Breast Cancer

Cancer and aging seem to go hand in hand. Most cancers and most cancer deaths occur in individuals over age 65 years. Likewise, as we age, osteoarthritis, heart disease, diabetes, and memory lapses seem to become part of our daily burden. Drs. Kimmick and Muss have detailed a strategy for managing breast cancer in older women. However, as they point out, there are several problems with defining optimal therapy for the elderly.

Breast cancer is a common problem in older women. As the number of medical illnesses increases with age and the life expectancy decreases, the benefits of systemic therapy for women with breast cancer become questionable. All women over age 65 years are at high enough risk of breast cancer to consider the risk/benefit ratio of preventive therapy with tamoxifen (Nolvadex) or participation in the Study of Tamoxifen and Raloxifene (STAR) trial. Adjuvant chemotherapy and hormonal therapies for early breast cancer significantly improve disease-free and overall survival; recommendations for their use are based on risk of tumor recurrence. Use of tamoxifen in the adjuvant setting in women with receptor-positive tumors is a relatively simple decision in light of its favorable toxicity profile. The delivery of adjuvant chemotherapy is a more complicated decision, and the patient’s wishes, estimated life expectancy, presence of comorbid conditions, and estimated benefit from treatment should be considered. The primary goal of the treatment of metastatic breast cancer is palliation. We discuss trials specific to older women and make appropriate treatment recommendations. Unfortunately, there is a paucity of data from clinical trials in women over age 70 years. However, because the clinical trial is the primary scientific mechanism for testing the efficacy of a treatment, every effort should be made to enter older women into treatment protocols. [ONCOLOGY 15(3):280-299, 2001]

CHICAGO-Computer-aided detection (CAD) is proving to be a technologic leap in the identification of breast tumors with subtle findings on mammography that can easily be missed by the radiologist, said Timothy W. Freer, MD, director of the Women’s Diagnostic and Breast Health Center, Plano, Texas.

EAST HANOVER, NJ-Novartis Oncology has announced that the FDA has approved Femara (letrozole tablets) for the first-line treatment of postmenopausal women with hormone-receptor-positive or hormone-receptor-unknown, locally advanced or metastatic breast cancer. Most postmenopausal women with advanced breast cancer fall into these tumor-receptor categories, the company said in a news release.

This second edition of the text edited by Bland and Copeland represents a comprehensive reference that reviews the history, pathobiology, and current clinical management of diseases of the breast. Much more than a book about breast

SAN ANTONIO-At a gala reception held during the 23rd Annual San Antonio Breast Cancer Symposium, nine cancer organizations released its list of the "top 100" breast cancer researchers- those with the most published studies in the 20th century advancing breast cancer treatment.

SAN ANTONIO-In the treatment of early-stage breast cancer, postoperative radiation therapy after sector resection (breast-conserving surgery) reduces recurrences but does not influence survival, according to a Swedish study presented at the 23rd Annual San Antonio Breast Cancer Symposium.

SAN ANTONIO-The Y-box-binding protein-1 (YB-1) appears to be a clinically significant tumor marker in breast cancer, according to results of a pilot study presented by Nadia Harbeck, MD, PhD, at the 23rd Annual San Antonio Breast Cancer Symposium.

SAN ANTONIO-Adding weekly paclitaxel (Taxol) and carboplatin (Paraplatin) to trastuzumab (Herceptin) improves disease control among women with advanced breast cancer, according to results of an ongoing phase II trial reported by Howard A. Burris III, MD, director of drug development, Sarah Cannon Cancer Center, Nashville.

For the first time, researchers believe they may be able to predict which breast cancer patients are at high risk of developing bone metastases. By identifying these patients, researchers say drugs now used to treat bone cancer may also prove useful in

Novartis Oncology recently announced that the US Food and Drug Administration (FDA) has approved letrozole (Femara) tablets for the first-line treatment of postmenopausal women with hormone-receptor-positive or hormone-receptor-unknown

The 4th National Institutes of Health (NIH) Consensus Conference on Adjuvant Therapy of Breast Cancer, held November 1-3, 2000, concluded that decreasing breast cancer mortality rates in the United States were due, at least in part, to advances made in adjuvant treatment. This fact lends credence to the importance of incremental improvements that have resulted from randomized, controlled clinical trials of adjuvant therapy, and underscores the value of this approach. With 185,000 new diagnoses of breast cancer expected in the United States in 2000, over 100,000 women may be candidates for some form of adjuvant therapy each year.[1]

Many active cytotoxic agents exist for breast cancer therapy, and numerous combination chemotherapy regimens are derived from them. Creating these combinations is sometimes empirically motivated by non-overlapping

Dr. Subir Nag et al are to be congratulated for their excellent, thorough analysis and presentation of the use and role of

The article by Nag and colleagues of the American Brachytherapy Society is a well-intentioned effort to establish guidelines

Breast cancer is sensitive to several cytotoxic drugs. Combination cytotoxic regimens are associated with higher response rates and longer durations of response and, occasionally, survival, than are single-agent regimens.

Numerous trials have shown that the pharmacokinetic interferences of epirubicin (Ellence)/paclitaxel (Taxol) combinations produce less pharmacodynamic effect than doxorubicin/paclitaxel regimens. Paclitaxel is more easily

Whole-breast external-beam radiation therapy (EBRT) involves a 6-week course of fractionated treatments. In

Pemetrexed disodium (Alimta, LY231514) is a novel, multitargeted antifolate that inhibits thymidylate synthase, dihydrofolate reductase, and glycinamide ribonucleotide formyl transferase. This agent is broadly active in a wide

In recent years, the clinical application of paclitaxel (Taxol), docetaxel (Taxotere), vinorelbine (Navelbine), and trastuzumab (Herceptin) has improved the management of advanced breast cancer. With the introduction of

Docetaxel (Taxotere) and gemcitabine (Gemzar) are active agents against breast cancer. Several phase I studies evaluated different schedules of their combination and clearly demonstrated that docetaxel and gemcitabine can

In a single-center, open, phase II trial, we assessed the toxicity and activity of a triple combination therapy-doxorubicin at 30 mg/m2 (day 1), paclitaxel (Taxol) at 135 mg/m2 (day 2), and gemcitabine (Gemzar) at 2,500 mg/m2

In a phase II trial, 29 patients with anthracycline-pretreated or anthracycline-resistant metastatic breast cancer in whom anthracycline-containing first- or second-line chemotherapy failed received combination paclitaxel

A phase II trial evaluated the effectiveness and toxicity of combination paclitaxel (Taxol), gemcitabine (Gemzar), and trastuzumab (Herceptin) as first-line therapy for patients with newly diagnosed HER2-overexpressing

The goal of this activity is to clarify challenging treatment issues of HER2+ breast cancer including incorporation of predictive and prognostic biomarker tests and evidence-based data into practice when determining individualized strategies that improve patient survival and quality of life.

Capecitabine (Xeloda) is the first orally available fluoropyrimidine approved for use in patients with cancer. It was initially approved for use in metastatic breast cancer, but significant data also support its use in the management

UFT and leucovorin (Orzel) is a combination of tegafur and uracil in a molar ratio of 1:4. Tegafur, a prodrug of 5-fluorouracil (5-FU), is converted to 5-FU by the hepatic cytochrome P450 pathway, whereas uracil enhances the

New treatment strategies for advanced breast cancer have focused on both the development of new molecular targets in breast cancer cells, as well as improving the therapeutic index of presently available therapy. The

WASHINGTON-Inositol hexa-phosphate (IP6) has shown antitumor effects in vitro and in animal models and may be ready for clinical trials in humans, said Ivana Vucenik, PhD, associate professor of medical and research technology, University of Maryland School of Medicine, Baltimore. She presented her study results at the Susan G. Komen Breast Cancer Foundation grants conference "Reaching for the Cure."

BETHESDA, Md-Adjuvant therapy should be offered as an option to node-negative breast cancer patients, even those with tumors smaller than 1 cm, said Bernard Fisher, MD, scientific director of the National Surgical Adjuvant Breast and Bowel Project (NSABP).