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Infusion Therapy Virtual Tour

Breast cancer - Highlights

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of breast cancer.

Alternative Names

Mammograms; Mastectomy

Highlights:

Drug Approvals

In 2008, the FDA approved bevacizumab (Avastin) for treatment of patients who have not received chemotherapy for metastatic HER2-negative breast cancer. Bevacizumab is used in combination with paclitaxel. Studies indicate that bevacizumab helps prolong the time that patients stay free of disease progression, but the drug does not appear to help improve symptoms or overall survival.
In 2007, the FDA approved ixabepilone (Ixempra) for patients with metastatic or locally advanced breast cancer who have not responded to chemotherapy treatments with an anthracycline or taxane drug. Ixabepilone is used in combination with capecitabine.

Genetic Test Approval

In 2008, the FDA approved a new genetic test that can help predict which patients with breast cancer are good candidates for drug treatment with trastuzumab (Herceptin).
The SPOT-Light HER2 CISH kit measures the HER2 gene in tumor tissue samples. Patients who overproduce the HER2 gene may benefit from trastuzumab treatment.
HER2-positive cancers account for 15 - 25% of early-stage breast cancer and are associated with more aggressive disease. Younger women tend to be most affected.

Drug Warning

In 2008, the FDA required new safety information for three drugs used to treat anemia associated with chemotherapy.
According to the updated labels, the erythropoiesis-stimulating drugs epoietin alfa (Epogen, Procrit) and darberpetin alfa (Aranesp) should not be used unless a patient� ' s hemoglobin level drops to below 10 g/dL. Erythropoiesis-stimulating drugs should be stopped as soon as chemotherapy is completed.
These drugs can cause serious health risks if they are used to achieve hemoglobin levels higher than 12 g/dL.

Resources

www.cancer.gov -- National Cancer Institute
www.cancer.org -- American Cancer Society
www.asco.org -- American Society of Clinical Oncology
www.breastcancer.org -- BreastCancer.Org
www.komen.org -- Susan G. Komen Breast Cancer Foundation
www.nccn.org -- National Comprehensive Cancer Network
www.cancer.net -- Cancer.Net
www.cancer.gov/clinicaltrials -- Find clinical trials

References

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Boyd NF, Guo H, Martin LJ, Sun L, Stone J, Fishell E, et al. Mammographic density and the risk and detection of breast cancer. N Engl J Med. 2007 Jan 18;356(3):227-36.

Casey PM, Cerhan JR and Pruthi S. Oral contraceptive use and risk of breast cancer. Mayo Clin Proc. 2008;83(1): 86-90.

Chia SK, Speers CH, D'Yachkova Y, Kang A, Malfair-Taylor S, Barnett J, et al. The impact of new chemotherapeutic and hormone agents on survival in a population-based cohort of women with metastatic breast cancer. Cancer. 2007 Jul 23;110(5):973-979 [Epub ahead of print]

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Ferguson T, Wilcken N, Vagg R, Ghersi D and Nowak AK. Taxanes for adjuvant treatment of early breast cancer. Cochrane Database Syst Rev. 2007;(4): CD004421.

Geiger AM, Thwin SS, Lash TL, Buist DS, Prout MN, Wei F, et al. Recurrences and second primary breast cancers in older women with initial early-stage disease. Cancer. 2007 Mar 1;109(5):966-74.

Harris L, Fritsche H, Mennel R, Norton L, Ravdin P, Taube S, et al. American Society of Clinical Oncology 2007 update of recommendations for the use of tumor markers in breast cancer. J Clin Oncol. 2007 Nov 20;25(33):5287-312.

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Ives A, Saunders C, Bulsara M, Semmens J. Pregnancy after breast cancer: population based study. BMJ. 2007 Jan 27;334(7586):194. Epub 2006 Dec 8.

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Kerlikowske K, Miglioretti DL, Buist DS, Walker R, Carney PA; National Cancer Institute-Sponsored Breast Cancer Surveillance Consortium. Declines in invasive breast cancer and use of postmenopausal hormone therapy in a screening mammography population. J Natl Cancer Inst. 2007 Sep 5;99(17):1335-9. Epub 2007 Aug 14.

Khatcheressian JL, Wolff AC, Smith TJ, Grunfeld E, Muss HB, Vogel VG, et al.American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting. J Clin Oncol. 2006 Nov 1;24(31):5091-7. Epub 2006 Oct 10.

Lehman CD, Gatsonis C, Kuhl CK, Hendrick RE, Pisano ED, Hanna L, et al. MRI evaluation of the contralateral breast in women with recently diagnosed breast cancer. N Engl J Med. 2007 Mar 29;356(13):1295-303. Epub 2007 Mar 28.

Lohrisch C, Paltiel C, Gelmon K, Speers C, Taylor S, Barnett J, et al. Impact on survival of time from definitive surgery to initiation of adjuvant chemotherapy for early-stage breast cancer. J Clin Oncol. 2006 Oct 20;24(30):4888-94. Epub 2006 Oct 2.

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Pierce JP, Natarajan L, Caan BJ, Parker BA, Greenberg ER, Flatt SW, et al. Influence of a diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer: the Women's Healthy Eating and Living (WHEL) randomized trial. JAMA. 2007 Jul 18;298(3):289-98.

Punglia RS, Morrow M, Winer EP and Harris JR. Local therapy and survival in breast cancer. N Engl J Med. 2007;356(23): 2399-405.

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Ravdin PM, Cronin KA, Howlader N, Berg CD, Chlebowski RT, Feuer EJ, et al. The decrease in breast-cancer incidence in 2003 in the United States. N Engl J Med. 2007 Apr 19;356(16):1670-4.

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Saslow D, Boetes C, Burke W, Harms S, Leach MO, Lehman CD, et al. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin. 2007 Mar-Apr;57(2):75-89.

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Wolff AC, Hammond ME, Schwartz JN, Hagerty KL, Allred DC, Cote RJ, et al. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer. J Clin Oncol. 2007 Jan 1;25(1):118-45. Epub 2006 Dec 11.

Reviewed last on: 11/10/2008
Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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