinely prescribe tamoxifen -- which inhibits estrogen's stimulatory effect on cancer cells -- to patients after breast cancer treatment, to help prevent a recurrence. "
Aromatase inhibitors and cardiac toxicity: getting to the heart of the matter. (Breast Cancer Res Treat. 2007)
Aromatase inhibitors in the adjuvant treatment of postmenopausal women with early breast cancer: putting safety issues into perspective. (Breast J. 2007)
PANEL RECOMMENDS TAMOXIFEN WARNING "The breast cancer drug tamoxifen may have a new label warning. A panel of FDA advisors has recommended that the agency add a warning that postmenopausal women who use the drug to treat breast cancer face an increased risk of recurrence if they have the gene variation CYP2D6."
Aromatase Inhibitors in the Adjuvant Treatment of Postmenopausal Women with Early Breast Cancer: Putting Safety Issues into Perspective (The Breast Journal 2007) "Tamoxifen treatment is limited to 5 years because of the development of de novo and acquired resistance, and an ongoing risk of adverse events, including endometrial cancer, thromboembolic events, and gynecological symptoms with long-term use. The third-generation aromatase inhibitors (AIs), letrozole, anastrozole, and exemestane, are displacing tamoxifen as the first-choice therapy for HR+ early breast cancer, and are now recommended as the preferred therapy by national and international guidelines. Recent randomized trials have demonstrated that the AIs are more effective than tamoxifen in preventing disease recurrence when used in substitution and sequential strategies in the early adjuvant setting, and letrozole has been shown to be more effective than placebo in the extended adjuvant setting (after 5 years of tamoxifen therapy). … Adverse events that are more frequent with adjuvant AI therapy compared with tamoxifen include arthralgia and myalgia, bone loss, and effects on the cardiovascular system and blood lipids."
Drugs
Aromatase inhibitors in adjuvant therapy for hormone receptor positive breast cancer: A systematic review. (Cancer Treat Rev. 2007)
Breast Cancer Survival Longer With Docetaxel Than Doxorubicin
Chemo Used for Fewer Breast Cancer Patients “Thousands of breast cancer patients each year could be spared chemotherapy or get gentler versions of it without harming their odds of beating the disease, new research suggests. One study found that certain women did better - were less likely to die or have a relapse - if given a less harsh drug than Adriamycin, a mainstay of treatment for decades.”
Taxanes for adjuvant treatment of early breast cancer. (Cochrane Database Syst Rev. 2007)
Drug a New Weapon Against One Form of Breast Cancer "When added to a standard chemotherapy, the drug paclitaxel (Taxol) cuts the recurrence of breast cancer by 41 percent in women with a particular form of tumor, a new study finds. Those tumors are called "HER2-positive" because their cells produce an excess of the protein human epidermal growth factor receptor-2 (HER2). In recent years, cancer specialists have found that breast tumors with different characteristics respond differently to various regimens. The new study adds another piece to that puzzle, experts say."
Controversies of adjuvant endocrine treatment for breast cancer and recommendations of the 2007 St Gallen conference. (Lancet Oncol. 2007)
[Adjuvant treatment of breast cancer - endocrine therapy.] (Ugeskr Laeger. 2007)
[Early breast cancer - adjuvant therapy:] (Ugeskr Laeger. 2007)
[Neoadjuvant antihormonal treatment of women with breast cancer.] (Ugeskr Laeger. 2007)
[Medical treatment of early breast cancer - chemotherapy.] (Ugeskr Laeger. 2007)
Potential use of bisphosphonates in the prevention of metastases in early-stage breast cancer. (Clin Breast Cancer. 2007)
Adjuvant therapy of the very young woman. (Breast. 2007)
Application of aromatase inhibitors in endocrine responsive breast cancers. (Breast. 2007)
The breast cancer continuum in hormone-receptor positive breast cancer in postmenopausal women: evolving management options focusing on aromatase inhibitors. (Ann Oncol. 2007)
Breast cancer adjuvant endocrine therapy. (Cancer J. 2007)
Hormonal therapies for early breast cancer: systematic review and economic evaluation. (Health Technol Assess. 2007)
Effectiveness of Adjuvant Tamoxifen Therapy among Older Women with Early Stage Breast Cancer. (Breast J. 2007)
Aromatase inhibitors in post-menopausal metastatic breast carcinoma. (Expert Opin Investig Drugs. 2007)
Neoadjuvant Chemotherapy Followed by Radical Surgery in Patients Affected by FIGO Stage IVA Cervical Cancer. (Ann Surg Oncol. 2007)
Survival differences observed in metastatic breast cancer patients treated with capecitabine when compared with vinorelbine after pretreatment with anthracycline and taxane. (Am J Clin Oncol. 2007) "CONCLUSIONS: This exploratory analysis suggests that patients with tumors previously treated with both anthracycline and taxane can still obtain significant survival benefit from further chemotherapy. The results indicate that capecitabine may be superior to vinorelbine in this setting."
Tamoxifen, hot flashes and recurrence in breast cancer. (Breast Cancer Res Treat. 2007)
Good, bad news on breast cancer "The good news is that Herceptin continues to prevent relapses years after patients stop taking it. The bad news is that the laboratory tests used to determine eligibility appear to be highly inaccurate. That means some women who could benefit from Herceptin don't get it, while others are subjected to the side-effects and high cost of the drug with no hope of a benefit. … About one-quarter of breast-cancer patients carry extra copies of a gene called HER2, which makes their tumors more aggressive but also makes them respond to Herceptin, a synthetic antibody that targets the HER2 protein. Herceptin, one of the first in a new generation of targeted cancer drugs, has been shown to reduce the risk of recurrence by about 50 percent. That is a huge benefit, because breast cancer doesn't become life-threatening unless it recurs and spreads to other parts of the body. … But Dr. Dennis Slamon of UCLA, who is largely credited with developing Herceptin, noted that false-positive results are also problematic, because the drug costs about $3,000 a month and has sometimes-serious side-effects, including a heightened risk of heart failure. Dr. Michael Press, a pathologist at the University of Southern California, said as many as one-third of positive antibody tests "could be false-positives.""
Prognostic factors of early distant recurrence in hormone receptor-positive, postmenopausal breast cancer patients receiving adjuvant tamoxifen therapy: results of a retrospective analysis. (Cancer. 2007) "CONCLUSIONS: In this study, a subset of patients was identified that was at low-risk of early recurrence (mSBR grade 1 and/or negative lymph node status). Women in that subset could be treated using sequential hormone therapy with tamoxifen and AIs. In women with mSBR grade 3 or lymph node-positive tumors, an upfront treatment with AIs seemed to be the current optimal strategy."
Preoperative chemotherapy for women with operable breast cancer. (Cochrane Database Syst Rev. 2007)
Clinical efficacy of capecitabine as first-line chemotherapy in metastatic breast cancer-How low can you go? (Breast. 2007)
[Trastuzumab (Herceptin) and breast cancer: mechanisms of resistance] (Bull Cancer. 2007) "The detection of overexpression of human epidermal growth factor receptor 2 (HER2) in some breast cancer tumors has led to the development of a targeted treatment that is tumor selective, effective at extending life expectancy in the patients with advanced or early breast cancers. Trastuzumab (Herceptin), a humanized monoclonal antibody to HER2 is indicated for patients whose tumor demonstrates an amplified copy number for the HER2 oncogene and/or overexpresses the HER2 oncoprotein. Despite a high level of efficacy in combination with chemotherapy, trastuzumab as single agent has limited effectiveness (up to 30% response rates) and patients who respond to trastuzumab will relapse despite continued treatment."
Bisphosphonate therapy for women with breast cancer and at high risk for osteoporosis. (J Natl Med Assoc. 2007)
Switching to an aromatase inhibitor provides mortality benefit in early breast carcinoma (Cancer 2007) "Switching to an aromatase inhibitor after 2 or 3 years of tamoxifen therapy significantly improves survival compared with continuing 2 or 3 years of additional tamoxifen treatment."
Newer Drugs Beat Tamoxifen for Breast Cancer Survival "Postmenopausal breast cancer patients who switch from tamoxifen therapy to another type of drug, called an aromatase inhibitor, may gain a significant boost in survival, Italian research shows. Women in the study made the switch two to three years into the typical five-year tamoxifen regimen, which is aimed at keeping recurrent breast cancer at bay. According to the researchers, the improved performance of aromatase inhibitors means patients may also avoid the increased risk of death from other causes -- such as stroke or endometrial cancer -- that have been associated with tamoxifen."
Breast tumours following combined hormone replacement therapy express favourable prognostic factors. (Int J Cancer. 2007)
[Aromatase inhibitors in the adjuvant treatment of early breast cancer.] (Presse Med. 2007 ) "Adjuvant hormone therapy is indicated only in patients whose tumors express estrogen or progesterone receptors. Aromatase inhibitors (AI) are indicated only in postmenopausal patients. AI are significantly more effective than tamoxifen in terms of disease-free survival and distant recurrence-free survival; these advantages will probably result in a significant overall survival benefit after sufficient follow-up. This benefit justifies the use of AI in all postmenopausal patients in the absence of contraindications and after complete explanations of the benefit/risk ratio and potential side effects of this treatment. The benefit of AI over tamoxifen may be particularly pronounced for tumors overexpressing HER-2 and perhaps for ER+PR- tumors."
Aromatase inhibitors for treatment of advanced breast cancer in postmenopausal women. (Cochrane Database Syst Rev. 2007) "AUTHORS' CONCLUSIONS: In women with advanced (metastatic) breast cancer, aromatase inhibitors including those in current clinical use show a survival benefit when compared to other endocrine therapy."
Early discontinuation of tamoxifen: a Lesson for oncologists. (Cancer. 2007) "CONCLUSIONS.: The rate of nonpersistence with tamoxifen therapy is higher than previously reported. This study demonstrates that persistence with tamoxifen cannot be assumed and raises concerns about persistence with other oral hormonal therapies for breast cancer and oral antineoplastics in general. Oncologists need to identify those at risk of nonpersistence and develop strategies to combat this barrier to treatment success."
Use of adjuvant systemic therapy for early breast cancer among women 65 years of age and older. (Cancer Control. 2007)
2-year follow-up of trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer: a randomised controlled trial. (Lancet. 2007) "INTERPRETATION: Our results show that 1 year of treatment with trastuzumab after adjuvant chemotherapy has a significant overall survival benefit after a median follow-up of 2 years. The emergence of this benefit after only 2 years reinforces the importance of trastuzumab in the treatment of women with HER2-positive early breast cancer."
Herceptin Cuts Death Rate for Breast-Cancer Patients "Women who took Herceptin after surgery and chemotherapy for breast cancer had better survival odds after three years than women who didn't take the drug, a new study found."
Late risk of relapse and mortality among postmenopausal women with estrogen responsive early breast cancer after 5 years of tamoxifen (Annals of Oncology 2007)
Five Years of Letrozole Compared With Tamoxifen As Initial Adjuvant Therapy for Postmenopausal Women With Endocrine-Responsive Early Breast Cancer: Update of Study BIG 1-98. (J Clin Oncol. 2007)
Current Trends and Controversies over Pre-operative Chemotherapy for Women with Operable Breast Cancer. (Jpn J Clin Oncol. 2007)
Exercise
Six-Month Follow-up of Patient-Rated Outcomes in a Randomized Controlled Trial of Exercise Training during Breast Cancer Chemotherapy. (Cancer Epidemiol Biomarkers Prev. 2007) “CONCLUSIONS: Improvements in self-esteem observed with RET during breast cancer chemotherapy were maintained at 6-month follow-up whereas reductions in anxiety not observed with AET during breast cancer chemotherapy emerged at 6-month follow-up. Moreover, adopting a combined aerobic and resistance exercise program after breast cancer chemotherapy was associated with further improvements in patient-rated outcomes. Exercise training during breast cancer chemotherapy may result in some longer-term and late effects for selected patient-rated outcomes.”
Exercise and yoga improves quality of life in women with early-stage breast cancer
Progressive resistance training in breast cancer: a systematic review of clinical trials. (Breast Cancer Res Treat. 2007) "Overall, the studies we reviewed suggest that women surgically treated for breast cancer can derive health-related and clinical benefits by performing PRT after breast cancer surgery."
Association between physical activity and quality of life among Western Australian breast cancer survivors. (Psychooncology. 2007) "We conclude that physically active and healthy weight breast cancer survivors report better QoL than their inactive and obese counterparts soon after completing adjuvant therapy."
Exercise May Reduce Fatigue, Nausea Associated With Adjuvant Breast Cancer Therapy
Randomized Trial of Exercise Therapy in Women Treated for Breast Cancer (J Clin Oncol 2007) "Conclusion: Exercise therapy had large, clinically meaningful, short-term beneficial effects on QoL in women treated for breast cancer; this finding cannot be attributable to attention, given that the exercise-placebo group did not report similar effects relative to usual care."
Prospective, longitudinal study of leisure-time exercise in women with early-stage breast cancer. (Cancer Epidemiol Biomarkers Prev. 2007)
Physical Activity, Body Mass Index, and Mammographic Density in Postmenopausal Breast Cancer Survivors. (J Clin Oncol. 2007) "CONCLUSION: Increasing physical activity among obese postmenopausal breast cancer survivors may be a reasonable intervention approach to reduce mammographic density."
General Information
Association between Breast Density and Subsequent Breast Cancer Following Treatment for Ductal Carcinoma In situ. (Cancer Epidemiol Biomarkers Prev. 2007)
Hereditary Breast Cancer: Part II. Management of Hereditary Breast Cancer: Implications of Molecular Genetics and Pathology. (Breast J. 2007)
Even Tiny Breast Tumors May Need Aggressive Treatment
Fewer Breast Patients May Need Chemo "The test is expensive -- $3,400 -- though many insurers are paying for it because it can avoid even more costly chemo."
Reducing the risk of early recurrence in hormone-responsive breast cancer. (Ann Oncol. 2007)
Weight Gain Hinders Breast Cancer Survival "New research suggests that for every 11 pounds a woman gains after being diagnosed with breast cancer, the chances of it proving fatal go up 14 percent."
MRI evaluation of pathologically complete response and residual tumors in breast cancer after neoadjuvant chemotherapy. (Cancer. 2007) "CONCLUSIONS.: MRI may predict pCR with high accuracy in HER-2 positive patients, but it has a high false-negative rate in HER-2 negative patients, particularly in patients who are receiving antiangiogenic agents. Results indicate that the chemotherapy agent should be taken into consideration when using MRI to interpret therapeutic outcomes. More studies are needed to establish the role of MRI in managing, especially surgical planning, patients who are receiving NAC."
HER-2 status discrepancy between primary breast cancer and metastatic sites. Impact on target therapy. (Int J Cancer. 2007) "For the treatment of metastatic patients, the evaluation of HER-2 status should be performed in neoplastic tissue from metastatic site, whenever possible. This procedure could be also suggested in the patients that are metastatic at the time of diagnosis."
Aromatase inhibitors: past, present and future in breast cancer therapy. (Med Oncol. 2007) "A greater understanding of this disease at a molecular level has led to the development of molecules that inhibit estrogen production by inhibiting the aromatase enzyme, that is the primary source of estrogen in postmenopausal women. This review examines the evolution of aromatase inhibitor (AI) based therapies over the past three decades. The third generation aromatase inhibitors (anastrozole, letrozole and exemestane), which have been found to be extremely specific and effective in an adjuvant/neoadjuvant/extended adjuvant setting are discussed from a biochemical and clinical perspective."
New Studies Are Raising Questions for Breast Cancer Patients "What's the controversy? Patients with breast cancer are routinely advised to take chemotherapy in addition to radiation and hormonal therapy following surgery, but some of the most effective chemotherapy drugs cause severe anemia, nerve damage and heart failure. The debate centers on who should use anthracyclines and when using the drugs Taxol and Herceptin provides enough additional benefits to offset the heart damage from Herceptin and nerve damage caused by Taxol. "
Some breast cancers don't respond to chemotherapy "An analysis of the results of several studies confirm previous reports suggesting that chemotherapy offers little or no survival benefits for young women with estrogen receptor (ER)-positive breast cancers and, if given, it should not be the sole second-phase, or "adjuvant" therapy. "Developing breast cancer at a young age is very worrying in terms of survival," lead researcher Dr. Jos J. A. van der Hage, from Leiden University in the Netherlands, said in a statement. "But some young women may be undergoing not only unpleasant but also unnecessary chemotherapy.""
Tracking Breast Cancer Treatment "Many breast cancer patients endure harsh rounds of chemotherapy only to find out their bodies don't respond. Doctors can use scans and physical exams to determine if a particular chemo is working, but that can take months. A new tool can tell women if their treatment is working within days."
[Locally advanced breast cancer:] (Ugeskr Laeger. 2007)
A multidisciplinary approach to the management of breast cancer, part 2: therapeutic considerations. (Mayo Clin Proc. 2007)
Trends for inflammatory breast cancer: is survival improving? (Oncologist. 2007)
Stress history and breast cancer recurrence. (J Psychosom Res. 2007)
A Multidisciplinary Approach to the Management of Breast Cancer, Part 1: Prevention and Diagnosis (Mayo Clin Proc. 2007) "It has become more evident that a multidisciplinary team approach that involves a spectrum of breast experts is necessary to provide optimal care to patients. This team includes medical oncologists, breast radiologists, breast pathologists, surgical breast specialists, radiation oncologists, geneticists, and primary care physicians. Furthermore, patient knowledge has increased use of the Internet, and more patients are seeking a multidisciplinary approach to treatment. This review considers information for health care professionals who will facilitate optimal patient care for women at increased risk for or presenting with a new diagnosis of breast cancer."
Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. (J Clin Oncol. 2007)
What progress have we made in managing inflammatory breast cancer? (Oncology (Williston Park). 2007)
Greater Survival After Breast Cancer in Physically Active Women With High Vegetable-Fruit Intake Regardless of Obesity (Journal of Clinical Oncology 2007)
Is the Whole Larger Than the Sum of the Parts? The Promise of Combining Physical Activity and Diet to Improve Cancer Outcomes "In summary, the data from the WHEL control cohort add to a growing body of literature that lifestyle does matter in breast cancer prognosis. Increasing physical activity to 30 to 60 minutes per day is a recommendation for the general population (US Department of Agriculture, the Department of Health and Human Services), and these data suggest that this recommendation should be extended to breast cancer patients and survivors. Similarly, increasing intake of vegetables and fruit is recommended for reducing risk for several diseases, and now seems to aid in improving breast cancer prognosis."
The Breast International Group 1-98 trial: big results for women with hormone-sensitive early breast cancer. (Expert Rev Anticancer Ther. 2007)
Postmastectomy radiation improves the outcome of patients with locally advanced breast cancer who achieve a pathologic complete response to neoadjuvant chemotherapy. (Int J Radiat Oncol Biol Phys. 2007)
Combo Therapies Work Best for Early Breast Cancer "Teaming up cancer therapies appears to be the ticket to survival for women with early stage breast cancer. New research shows women who receive both chemotherapy and tamoxifen end up living longer than those who receive tamoxifen alone"
The safety of breast-conserving therapy in patients with breast cancer aged (Cancer. 2007) "CONCLUSIONS.: The risk of local recurrence in young patients who underwent BCT was reduced strongly by using adjuvant systemic treatment. This finding may provide an argument if favor of advising the use of systemic treatment for all patients aged
Breast cancer therapies' side effects vary by age Risk of second non-hematological malignancies among 376,825 breast cancer survivors.
(Breast Cancer Res Treat. 2007) " Breast cancer survivors are at increased risk of treatment-related second cancers. This study is the first to examine risk 30 or more years after diagnosis and to present absolute risks of second cancer which accounts for competing mortality."
Management of early breast cancer in the elderly.
(nt J Cancer. 2007) Improving the quality and efficiency of follow-up after curative treatment for breast cancer - rationale and study design of the MaCare trial.
(BMC Cancer. 2007)
Guidelines
Recommendations from an international expert panel on the use of neoadjuvant (primary) systemic treatment of operable breast cancer: new perspectives 2006 (Annals of Oncology 2007)
NGC - Gemcitabine for the treatment of metastatic breast cancer. (2007)
NGC - Docetaxel for the adjuvant treatment of early node-positive breast cancer. (2006)
NGC - Paclitaxel for the adjuvant treatment of early node-positive breast cancer. (2006)
NGC - Trastuzumab for the adjuvant treatment of early-stage HER2-positive breast cancer. (2006)
SIGN - Management of breast cancer in women (2007)
Breast Cancer Follow-Up Guideline Summary and Surveillance Flow Sheet (2006)
Canadian breast cancer guidelines are as effective as possible under the circumstances.
Canadian breast cancer guidelines: have they made a difference? (CMAJ. 2007) "Our results suggest that the Canadian breast cancer guidelines are not meeting their stated objective. New strategies for guideline dissemination and implementation may be required."
NGC - Management of ductal carcinoma in situ of the breast: a clinical practice guideline. (2006)
Immunotherapy
Internet Sites
Treatment Information
National Comprehensive Cancer Network
NCI - Breast Cancer (PDQ®): Treatment
NCI - Dictionary of Cancer Terms
NCI - Overview of Nutrition in Cancer Care
Drug-Food-Supplement Information
DrugDigest (drug interactions)
FDA - Drug Interactions: What You Should Know
NIH - Botanical Dietary Supplements: Background Information
NIH - Drug, Supplements, and Herbal Information
NIH - Herbal Supplements: Consider Safety, Too
NIH - Vitamin and Mineral Supplement Fact Sheets
Nutrition
Dietary Flavonoid Intake and Breast Cancer Survival among Women on Long Island (Cancer Epidemiology Biomarkers & Prevention 2007) "Conclusion: Mortality may be reduced in association with high levels of dietary flavones and isoflavones among postmenopausal U.S. breast cancer patients. Larger studies are needed to confirm our findings."
Influence of a Diet Very High in Vegetables, Fruit, and Fiber and Low in Fat on Prognosis Following Treatment for Breast Cancer (JAMA 2007) "Conclusion Among survivors of early stage breast cancer, adoption of a diet that was very high in vegetables, fruit, and fiber and low in fat did not reduce additional breast cancer events or mortality during a 7.3-year follow-up period."
Can the combination of flaxseed and its lignans with soy and its isoflavones reduce the growth stimulatory effect of soy and its isoflavones on established breast cancer? (Mol Nutr Food Res. 2007)
Other
Radiation-Chemotherapy
Other Treatments
Experimental
Epigallocatechin-3 gallate induces growth inhibition and apoptosis in human breast cancer cells through survivin suppression. (Int J Oncol. 2007)
Radiotherapy
Left-sided breast cancer radiation ups heart risk "Women with early-stage cancer of the left breast who are treated with radiation as a component of breast-sparing treatment, have an increased risk of developing radiation-related coronary damage, researchers report."
Breast cancer in elderly women: Can radiotherapy be omitted? (Eur J Cancer. 2007)
[The role of radiotherapy in breast cancer.] (Gan To Kagaku Ryoho. 2007)
Less radiation safe for breast cancer "Women received either the standard 50 Grays, the unit used in measuring radiation, in 25 treatments spread over five weeks, or roughly 40 Grays given in 13 treatments every other day for five weeks or in 15 treatments over three weeks. Five years later, cancer recurrence rates were low for all groups, ranging from 2 percent to 5 percent. So few recurrences occurred — 158 — that doctors believe the treatments are equivalent but cannot say so with certainty. Many will want to see what happens to these women with longer follow up, said Dr. Gary Freedman of Fox Chase Cancer Center in Philadelphia."
Risk of second malignancies after adjuvant radiotherapy for breast cancer: A large-scale, single-institution review. (Int J Radiat Oncol Biol Phys. 2007) "CONCLUSIONS: This study suggests that adjuvant RT increased the rate of sarcomas and lung cancers, whereas it did not increase the rate of other malignancies."
Radiotherapy for Breast Cancer Raises Heart Disease Risk "As a treatment for breast cancer, radiotherapy, even modern regimens, appears to increase the risk of cardiovascular disease, according to a report in the Journal of the National Cancer Institute for March 7. Earlier reports have indicated that radiotherapy regimens used in the 1970s elevate cardiovascular risk, but it has been less clear if more recent regimens also increase the risk. "
Partial-breast irradiation: towards a replacement for whole-breast irradiation? (Expert Rev Anticancer Ther. 2007)
Rates of myocardial infarction and coronary artery disease and risk factors in patients treated with radiation therapy for early-stage breast cancer. (Cancer. 2007) " CONCLUSIONS.: Patients in this series had lower risk of ischemic cardiac events than expected. Although small in absolute magnitude, patients radiated to the left side did have a statistically significant increased risk of MI. These findings support further investigation of techniques to minimize the long-term cardiac risks faced by breast cancer patients."
Long-term results of breast cancer irradiation treatment with low-dose-rate external irradiation. (Int J Radiat Oncol Biol Phys. 2007)
Supplements-Vitamins-CAM
Complementary and alternative medicine use among breast cancer survivors. (J Altern Complement Med. 2007)
Ameliorating effect of coenzyme Q(10), riboflavin and niacin in tamoxifen-treated postmenopausal breast cancer patients with special reference to lipids and lipoproteins. (Clin Biochem. 2007)
Surgery
Recurrent Disease after Breast Preserving Therapy (BPT) and Radiation Therapy for Breast Cancer - Diagnostic Yield of Palpation, Mammography and Ultrasonography. (Ultraschall Med. 2007) "CONCLUSION: For diagnosing recurrent disease in patients status post BPT and radiation therapy, ultrasonography is superior to palpation and/or mammography and should become an obligatory follow-up tool. The role of mammographic follow-up appears overrated and the role of ultrasonographic assessment underrated. The S-3 guidelines will need to be changed accordingly."
Surgery Is Associated with Lower Morbidity and Longer Survival in Elderly Breast Cancer Patients over 80. (Breast J. 2007)
[The treatment of primary breast cancer, surgical approach.] (Gan To Kagaku Ryoho. 2007)
The safety of breast-conserving therapy in patients with breast cancer aged (Cancer. 2007) "CONCLUSIONS.: The risk of local recurrence in young patients who underwent BCT was reduced strongly by using adjuvant systemic treatment. This finding may provide an argument if favor of advising the use of systemic treatment for all patients aged
Breast Cancer Surgery May Do Harm Surgery, with or without tamoxifen, vs tamoxifen alone for older women with operable breast cancer: Cochrane review.
(Br J Cancer. 2007) Age remains the first prognostic factor for loco-regional breast cancer recurrence in young (<40 years) women treated with breast conserving surgery first.
(Radiother Oncol. 2007)
Transplantation
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