Breast cancer is a prevailing disease worldwide that requires effective and rational therapy. For this purpose the use of various treatment modalities should be optimized according to the stage of disease and the risk: benefit ratio of the therapeutic agents employed in the patients. Although the therapies involved provide reduction in morbidity and mortality rates, monitoring is required to combat the resulting adverse drug reactions. This review would be helpful for healthcare professionals to address the multi factorial disease in accordance with its occurrence thereby providing rationalized therapy to the patients. Keywords: Breast cancer; Chemotherapy; Endocrine therapy; Adjuvant therapy IntroductionBreast cancer has increased universally [1,2] and is considered as the second chief mortality cause in women. Among top five cancers in Americans, it is the third fatal cancer [3] while it is also the most prevalent cancer in Asians [4]. Since breast cancer is a very diverse ailment [5] it has several indicators [6] associated to typical features of tissues, therapeutic evaluation and reaction to therapy [7]. Improvements in the diagnosis and management of breast cancer have yielded drop in mortality frequency, but it varies widely between diverse geographic areas [8,9]. For early and locally advanced breast carcinoma, the intention of treatment is cure while for metastasis, it is improvement in clinical presentation of disease and quality of life. Various approaches are employed for breast cancer management like surgery, radiation treatment, endocrine treatment and chemotherapy [10]. The management of breast cancer is discussed as follows since the disease requires proper monitoring and optimized treatment schedules in the patients. The incidence and risk factors of breast cancer vary geographically; also patients respond to the provided treatment differently, therefore, rationalized therapy in individual cases according to the stage of the disease is essential. General treatment recommendations according to Breast cancer stagingThe staging of breast cancer is one of the most consistent prognostic signs that provide valuable confirmation about the current status of cancer identification and its therapy. The staging of breast cancer involves tumor size (T 1-4), association of lymph nodes (N 1-3) and existence of distant metastases (M 0-1).In stage 0, lumpectomy alone can be employed for Ductal Carcinoma in Situ (<0.5cm diameter) but for larger lesions, it is used with adjuvant radiation therapy. Extensive Ductal Carcinoma in Situ (i.e. involving two or more quadrants of the breast) requires mastectomy; adjuvant Tamoxifen therapy is considered in all patients [11].According to existing practice for Stage I and II, after considering axillary lymph node status, lumpectomy and radiation therapy are used in patients with stage I or II breast cancer; this has displayed equivalent effects for total mastectomy and for lumpectomy followed by radiation therapy with 5 and 8 year disease-free and overall survival ra...

Breast cancer is a commonly diagnosed neoplastic ailment in females particularly near menopause. This ailment signifies a substantial health problem as it has influenced a large number of women. Several risk factors are associated with breast cancer that cannot be altered, but certain can be modified. The existence of risk factors of breast carcinoma does not mean that cancer is unavoidable; numerous females having risk factors not ever developed the disease. The risk factors aid in identifying the females who may get help at maximum from screening or other precautionary measures. It is noteworthy that breast carcinoma can also ensue in females with no recognizable risk factors. The augmented occurrence of breast cancer worldwide revealed by several epidemiological investigations indicates the need of aiming multidirectional investigations so as to ascertain risk factors linked with the incidence of this disease.

Introduction: A descriptive, non-interventional study was conducted from April 2011 to September 2013, at KIRAN hospital, Karachi among n = 811 female breast cancer patients to assess the effects of chemotherapeutic agents that were employed for the treatment of breast cancer. The assessment was done so as to see the variation in response of the patients towards the drugs used specifically the adverse effects that have to be combated during therapy.Methodology: During 3-6 months, a follow up was done to collect data for ADEs (Adverse Drug Events) that occurred among patients after therapy. The SPSS version 16.0 was used for statistical analysis of the data. The adverse events that occurred due to adjuvant chemotherapy including severity, preventability and causality were evaluated using three International scales i.e. Modified Schumock and Thornton scale, modified Hartwig's and Siegal's scale and Naranjo's algorithm. Results and Discussion:Majority of the patients received 6 cycles of FAC therapy (5-fluorouracil, Adriamycin/doxorubicin, cyclophosphamide) and showed good response. The assessment of ADRs using different scales revealed hair loss, nausea, vomiting, anemia and neutropenia as the non-preventable definite effects that were experienced by the patients. Mild to moderate diarrhea/constipation was probably preventable and hence doubtful. Moderately probable effects included mucositis and mouth ulcers whereas possible effects included fever and chills. Conclusion:Through the right use of medicines, the mild effect of headache and pain could be certainly preventable. Hence chemotherapeutic agents must be chosen for each patient on individual basis to prevent or lessen the toxic effects rendered to them and be useful in the disease course.

No abstract