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Journal of Nuclear Medicine : Official... Feb 2016The diagnosis and management of breast cancer are undergoing a paradigm shift from a one-size-fits-all approach to an era of personalized medicine. Sophisticated... (Review)
Review
The diagnosis and management of breast cancer are undergoing a paradigm shift from a one-size-fits-all approach to an era of personalized medicine. Sophisticated diagnostics, including molecular imaging and genomic expression profiles, enable improved tumor characterization. These diagnostics, combined with newer surgical techniques and radiation therapies, result in a collaborative multidisciplinary approach to minimizing recurrence and reducing treatment-associated morbidity. This article reviews the diagnosis and treatment of breast cancer, including screening, staging, and multidisciplinary management.
Topics: Antineoplastic Agents; Breast Neoplasms; Disease Management; Female; Humans; Molecular Targeted Therapy; Neoplasm Recurrence, Local; Precision Medicine
PubMed: 26834110
DOI: 10.2967/jnumed.115.157834 -
American Family Physician Jun 2010Understanding breast cancer treatment options can help family physicians care for their patients during and after cancer treatment. This article reviews typical... (Review)
Review
Understanding breast cancer treatment options can help family physicians care for their patients during and after cancer treatment. This article reviews typical treatments based on stage, histology, and biomarkers. Lobular carcinoma in situ does not require treatment. Ductal carcinoma in situ can progress to invasive cancer and is treated with breast-conserving surgery and radiation therapy without further lymph node exploration or systemic therapy. Stages I and II breast cancers are usually treated with breast-conserving surgery and radiation therapy. Radiation therapy following breast-conserving surgery decreases mortality and recurrence. Sentinel lymph node biopsy is considered for most breast cancers with clinically negative axillary lymph nodes, and it does not have the adverse effects of arm swelling and pain that are associated with axillary lymph node dissection. Choice of adjuvant systemic therapy depends on lymph node involvement, hormone receptor status, ERBB2 (formerly HER2 or HER2/neu) overexpression, and patient age and menopausal status. In general, node-positive breast cancer is treated systemically with chemotherapy, endocrine therapy (for hormone receptor-positive cancer), and trastuzumab (for cancer overexpressing ERBB2). Anthracycline- and taxane-containing chemotherapeutic regimens are active against breast cancer. Stage III breast cancer typically requires induction chemotherapy to downsize the tumor to facilitate breast-conserving surgery. Inflammatory breast cancer, although considered stage III, is aggressive and requires induction chemotherapy followed by mastectomy, rather than breastconserving surgery, as well as axillary lymph node dissection and chest wall radiation. Prognosis is poor in women with recurrent or metastatic (stage IV) breast cancer, and treatment options must balance benefits in length of life and reduced pain against harms from treatment.
Topics: Antineoplastic Agents; Breast Neoplasms; Combined Modality Therapy; Female; Humans; Mastectomy; Neoplasm Staging; Sentinel Lymph Node Biopsy
PubMed: 20521754
DOI: No ID Found -
Pediatric Blood & Cancer Dec 2018Breast cancer is the most common cancer of adolescents and young adult (AYA) women aged 15 to 39 years, accounting for 5.6% of all invasive breast cancer in women. In... (Review)
Review
Breast cancer is the most common cancer of adolescents and young adult (AYA) women aged 15 to 39 years, accounting for 5.6% of all invasive breast cancer in women. In comparison with older women, AYAs are more likely to have familial cancer predisposition genes, larger breast tumors, unfavorable biological characteristics, distant metastatic disease at diagnosis, and adverse outcome. Endocrine therapy and some chemotherapy recommendations differ between young and older women. AYAs require coordinated multidisciplinary care, treatment regimens that minimize late effects such as premature menopause and osteoporosis, and proactive management of psychological and sexual health during and after cancer treatment.
Topics: Adolescent; Adult; Breast Neoplasms; Female; Humans; Young Adult
PubMed: 30156052
DOI: 10.1002/pbc.27397 -
The Oncologist May 2018Chemotherapy has been the historical mainstay of treatment for patients with breast cancer, with immunohistochemical markers and tumor characteristics driving treatment... (Review)
Review
PURPOSE
Chemotherapy has been the historical mainstay of treatment for patients with breast cancer, with immunohistochemical markers and tumor characteristics driving treatment decisions. The discovery of different intrinsic subtypes of breast cancer has advanced the understanding of breast cancer, with gene-based assays shedding further light on tumor behavior and response to treatment.
DESIGN
This review focuses on the landscape of the luminal A subtype, its definition based on immunohistochemistry (IHC) and gene assays, the prognostic and predictive value of these assays, guideline recommendations, and treatment implications.
RESULTS
Clinical studies of the prognostic value of gene-based and IHC-based assays in patients with luminal A-subtype breast cancers suggest a better prognosis for these patients compared with those with breast cancers of other subtypes.
CONCLUSION
In today's era of precision medicine, the best treatment regimen for patients with luminal A-subtype tumors is still undetermined, but available data raise the question whether chemotherapy can be omitted and endocrine therapy alone is sufficient for this patient population.
IMPLICATIONS FOR PRACTICE
Immunohistochemical markers have traditionally guided treatment decisions in breast cancer. However, advances in gene-expression profiling and availability of gene-based assays have launched these newer tests into everyday clinical practice. Luminal A-subtype tumors are a unique subset that may have favorable tumor biology. Properly defining this tumor subtype is important and may identify a subset of patients for whom endocrine therapy alone is sufficient.
Topics: Breast Neoplasms; Female; Humans; Immunohistochemistry
PubMed: 29472313
DOI: 10.1634/theoncologist.2017-0535 -
Polski Przeglad Chirurgiczny Dec 2020<br><b>Introduction:</b> Fibroadenomas are one of the most common benign tumors of the breast in the adolescent females accounting for about... (Review)
Review
<br><b>Introduction:</b> Fibroadenomas are one of the most common benign tumors of the breast in the adolescent females accounting for about 2/3<sup>rd</sup> of all the breast lumps and more than half of all the biopsied breast lesions. They come into being due to overgrowth of glandular tissue under the influence of hormonal changes that the girls undergo at the time of puberty. Due to the wide prevalence of fibroadenomas and the psychosocial morbidity associated with the finding of a breast mass, it is imperative for physicians treating adolescent patients to be thoroughly familiar and updated with this disease. <br><b>Aim:</b> The article aims at providing a brief review of the classification, presentation, diagnosis, and update on the management of breast fibroadenomas on the basis of recent literature.
Topics: Adolescent; Adolescent Health; Breast Neoplasms; Female; Fibroadenoma; Humans
PubMed: 33729177
DOI: 10.5604/01.3001.0014.5676 -
Cancer Treatment Reviews Sep 2022Current follow-up policies for early breast cancer aim to detect loco-regional recurrences and manage treatment-related adverse effects. Their "one size fits all"... (Review)
Review
Current follow-up policies for early breast cancer aim to detect loco-regional recurrences and manage treatment-related adverse effects. Their "one size fits all" approach does not take into account differences in subtypes at initial diagnosis, individual prognosis and treatments received. They are derived from clinical trials conducted when early detection means - other than mammography - and treatment options were limited. Herein, we address the arguments for re-evaluating current breast cancer follow-up strategies starting from recent advances in breast cancer local and systemic treatments and discussing individual risk of recurrence prediction models, time-adapted imaging and biomarker assessment for disease diagnostic anticipation. This change in perspective would transform breast cancer follow-up into an integrated, multidisciplinary team medical practice. Hence we discuss the important role of patient-centered approaches, but also of general practitioners and other health professionals, in the final promotion of personalized surveillance programs and patient education.
Topics: Breast Neoplasms; Female; Follow-Up Studies; Humans; Mammography; Neoplasm Recurrence, Local
PubMed: 35933845
DOI: 10.1016/j.ctrv.2022.102434 -
Breast Cancer Research : BCR Jan 2021Invasive lobular carcinoma (ILC) is the most common of the breast cancer special types, accounting for up to 15% of all breast cancer cases. ILCs are noted for their... (Review)
Review
Invasive lobular carcinoma (ILC) is the most common of the breast cancer special types, accounting for up to 15% of all breast cancer cases. ILCs are noted for their lack of E-cadherin function, which underpins their characteristic discohesive growth pattern, with cells arranged in single file and dispersed throughout the stroma. Typically, tumours are luminal in molecular subtype, being oestrogen and progesterone receptor positive, and HER2 negative. Since last reviewing the lobular literature (McCart Reed et al., Breast Cancer Res 17:12, 2015), there has been a considerable increase in research output focused on this tumour type, including studies into the pathology and management of disease, a high-resolution definition of the genomic landscape of tumours as well as the evolution of several potential therapeutic avenues. There abounds a huge amount of new data, which we will review herein.
Topics: Biomarkers, Tumor; Breast Neoplasms; Carcinoma, Lobular; Diagnosis, Differential; Disease Progression; Disease Susceptibility; Drug Resistance, Neoplasm; Female; Gene Expression; Genomics; Humans; Mutation; Neoplasm Grading; Neoplasm Staging; Phenotype; Prognosis; Tumor Microenvironment
PubMed: 33413533
DOI: 10.1186/s13058-020-01384-6 -
Asian Pacific Journal of Cancer... Apr 2020Breast cancer is the most prevalent cancer in women. To date, regional differences in breast cancer risk factors have not been identified. The aim of our review was to... (Review)
Review
BACKGROUND AND AIM
Breast cancer is the most prevalent cancer in women. To date, regional differences in breast cancer risk factors have not been identified. The aim of our review was to gain a better understanding of the role of risk factors in women with breast cancer in Asia.
METHODS
We conducted a PubMed search on 15 March 2016, for journal articles published in English between 2011 and 2016, which reported data for human subjects in Asia with a diagnosis of breast cancer. Search terms included breast neoplasm, epidemiology, Asia, prevalence, incidence, risk and cost of illness. Studies of any design were included, except for review articles and meta-analyses, which were excluded to avoid duplication of data. No exclusions were made based on breast cancer treatment. We reported the results using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.
RESULTS
A total of 776 abstracts were retrieved. After screening against the eligibility criteria, 562 abstracts were excluded. The remaining 214 abstracts, which were published between 2013 and 2015, were included in this review. Results were summarized and reported under three categories: incidence, prevalence or outcomes for breast cancer in Asia; modifiable risk factors; and non-modifiable risk factors. We found that the increased risk of breast cancer among participants from Asia was associated with older age, family history of breast cancer, early menarche, late menopause, high body mass index, being obese or overweight, exposure to tobacco smoke, and high dietary intake of fats or fatty foods. In contrast, intake of dietary fruits, vegetables, and plant- and soy-based products was associated with a decreased breast cancer risk. While based on limited data, when compared to women from the United States, women from Asia had a decreased risk of breast cancer.
CONCLUSIONS
This review of 214 abstracts of studies in Asia, published between 2013 and 2015, confirmed the relevance of known non-modifiable and modifiable risk factors for women with breast cancer.
Topics: Asia; Body Mass Index; Breast Neoplasms; Early Detection of Cancer; Female; Humans; Incidence; Obesity; Risk Factors
PubMed: 32334446
DOI: 10.31557/APJCP.2020.21.4.867 -
BMC Cancer May 2019Breast cancer (BC) is the most common type of cancer in women worldwide. Post-treatment, patients suffer from side effects and have various rehabilitation needs, which...
BACKGROUND
Breast cancer (BC) is the most common type of cancer in women worldwide. Post-treatment, patients suffer from side effects and have various rehabilitation needs, which means that individualization is fundamental for optimal rehabilitation. This systematic review (SR) of SRs aims to evaluate the current evidence on rehabilitation interventions in female patients following BC treatment.
METHODS
Full-text SRs published in English from 2009 were searched in Embase, PubMed, Cinahl Complete, PsycINFO, AMED, SCOPUS, and Cochrane Library.
INCLUSION CRITERIA
SRs of randomized or non-randomized controlled trials investigating the effects of rehabilitation interventions in women following BC treatment. All outcomes were considered. Methodological quality was evaluated using the AMSTAR 2 tool and interrater agreement was evaluated. Out of 1269 citations retrieved, 37 SRs were included.
RESULTS
Five rehabilitation areas were identified: exercise and physical activity (PA), complementary and alternative medicine (CAM), yoga, lymphoedema treatment, and psychosocial interventions. The most solid evidence was found in exercise/PA and yoga. Exercise interventions improved outcomes such as shoulder mobility, lymphoedema, pain, fatigue and quality of life (QoL). Effects of yoga were shown on QoL, anxiety, depression, sleep disturbance, fatigue and gastrointestinal symptoms. The effect of CAM was shown on nausea, pain, fatigue, anger and anxiety but these results need to be interpreted with caution because of low methodological quality in included studies in the SRs. Among the lymphoedema treatments, positive effects were seen for resistance training on volume reduction and muscle strength and psychosocial interventions such as cognitive behavioural therapy had positive effects on QoL, anxiety, depression and mood disturbance.
CONCLUSIONS
This SR of SRs show solid positive effects of exercise/PA and yoga for women following BC treatment, and provides extended knowledge of the effects of CAM, yoga, lymphoedema treatment and psychosocial interventions. It is evident that more than one intervention could have positive effects on a specific symptom and that the effects depend not only on intervention type but also on how and when the intervention is provided. The results can be used as a foundation for individualized rehabilitation and aid health care professionals in meeting patients' individual needs and preferences.
TRIAL REGISTRATION
PROSPERO ( CRD42017060912 ).
Topics: Breast Neoplasms; Exercise; Female; Humans; Lymphedema; Quality of Life; Resistance Training; Systematic Reviews as Topic; Treatment Outcome; Yoga
PubMed: 31109309
DOI: 10.1186/s12885-019-5648-7 -
Cancer Cell Dec 2006Recent studies suggest that thousands of genes may contribute to breast cancer pathophysiologies when deregulated by genomic or epigenomic events. Here, we describe a...
Recent studies suggest that thousands of genes may contribute to breast cancer pathophysiologies when deregulated by genomic or epigenomic events. Here, we describe a model "system" to appraise the functional contributions of these genes to breast cancer subsets. In general, the recurrent genomic and transcriptional characteristics of 51 breast cancer cell lines mirror those of 145 primary breast tumors, although some significant differences are documented. The cell lines that comprise the system also exhibit the substantial genomic, transcriptional, and biological heterogeneity found in primary tumors. We show, using Trastuzumab (Herceptin) monotherapy as an example, that the system can be used to identify molecular features that predict or indicate response to targeted therapies or other physiological perturbations.
Topics: Breast Neoplasms; Cell Line, Tumor; Female; Gene Expression Profiling; Gene Expression Regulation, Neoplastic; Genomics; Humans; Neoplasm Proteins
PubMed: 17157791
DOI: 10.1016/j.ccr.2006.10.008