et al. Ingle JN, 2004;350(11):1081–1092. Jacquemier J, 6. J Natl Cancer Inst. Bordes V, Mieog JS, van der Hage JA, van de Velde CJ. 33. Axillary recurrence after a tumour-negative sentinel node biopsy in breast cancer patients: a systematic review and meta-analysis of the literature. Drugs.com. Langer I,

Is a Breast Cancer Clinical Trial Right for You? Bordes V, Duffy MJ, Clarke M, Because of the benefit of adding trastuzumab to adjuvant chemotherapy in early-stage breast cancer, 12 months of postoperative trastuzumab is recommended for patients who have LABC with ERBB2 overexpression. Coombes RC, 43. Smith I, Classe JM, AJCC Cancer Staging Manual. Prognosis after treatment for loco-regional recurrence after mastectomy or breast conserving therapy in two randomised trials (EORTC 10801 and DBCG-82TM). Risk factors for breast recurrence in premenopausal and postmenopausal patients with ductal cancers treated by conservation therapy. 2008;15(11):3227–3231. 81/No. Think about joining a support group.

et al. et al. Guller U, 2010. Limeres González MA, **— May not need to explore axilla if ALN dissection is done initially and there are clinically negative nodes with recurrence. Progress and promise: highlights of the international expert consensus on the primary therapy of early breast cancer 2007 [published correction appears in Ann Oncol. Sentinel lymph node biopsy in breast cancer: a comprehensive literature review. A personalized approach to cancer treatment: how biomarkers can help.

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38. Benefit of adjuvant therapy is uncertain and currently being studied; until results are available, chemotherapy is generally recommended. East Hanover, N.J.: Novartis Pharmaceuticals Corporation; 2010. http://www.femara.com/full-prescribing-information.jsp. Hsu-Schmitz SF, Perez EA, et al. Studies of the HER-2/neu proto-oncogene in human breast and ovarian cancer. Ferguson T, Wilcken N, Vagg R, Ghersi D, Nowak AK.

Amalric R, KAREN L. MAUGHAN, MD, is an associate professor of family medicine and assistant residency director at the University of Virginia in Charlottesville.... MARK A. LUTTERBIE, MD, is an academic fellow in the Department of Family Medicine at the University of Virginia. Tax ID Number: 13-1788491. If time permits, it is often a good idea to seek a second opinion. After induction chemotherapy, patients are usually treated with mastectomy followed by chest wall radiation. Crown J. 5. Want to use this article elsewhere?

Bryant J, ; Aromatase inhibitors should be considered in all post-menopausal women with hormone receptor–positive breast cancer.

NCCN clinical practice guidelines in oncology: breast cancer. HER2 and responsiveness of breast cancer to adjuvant chemotherapy. et al. Eur J Surg Oncol. Voogd AC, Darby S, If there is evidence of axillary involvement without distant metastases, axillary evaluation is recommended. Most studies suggest a small benefit for treatment with anthracyclines or taxanes over other chemotherapies,12 particularly in women with tumors overexpressing ERBB2.48 A systematic review of 12 studies demonstrated disease-free and overall survival advantages when using a taxane-containing regimen for premenopausal and post-menopausal women with early-stage breast cancer.49 A meta-analysis of 13 RCTs determined that adding a taxane to an anthracycline-based regimen improved disease-free survival (five-year risk reduction = 5 percent) and overall survival (five-year risk reduction = 3 percent).50, Endocrine Therapy. Trials consistently show that aromatase inhibitors reduce the risk of relapse of early-stage breast cancer both in direct comparison with and after completion of tamoxifen.36,38,51,52 A large RCT showed that treatment with letrozole (Femara) following five years of treatment with tamoxifen decreased the incidence of contralateral breast cancer and improved disease-specific survival in patients who were node positive.53 None of these studies showed improvement in overall survival compared with tamoxifen.36,38,51–53 Many women tolerate aromatase inhibitors better than tamoxifen.40 Aromatase inhibitors are not indicated for premenopausal women. Jonsson PE. ; et al. ALN dissection is indicated for all women with palpable lymph nodes or a positive SLN.32, Typically, whole-breast radiation is performed following breast-conserving surgery to treat subclinical disease.

The American Cancer Society is a qualified 501(c)(3) tax-exempt organization. Combinations of chemotherapy drugs are most often used for breast cancer because they are more effective than single drugs. CA Cancer J Clin.

Yap J, Ring A, 2003;349(19):1793–1802. 2005;103(4):689–695.

De Laurentiis M, Prechtl A, [email protected] for copyright questions and/or permission requests. J Clin Oncol. Extensive lymph node involvement (i.e., more than three axillary, internal mammary, or clavicular nodes), residual pathologic tumors larger than 2 cm, multifocal residual disease, and lymphovascular invasion increase the rate of local recurrence following breast-conserving surgery after induction chemotherapy and, therefore, warrant mastectomy.19, Most patients presenting with LABC have clinically positive lymph nodes and require ALN dissection. ; Breast-conserving surgery should be followed by radiation therapy in women with early-stage invasive or locally advanced breast cancer. May not need to explore axilla if ALN dissection is done initially and there are clinically negative nodes with recurrence.
Our volunteers provide one-on-one support through our website and mobile app to help those facing breast cancer cope with diagnosis, treatment, side effects, and more. Karam A, Morrow M, Progress on BIG 1-02/IBCSG 27-02/NSABP B-37, a prospective randomized trial evaluating chemotherapy after local therapy for isolated locoregional recurrences of breast cancer. New York, NY: Springer-Verlag; 2002:223–240. Sentinel lymph node biopsy in operations for recurrent breast cancer. Data were collected through 2006 and reported using classifications of in situ, localized, regional, and distant. 2005;366(9503):2087–2106.

National Cancer Institute of Canada Clinical Trials Group. Be sure to talk to your cancer care team about any method you are thinking about using. Lancet. ; They can help you learn what is known (or not known) about the method, which can help you make an informed decision. 2008;34(12):1277–1284. Chemoprevention of breast cancer: recommendations and rationale. Accessed February 8, 2010.

What does it take to outsmart cancer? People with cancer need support and information, no matter what stage of illness they may be in. Salem A. Breast-conserving surgery followed by radiation therapy is standard treatment for DCIS; however, mastectomy may be recommended for extensive or multifocal disease. Buzdar A, 62.

et al. Giuliano AE,