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Regina J. Brown, MD

Regina J. Brown, MD

Medical Director of Oncology, Lone Tree Health Center, University of Colorado Health, Lone Tree, Colorado
Assistant Professor of Medicine, Division of Medical Oncology, University of Colorado Anschutz Medical Campus, Aurora, Colorado

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A 46-year-old woman had a routine screening mammogram that showed new calcifications in the posterior left breast. A diagnostic mammogram showed several small punctate calcifications, and a 6-month interval follow-up was recommended.

A 22-year-old college student with primary amenorrhea due to Müllerian agenesis presented with a headache, dysarthria, nausea, vomiting, and left upper extremity weakness. MRI of the brain showed numerous intracranial lesions.

Improvements in early diagnosis
and treatment of breast cancer over
the past few decades have clearly
reduced disease-related mortality. The
2000 Oxford Overview published recently
by the Early Breast Cancer Trialists’
Cooperative Group (EBCTCG)
highlights some of the widely practicable
adjuvant drug treatments that
were under investigation in the 1980s,
and have substantially reduced 5-year
recurrence rates as well as 15-year
mortality rates.[1] Optimal adjuvant
hormone therapy is associated with a
substantial improvement of disease
outcomes in hormone receptor–positive
women. Chemotherapy is also
associated with considerable benefits
in women with breast cancer, regardless
of age, stage, or hormone receptor
status. However, chemotherapy is
not without risks. The treatment is
associated with many adverse events
that may significantly affect a patient’s
quality of life while she is receiving
treatment. Other effects may be longstanding,
permanent, and, rarely, lifethreatening.

Drs. Partridge and Schapira are
to be complimented on a concise
and comprehensive review
of pregnancy before, during, and
after a diagnosis of breast cancer. As
women are able and willing to defer
pregnancy until later in life, the issues
addressed in this article will be encountered
with increasing frequency
in oncology.

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