Breast cancer research and treatment
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Breast Cancer Res. Treat. · Dec 2008
Extending the benefits of adjuvant therapy in early HR+ breast cancer.
The benefits of adjuvant tamoxifen are well documented, but therapy is limited to 5 years because of reports of an unfavorable risk: benefit profile in later years. However, the risk of relapse continues beyond the end of therapy. Before the MA.17 trial, no agent given after the standard 5 years of adjuvant tamoxifen had been shown to provide additional benefit, leaving women unprotected against the ongoing risk of late recurrences of breast cancer. ⋯ In subsequent intention-to-treat analyses, the benefit of letrozole persisted, despite a significant proportion of patients in the placebo arm having crossed over onto late extended adjuvant letrozole. In additional pre-unblinding, retrospective analyses derived from the core MA.17 data, the benefits of extended adjuvant letrozole increased with treatment duration, at least upto 4 years, and the efficacy of letrozole appeared to vary in defined patient subgroups. Current data strongly support the use of extended adjuvant letrozole to protect postmenopausal women with HR+ early breast cancer against the risk of late recurrence of disease, and suggest that all women should be considered for letrozole, even if several years have elapsed since tamoxifen was completed.
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Breast Cancer Res. Treat. · Dec 2008
Randomized Controlled TrialA phase III randomized comparison of lapatinib plus capecitabine versus capecitabine alone in women with advanced breast cancer that has progressed on trastuzumab: updated efficacy and biomarker analyses.
Lapatinib is a small molecule, dual tyrosine kinase inhibitor of epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor type 2 (HER2). Initial results of a phase III trial demonstrated that lapatinib plus capecitabine is superior to capecitabine alone in women with HER2-positive advanced breast cancer that progressed following prior therapy including trastuzumab. Updated efficacy and initial biomarker results from this trial are reported. ⋯ The addition of lapatinib to capecitabine provides superior efficacy for women with HER2-positive, advanced breast cancer progressing after treatment with anthracycline-, taxane-, and trastuzumab-based therapy. Biomarker studies could not identify a subgroup of patients who failed to benefit from the addition of lapatinib to capecitabine.
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Breast Cancer Res. Treat. · Dec 2008
Paget's disease of the breast: the experience of the European Institute of Oncology and review of the literature.
Paget's disease of the breast is an uncommon presentation of breast malignancy, accounting for 1-3% of all the breast tumors and presents in different histopathologic patterns: in association with an underlying invasive or non invasive carcinoma, or without any underlying neoplasia. In the literature, different methods are used for the treatment. Mastectomy with or without axillary dissection has been considered as the standard treatment procedure for many years. Several studies have already shown that breast conservation with radiation therapy is an oncologically safe option. Regarding the axillary approach, several studies have documented the presence of positive sentinel lymph node even in Paget's disease alone. The objective of this study was to retrospectively analyze outcome of patients affected by Paget's breast disease and to define our institutional experience. ⋯ Screening examination and imaging techniques are fundamental. Breast conserving surgery combined with breast irradiation for patients with invasive and non invasive breast carcinoma has become the treatment of first choice. All surgical conservative approaches should include the complete nipple-areolar complex and margins of resected specimen free of tumor. Thanks to the evolution of the conservative approach, good cosmetic result can be obtained. To be informed about the axillary lymph node status and to avoid the patient to have a second surgical approach, sentinel lymph node biopsy should be performed.