Adjuvant Therapy of Breast Cancer IV

Advances in breast cancer research, achieved through the progress of knowledge and development of new therapies, have been translated into improved quality of care for breast cancer patients. Clinical investigations and clinical trials have made the largest contribution to the body of knowledge that finds its way to the patient. Never before during the past decades of management of breast cancer has there been such a fruitful intellectual cross-fertilization of ideas among individuals involved in the generation of hypotheses, basic research, development of drugs and treatments, conduct of clinical trials, and statistical evaluation - the results of all of which are now translated into progress in clinical care. Even issues such as the quality of life of breast cancer patients, once the domain for few, are now being openly addressed by trials and discussed in a much broader forum. The IVth International Conference on the Adjuvant Therapy of Primary Breast Cancer, also known as the st. Gallen Conference, was again attended by more than 800 scientists and clinicians interested in this broad spectrum of breast cancer research and the interactions between such diverse fields of interest and specialties as cancer pathology, molecular biology, and psychosocial oncology. This volume collects findings and conclusions presented at the conference.

Klappentext

This volume represents an up-to-date survey of current (mainly clinical) research on the treatment of primary breast cancer, summarizing most of the expert lectures given at the 4th International Conference on Adjuvant Therapy of Primary Breast Cancer in February 1992 in St. Gallen, Switzerland. It covers relevant topics from biological mechanisms on cell kill and overcoming drug resistance to new aspects of breast conserving surgery and adjuvant endocrine as well as cytotoxic therapies; updating results of most important international trials on adjuvant therapy of breast cancer. Of particular importance is a closing summary reporting the common opinions of an `international consensus' on risk-adapted adjuvant therapy of breast cancer, setting the stage for optimal treatment of breast cancer patients both clinically and psycho-socially. The volume is a 'must' for all clinicians and scientists in the field of breast cancer.

Inhalt
I. Biological Mechanisms and Models.- Kinetic Concepts in the Treatment of Breast Cancer.- Tumor Stem Cells and the Curability of Early Human Breast Cancer.- A New Paradigm for Breast Cancer.- A Laboratory Model To Explain the Survival Advantage Observed in Patients Taking Adjuvant Tamoxifen Therapy.- Growth Factors and Angiogenesis in Breast Cancer.- Mechanisms of Treatment Failure.- Expression of the MDR1 Gene (P-Glycoprotein) in Breast Cancer.- II. Prognosis and Prediction of Response.- Prognosis of Breast Cancer Patients: How To Use What?.- DNA Flow Cytometry Measurements and Their Clinical Relevance in Node-Negative Breast Cancer Patients.- Review of Proliferative Variables and Their Predictive Value.- Critical Review of Growth Factors as Clinical Tools in Primary and Metastatic Breast Cancer.- Prognosis and Prediction for Early Breast Cancer.- III. Primary Therapy for Early Breast Cancer.- Trials of Breast Conservation: A Critical Review of All Options.- Selection and Technique for Lumpectomy.- Salvage Treatment After Local Breast Cancer Relapse.- Primary Chemotherapy for Resectable Breast Cancer.- IV. Radiation Therapy as Part of Primary Treatment.- Radiation Therapies for Breast Cancer: Current Knowledge of Advantages and Disadvantages.- How To Combine Adjuvant Chemotherapy and Radiation Therapy.- Factors Which Predict Breast Relapse.- Summary Report: Radiation Therapy as Part of Primary Treatment.- V. Adjuvant Systemic Therapy: Overview and Improvement of Therapy.- Systemic Treatment of Early Breast Cancer by Hormonal, Cytotoxic, or Immune Therapy: 133 Randomised Trials Involving 31000 Recurrences and 24 000 Deaths Among 75 000 Women (Summary).- What Did We Learn from the Results of the International Overview about the Effects of Endocrine Therapy?.- The WorldOverview at 10 Years: What Did We Learn about the Results of Chemotherapy?.- From the Overview to the Patient: How To Interpret Meta-analysis Data.- High-Dose Adjuvant Chemotherapy for High-Risk Breast Cancer.- Maintenance Tamoxifen After Induction Postoperative Chemotherapy in Node-Positive Breast Cancer Patients: The Eastern Cooperative Oncology Group Trials.- Adjuvant Systemic Therapy: Overview.- VI. Quality-of-Life Considerations in the Adjuvant Setting.- Assessment of Quality of Life and Benefits from Adjuvant Therapies in Breast Cancer.- Coping and Survival in Early Breast Cancer: An Update.- How To Compare Quality of Life of Breast Cancer Patients in Clinical Trials.- Psychosocial Issues in Breast Cancer Clinical Trials.- Quality-of-Life Considerations in the Adjuvant Setting: Critical Review.- VII. Long-Term Toxicity and Economic Aspects.- Long-Term Sequelae from Adjuvant Chemotherapy.- Long-Term Toxicity of Tamoxifen.- New Endocrine Agents for the Treatment of Breast Cancer.- Financial Costs, Benefits, and Patient Risk Preferences in Node-Negative Breast Cancer: Insights from a Decision Analysis Model.- Long-Term Toxicity and Economic Aspects: Critical Review.- VIII. Conclusion.- Adjuvant Therapy of Primary Breast Cancer: Closing Summary.