Sandra M. Swain, MD, FACP

At this point, there is expectation that pertuzumab given in the neoadjuvant setting will improve long-term efficacy. We welcome the opportunity to include pertuzumab in the neoadjuvant regimen of patients with HER2-positive breast cancer.

Inflammatory breast cancer (IBC) is an aggressive and lethal form of breast cancer. It is also an entity for which no consensus exists regarding its clinical definition. The current nomenclature is considered a misnomer since its clinical presentation is not caused by inflammatory components but mainly by lymphatic obstruction.

More women, and especially more premenopausal women, are surviving their cancer diagnosis. However, due to their therapy, these women may become symptomatic from iatrogenic ovarian failure. For some, the use of hormone replacement therapy (HRT) is contraindicated because it may affect the course of their disease. Other women and their physicians may feel uncomfortable with the use of hormones because research is inconclusive regarding long-term survival or disease recurrence. Women who experience a cessation of menses due to adjuvant therapy for breast cancer are more likely than women undergoing a natural menopause to experience severe hot flashes, night sweats, and fatigue.[1] However, nonhormonal interventions appear to benefit many of these women[2] and should be used to decrease their symptoms. Barton, Loprinzi, and Gostout address these concerns in their excellent review and offer recommendations for pharmacologic and nonpharmacologic interventions.

Adjuvant chemotherapy represents a significant advance in the management of early-stage breast cancer and, as such, has saved many lives. Worldwide, adjuvant chemotherapy has benefitted all groups tested, including

There are several million breast cancer survivors worldwide. In the United States, 180,000 women were diagnosed with breast cancer in 1997, and approximately 97,000 of these women have an extremely low chance of suffering a recurrence of their cancer. With an average age at diagnosis of 60 years and a 25-year expected duration of survival, the current number of breast cancer survivors in the United States may approach 2.5 million women. Since breast cancer is now being detected at an earlier stage than previously and since adjuvant chemotherapy may cause ovarian failure, an increasing number of women are becoming postmenopausal at a younger age after breast cancer treatment. This conference was convened in September 1997 to consider how menopausal breast cancer survivors should be treated at the present time and what future studies are needed to develop improved therapeutic strategies. A total of 59 breast cancer experts and patient advocates participated. The proceedings of the conference will be published in six installments in successive issues of oncology. The first part, published last month, defined the problem and explored its magnitude and ramifications for patient management. This second part focuses on the benefits and risks of hormone replacement therapy (HRT) in patients with breast cancer. [ONCOLOGY 13(2):245-267, 1999]

There are several million breast cancer survivors worldwide. In the United States, 180,000 women were diagnosed with breast cancer in 1997, and approximately 97,000 of these women have an extremely low chance of suffering a recurrence of their cancer. With an average age at diagnosis of 60 years and a 25-year expected duration of survival, the current number of breast cancer survivors in the United States may approach 2.5 million women. Since breast cancer is now being detected at an earlier stage than previously and since adjuvant chemotherapy may cause ovarian failure, an increasing number of women are becoming postmenopausal at a younger age after breast cancer treatment. This conference was convened in September 1997 to consider how menopausal breast cancer survivors should be treated at the present time and what future studies are needed to develop improved therapeutic strategies. A total of 47 breast cancer experts and 13 patient advocates participated. The proceedings of the conference will be published in six installments in successive issues of oncology. This first part defines the problem and explores its magnitude and ramifications for patient management. [ONCOLOGY 1(13):109-136, 1999]

The incidence of ductal carcinoma in situ (DCIS) has increased dramatically since the advent of screening mammography in the 1980s. The age-adjusted DCIS incidence rates increased 17.5% annually from 1983 to 1992.[1] The percentage of patients with DCIS treated with mastectomy has decreased from 71% in 1983 to 44% in 1992. The percentage of patients with DCIS undergoing lumpectomy and radiation in 1992 was 23.3% and lumpectomy only was 30.2%.