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Breast Cancer

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The National Cancer Act of 1971 was established when then President Nixon declared the "war on cancer." Since that time, no magic bullet has been discovered, and it is apparent that we have not been victors in the war against the nation's second leading killer. Overall cancer rates have continued to rise, with only a slight decrease in mortality from breast and other cancers. Nevertheless, remarkable progress has been made in the cure of childhood cancers, Hodgkin's disease, and testicular cancer.[1,2]

Tamoxifen is currently the endocrine therapy of choice for early and advanced breast cancer. Attempts to improve the therapeutic efficacy have included altering the triphenylethylene ring structure of tamoxifen, forming

In 1977, tamoxifen, a nonsteroidal antiestrogen, was approved in the United States for the management of advanced breast cancer in postmenopausal women. Since that time, tamoxifen's therapeutic role has grown to

Tamoxifen is currently the endocrine treatment of choice for all stages of breast cancer and is the gold standard for antiestrogen treatment. Over the last 25 years, the drug has revolutionized breast cancer therapy. The extension of the use of this agent has occurred because of open dialogue between the laboratory and the clinic, in which laboratory findings led to extension of clinical use. Tamoxifen was originally discovered as part of a contraceptive research program at ICI Pharmaceuticals (now Zeneca). On the basis of the estrogen dependence of many breast cancers, tamoxifen, a potent antiestrogen, was predicted to have anticancer activity. Laboratory and animal studies demonstrated efficacy in breast cancer and an ability to block binding of estradiol to the estrogen receptor of human breast cancer. Preclinical studies showed the benefit of long-term vs short-term tamoxifen treatment, a finding duplicated in the clinic. [ONCOLOGY 11(Suppl 1):7-13, 1997]

DALLAS-A new interactive computer program, The Ethics Companion, is currently under development to help physicians think through ethical dilemmas in genetic testing for breast cancer, Gail Tomlinson, MD, PhD, of the University of Texas Southwestern Medical Center, said at a poster paper at the San Antonio meeting.

BOSTON-Neither the presence nor the extent of lobular carcinoma in situ (LCIS) is related to risk of local recurrence in patients with invasive breast cancer treated with conservative surgery and radiotherapy, a retrospective study from the Joint Center for Radiation Therapy has shown.

SAN ANTONIO--A new decision aid, developed by a group of Canadian researchers, uses an audiotape and a workbook to help women with early-stage breast cancer decide between mas-tectomy and breast-conserving surgery with radiation therapy.

CHICAGO--Although mammography is the best screening tool for breast cancer, it misses carcinoma in 15% or more of women with dense breasts. Supplemental, bilateral, high-resolution ultrasound can find these malignancies, Thomas M. Kolb, MD, a New York City radiologist who specializes in breast cancer detection, reported at the Radiological Society of North America meeting.

ROCKVILLE, Md--The Food and Drug Administration's Oncologic Drugs Advisory Committee (ODAC) voted, with one abstention, to recommend the approval of Femara Tablets (letrozole, Ciba-Geigy Corp.) for the treatment of advanced breast cancer in postmenopausal women who suffer a relapse or disease progression after antiestrogen therapy.

COLUMBUS, Ohio--Many of the diagnostic tests and procedures following treatment for breast cancer fail to extend survival, as demonstrated by two randomized, prospective studies and nine retrospective studies, said Victor G. Vogel, MD, MHS, director of the Comprehensive Breast Cancer Program at the University of Pittsburgh.

PALM SPRINGS, Calif--A large body of research on toremifene (Fareston) has been accumulated in research carried out over more than a decade in Europe, the United States, and the former Soviet Union, John T. Hamm, MD, of the University of Louisville and Alliant Health Systems, said in his presentation on the phase II trials of the agent.

SAN ANTONIO--Hormone responsiveness is one of the few prognostic markers for breast cancer that actually predicts a better prognosis, Benita S. Katzenellenbogen, PhD, said in her William L. McGuire Memorial Lecture at the San Antonio Breast Cancer Symposium.