Adjuvant therapy in stage I carcinoma of the breast

Abstract

BACKGROUND: Breast Health International and the Kimmel Cancer Center of Thomas Jefferson University cosponsored a consensus conference that included an international group of experts. METHODS: Since the adoption of adjuvant chemotherapy for stage I, lymph node‐negative breast cancers in 1988, investigators have tried to “fine‐tune” the treatment criteria. At this consensus conference, the group debated recommendations for adjuvant hormone and cytotoxic chemotherapy in stage I breast cancers. RESULTS: Discussions during the conference addressed issues of adjuvant therapy for stage I breast cancer and the influence of multigene analyses and molecular phenotyping. The panelists discussed various demographic, morphologic, biologic, and genetic factors expressed by individual tumors and their influence on treatment decisions. CONCLUSIONS: The panel tried to create guidelines for the consideration of adjuvant treatment of these patients, including both hormone and cytotoxic regimens. They also encouraged further research into the molecular analysis of breast cancers and the introduction of clinical trials based on current data, although they concluded that it is too early to add any of those analyses into the decision‐making algorithms of recommendations for the treatment of stage I breast cancer. Cancer 2012;. © 2012 American Cancer Society.

Cancer–stromal cell interactions mediated by hypoxia-inducible factors promote angiogenesis, lymphangiogenesis, and metastasis

“…51 Women with triple-negative ( i.e. ER − /PR − /HER2 − ) breast cancer are treated with cytotoxic chemotherapy, but have early recurrence and a poor prognosis, 52 indicating a need for novel therapeutic approaches.…”

The added value of ultrasound imaging biomarkers to clinicopathological factors for the prediction of high-risk Oncotype DX recurrence scores in patients with breast cancer

“…It is widely acknowledged that adjuvant chemotherapy should not be administered for HR-positive, HER2-negative tumors except for those in very young women (aged <40 years). Molecular analysis in this patient category has been recommended for influencing the treatment recommendation ( 24 ). As ODX is the most widespread tool for genetic analysis, our study established a model for assessing ODX RS and achieved good results in this population.…”

Clinicians’ Expectations for Gene-Driven Cancer Therapy

“…It was concluded in 2012 that as a rule the molecular data on gene-driven therapies and specifically on breast cancer gene profiles were not sufficiently mature to include them in decision-making algorithms determining treatment recommendations for individual patients. 18 In many ways, the promise of a new era of gene-driven therapies relies on all tumor genes being taken into account at one time and making a difference to patient therapy. 28 However, development is proceeding slowly and is likely to advance stepwise through the application of the classical logic of the natural sciences.…”