Breast Cancer

Anecdotal reports of cognitive compromise among patients treated with chemotherapy are relatively common among breast cancer survivors and may play an important role in adversely affecting functioning in multiple domains. As noted by Dr. Olin,

Dr. Julie Olin has highlighted an important issue for patients and providers contemplating systemic therapy for breast cancer: how the brain works after such treatment. Her excellent article summarizes four important studies, identifies the research design problems and questions raised by these and other studies, and proposes a model for how chemohormonal therapy might affect cognitive functioning and quality of life (see Figure 1 of her article). Finally, she identifies how actual, as well as potential, cognitive impairment might influence patient decisions and care (the author’s Table 1).

Several trials have shown that anthracyclines and taxanes can be combined to achieve response rates ranging from 70% to 90%, with complete responses ranging from 19% to 41%. In an attempt to increase the activity while

Recently initiated is a phase III randomized trial (MA.21 trial) of adjuvant chemotherapy for node-positive and high-risk node-negative, premenopausal and postmenopausal (£ 60 years) women with breast cancer who have

Doxorubicin/paclitaxel (Taxol) combinations are very active in advanced breast cancer, with objective response rates up to 90%, but have shown a high incidence of cardiotoxicity. A phase I/II trial replacing

The aromatase inhibitors represent an important class of hormonal agents for the management of breast cancer. The third-generation aromatase inhibitors have replaced megestrol acetate as second-line hormonal

Tamoxifen (Nolvadex) has long been established as "standard" adjuvant therapy for receptor-positive, early-stage breast cancer. Results from clinical trials suggest that after approximately 5 years, tamoxifen may lose its

An underinvestigated area of breast cancer survivorship involves the possible impairment of cognitive function following adjuvant chemohormonal therapy. Numerous reports of disturbing and disruptive changes in short- and

Several attempts have been made to improve the survival rates of breast cancer patients. The benefit of adjuvant chemotherapy was clearly shown, but the absolute difference of 2% to 11% in overall survival, depending on the

According to data presented at the American Society of Hematology (ASH) meeting and the San Antonio Breast Cancer Symposium, elderly cancer patients may be up to two times as likely as younger patients to receive chemotherapy doses

FORT LAUDERDALE, Florida-A panel of breast cancer experts has revised the National Comprehensive Cancer Network (NCCN) breast cancer guideline to reflect an evolution rather than change. "The differences between this and last year’s guidelines are overall meaningful but subtle," Robert W. Carlson, MD, of Stanford Hospitals and Clinics, said at the Sixth Annual NCCN Conference.

SAN ANTONIO-By using a system combining color-based imaging and automated microscopy, pathologists were able to significantly improve their accuracy in evaluating HER-2 protein expression in breast cancer tissue, said Kenneth Bloom, MD, of Rush-Presbyterian-St. Luke’s Medical Center, Chicago.

NEW YORK-The jury may still be out on the value of adjuvant paclitaxel (Taxol) for early breast cancer (see article on page 3 on the updated NCCN breast cancer guideline), but a study from M.D. Anderson suggests it may have a small

WASHINGTON-Despite some promising new technologies, traditional x-ray film mammography remains the gold standard in screening for breast cancer, a committee of the Institute of Medicine (IOM) has concluded.

Medical researchers at the 23rd annual San Antonio Breast Cancer Symposium reported the results of a study showing that automated cell imaging adapted from Star Wars missile-

In response to the increasing use of sentinel lymphadenectomy, a panel convened by the American Society of Breast Surgeons has issued a revised consensus statement on performance and utilization criteria for sentinel lymphadenectomy.

BETHESDA, Md-A study of breast cancer patients with hereditary BRCA1 and BRCA2 mutations or sporadic cancers has shown a distinctive gene-expression profile for each type of breast cancer gene mutation and also revealed an unanticipated finding-a patient with a nonhereditary BRCA1 mutation.

BETHESDA, Md-General Motors Corp. is mailing information on the opportunity for a breast cancer risk assessment, available through the Study of Tamoxifen and Raloxifene (STAR), to 140,000 of its active and retired salaried female

The article by Dr. William Small on the role of radiation therapy in the treatment of breast cancer is a comprehensive review of the current standards of care and highlights the controversies surrounding recent trends. Breast cancer treatment has come full circle in the last 20 years, with emphasis now being placed on technical advances and treatment techniques as new data substantiate the impact of radiation therapy on survival following local surgery and mastectomy.

Dr. Small is to be commended for a well-written succinct review of the role of radiation therapy in the treatment of breast cancer. As he notes, there is still controversy in the management of these patients. However, as more evidence-based data are accumulated, the role of radiation therapy is being clarified.

Radiation therapy in combination with lumpectomy and axillary dissection has remained standard therapy for early-stage disease since the 1970s. Although there has been no definitive trial in patients with ductal carcinoma

The role of radiation therapy in the management of breast cancer has continued to evolve over the past several years, in both the breast-conserving and postmastectomy settings. In this issue of ONCOLOGY, Dr. William Small provides a thorough yet concise review of current practices in radiation therapy for ductal carcinoma in situ (DCIS), early-stage invasive breast cancer managed conservatively, and postmastectomy situations. These discussions are supported by a well-selected group of publications on each topic. In addition, the author summarizes the available data and some of the controversies surrounding the use of nodal irradiation, especially in this era of sentinel node biopsy. We would like to mention a few points that warrant further discussion.

WASHINGTON-A new analysis of data from the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) shows that among women who received their first NBCCEDP Pap test between 1991 and 1998, American Indian and Alaskan Native (AI/AN) women had the highest proportion of abnormal Pap tests, while white women had the highest rate of serious cervical lesions detected by biopsy.

SAN ANTONIO-The mitotic activity index (MAI), a measure of tumor cell proliferation, has been shown to be an independent prognostic factor for recurrence-free survival in breast cancer. It is being used in the Netherlands to select which node-negative patients require adjuvant chemotherapy, Elsken van der Wall, MD, PhD, said at the 23rd Annual San Antonio Breast Cancer Symposium.

SAN ANTONIO-Two computer programs designed to aid women with early breast cancer and their physicians in making decisions about adjuvant therapy will soon be available, according to presentations at the 23rd Annual San Antonio Breast Cancer Symposium.