Adjuvant Therapy of Breast Cancer V

This volume provides an up-to-date survey of current laboratory and, mainly, clinical research on the diagnostic and treatment options in primary breast cancer. The chapters derive from the invited expert lectures presented at the 5th International Conference of Primary Breast Cancer held in St. Gallen, Switzerland, in March 1995. The papers cover relevant issues such as epidemiology and genetics as well as the biology of breast cancer, prognosis of response and tumor markers, screening and treatment of DCIS, surgery for early breast cancer, radiotherapy as part of primary management, adjuvant systemic cytotoxic and endocrine therapies, and, for the first time, women's health perceptions and breast cancer. As at previous conferences, this one also closed with an international consensus on the primary treatment of breast cancer, formulated by American, European, and Australian experts in various treatment modalities and biostatics. These 1995 treatment recommendations encompass pratical decisions outside of clinical trials and future research questions.

Klappentext

We often hear physicians, health care professionals, poli­ ticians, and patient advocates that "nothing has happened in the treatment of breast cancer," since patients with breast cancer, the most frequent neoplastic condition in women in industrialized countries, are continuing to suffer relapse and succumb to this dreadful disease! This negativistic attitude does not seem to be justified, but, why is the transmission of clinical trial results into general practice, and with it progress, such a slow process? After many decades of frustrating stagnation of long-term survival expectations, in all stages of early, oper/lble breast cancer treated only by surgery and locoregional radio­ therapy, adjuvant systemic therapy (chemo- as well as endocrine treatments) clearly showed to significantly benefit in terms of disease-free and overall survival. This evolution has been extensively expounded on by the Worldwide Oxford Overview and the Expert Consensus Panel at the fourth International Conference 'on Adjuvant Therapy of Primary Breast Cancer in St. Gallen (Early Breast Cancer Trialists' Collaborative Group 1992; Glick et al. 1992). What has happened since then? During the past 3-5 years, several new concepts and treatment strategies have emerged and have been studied in various major breast cancer groups and treatment centers worldwide. Some of these can already be considered to assist in the primary treatment of operable breast cancer today, while others are . still undergoing clini,cal trials for better definition of their practical usefulness.

Inhalt

The Control of Breast Cancer: A Look into the Future.- I. Epidemiology and Genetics of Breast Cancer.- Familial Breast Cancer.- The Food-Derived Heterocyclic Amines and Breast Cancer: A 1995 Perspective.- Menstrual Cycle Timing of Breast Cancer Resection.- Summary.- II. Biology of Breast Cancer.- Peptide Growth Factors and Breast Cancer Treatment: Recent Translational Research.- Single-Chain Fusion Toxins for the Treatment of Breast Cancer: Antitumor Activity of BR96 sFv-PE40 and Heregulin-PE40.- Tamoxifen and Endometrial Cancer: From Experiment to Patient.- Summary.- III. Prognosis of Response and Tumor Markers.- Review of Known Prognostic Variables.- Prognostic Variables and Future Predictors of Behaviour and Response.- Serum (Circulating) Tumor Markers for Breast Cancer.- Summary.- IV. Screening for Breast Cancer and Treatment of Early Lesions (Ductal Carcinoma In Situ).- A Critical Review of Screening for Breast Cancer.- Ductal Carcinoma In Situ.- Intraductal Breast Carcinoma: Experiences from The Breast Center in Van Nuys, California.- Summary.- V. Surgery for Breast Cancer: Special Issues.- Surgical Treatment of Breast Cancer Relapse.- Primary and Secondary Breast Reconstruction with Special Emphasis on the Use of Prostheses.- The Primary Use of Chemotherapy for Operable Breast Cancer: Does Systemic Therapy Make Surgery Superfluous?.- Summary.- VI. Adjuvant Systemic Therapy.- The Role of Anthracyclines in Adjuvant Chemotherapy of Breast Cancer: A Critical Appraisal.- Adjuvant Systemic Therapy: The Issues of Timing and Sequence.- Current and Future Roles of Adjuvant Endocrine Therapy in the Management of Early Carcinoma of the Breast.- Future Developments in Adjuvant Systemic Therapy for High-Risk Breast Cancer.- Summary.- VII. Radiation Therapy as Part of Primary Treatment.- Radiation Therapy in the Primary Management of Early-Stage Breast Cancer.- Quality Assurance in Early Breast Cancer Treatment: Clinical Aspects of Postoperative, External, Whole Breast Irradiation.- How To Predict the Risk of Local Relapse in the Preserved Breast.- Summary.- VIII. Women's Health Perception and Breast Cancer: Issues of Fertility, Hormone Substitution, and Cancer Prevention.- Reproductive Potential After Adjuvant Chemotherapy for Breast Cancer.- Sex Hormones and Breast Cancer: The Issue of Hormone Replacement.- The Women's Health Initiative: Will It Resolve the Issues?.- The Women's Health Initiative: The Road to Scientific Clarity?.- Design and Current Status of the NSABP Breast Cancer Prevention Trial.- Summary.- IX. International Consensus Conference on Primary Treatment of Breast Cancer.- Summary.