Breast Cancer Breast Managed Clinical Network
|
|
- Pamela Copeland
- 5 years ago
- Views:
Transcription
1 Initial Evaluation Clinical Stage Pre-Treatment Evaluation Treatment and pathological stage Less than 4 positive lymph nodes Adjuvant Treatment ER Positive HER2 Negative (see page 2 & 3 ) HER2 Positive (see page 4) Primary Diagnosis: Mammography History and physical Fine needle aspiration Core biopsy Full blood count Chest X-Ray Biochemistry Operable by Conservation Surgery Operable by Mastectomy Surgery Candidate for Primary Medical Treatment 4 or more positive lymph nodes Bone Scan CT chest and abdomen Ultrasound liver If staging positive ER Negative PR Negative HER2 Negative (see page 5) Primary medical therapy (see page 6) Metastatic disease (see page 7) August 2008 Breast Cancer CMG Version 1.0 1
2 Pathological stage Adjuvant Treatment Low risk: G1 & <1cm Tamoxifen de Negative Pre-menopausal ER Positive HER2 Negative Medium risk: G1 > 1.1cm or G2 <2cm G2 Post-menopausal See page 3 High Risk: G2 >2cm or G3 G3 Pre-menopausal Post-menopausal Tamoxifen 5 years See page 3 G1 or G2 1-3 nodes Post-menopausal See page 3 de Positive >4 des 1 SEE PAGE 8 AC or Epi / CMF Pre-menopausal Tamoxifen 5 years TC if previous anthracyclines or cardiac issues August 2008 Breast Cancer CMG Version 1.0 2
3 Adjuvant Hormonal Therapy POSTMENOPAUSAL? ANY ONE OF: Menopausal Status - Definitions: Post Menopausal at time of diagnosis of breast cancer defined as: Amenorrhea > 2 Years and > 50 years If amenorrhea <2 years and/or < 55 years check LH/FSH/Oestrodiol before chemotherapy Grade 3 de +ve 1 ER poor 2 Her 2 +ve Path size 5cm (T3 & T4) Prev. neoadj AI with response Aromatase Inhibitor 3 5 years duration CHEMOTHERAPY INDUCED AMENORRHOEA DOES NOT EQUAL POSTMENOPAUSAL And ovarian function tests are unreliable post chemotherapy/hormonal therapy If pre-menopausal before chemotherapy with persisting chemo induced amenorrhoea following chemo then at the time of considering an AI : If < 50 years old exclude- unless ovarian ablation If years use assessment of menopausal status pre chemotherapy ALL OF: Grade 1 AND de -ve 1 AND Size <2cm ALL THE REST i.e. Grade 2 node ve 1 Size<5cm Grade 1 node ve 1 Size 2-5cm Tamoxifen 5 years duration Extended adjuvant 3 (5yrs tam +3yearsAI) Or Switch 3 (2.5 yrs tam +2.5years AI) If > 55 years class as postmenopausal Ineligible for AI Consider tamoxifen 1micrometastases defined as 0.2-2mm = node positive, isolated tumour cells defined as <0.2mm = node negative 2ER poor defined as Allred 3-5 3Aromatase inhibitor as per current licenses. The choice of AI should be as per local Health Board policy and approvals August 2008 Breast Cancer CMG Version 1.0 3
4 Pathological stage Adjuvant Treatment Low risk: G1 & <1cm ER positive? systemic therapy de Negative Medium risk: G1 & < 3cm or G2 & <2cm ER positive? Pre-menopausal Post-menopausal Ovarian suppression + Tamoxifen Aromatase inhibitor a HER2 Positive Pre-menopausal Ovarian suppression + Tamoxifen ER positive Trastuzumab 2 1: SEE PAGE 8 AC or Epi/CMF if node negative FEC > D or TC if node positive de Positive Post-menopausal Aromatase inhibitor 3 2: See Trastuzumab guideline, page 6 3: Aromatase inhibitor as per current licence & Health Board policy ER negative August 2008 Breast Cancer CMG Version 1.0 4
5 Pathological stage Adjuvant Treatment de Negative Low risk: G1 & <2cm systemic therapy >70 years ER Negative PR Negative HER2 Negative <70 years de Positive 1 SEE PAGE 8 AC or Epi/CMF if node negative : FEC > D or TC if node positive August 2008 Breast Cancer CMG Version 1.0 5
6 Primary medical therapy Postmenopausal Either Letrozole 2.5mg od 4-6 months ER Positive Premenopausal Fit FEC100 X 3 Poor response Good response Docetaxel [See note A below ]100mg/m 2 x 3 FEC100 X 3 Un-Fit AC 4-6 Inoperable Large Inflammatory Surgery + 3 field radiotherapy Tamoxifen 5 yrs + OS if HER2 pos ER/PR positive Premenopausal Postmenopausal further tx ER/PR negative ER Negative A: Pre-operative Docetaxel subject to non-formulary process, unless remains inflammatory/ inoperable. Requires primary prophylaxis with G-CSF. B: Trastuzumab subject to nonformulary process if initially inflammatory tumour. HER 2 Positive > Add 1 year Trastuzumab [see note B] ER/PR positive Complete 5 yrs letrozole ER/PR negative further tx August 2008 Breast Cancer CMG Version 1.0 6
7 Evaluation for metastases Treatment of metastases Good response Other (eg Megestrol) Poor response >2 years ago Taxane and Traztuzumab (if HER2 Positive) See note A, page 9 Good response Alternative AI Poor response Previous Taxane <2 years ago Relapse Relapse Aromatase inhibitor Poor response Primary Diagnosis: Mammography History and physical Fine needle aspiration Core biopsy Full blood count Chest X-Ray Biochemistry Bone Scan CT chest and abdomen Ultrasound liver Metastatic Diagnosis ER positive ER negative Hormone treatment candidate Suitable for chemotherapy Palliative therapy Previous adjuvant treatment Fluorouracil/epirubicin/ cyclophosphamide or Epirubicin See note B, page 9 Relapse Taxane and Traztuzumab (if HER2 Positive) See note A, page 9 Bone Metastases Bisphosphonate with other treatment See note E, page 9 Capecitabine or Vinorelbine See note C, page 9 Consider 3th/4 th line therapies See note D, page 9 August 2008 Breast Cancer CMG Version Relapse Relapse
8 Adjuvant/Primary Chemotherapy Regimens For full details please refer to relevant WoSCAN chemotherapy protocol Acceptable regimens for adjuvant/primary chemotherapy: AC : Doxorubicin (Adriamycin) 60mg/m 2 + Cyclophosphamide 600mg/m2 3 weekly x 4 cycles For women > 70 or low risk or patients needing chemotherapy but thought not able to tolerate more intensive regimen Epi >CMF: Epirubicin 100mg/m2 3 weekly x 4 cycles > CMF day weekly x 4 cycles x 4 cycles Standard anthracycline based schedule FEC > D: Fluorouracil 500mg/m2 + Epirubicin 100mg/m2 + Cyclophosphamide 500mg/m2 x 3 cycles 3 weekly > Docetaxel 100mg/m2 x 3 cycles 3 weekly Taxane based chemotherapy preferred option [node positive, triple receptor negative or HER2 positive]. < 65 years, Performance status 0,1 TC: Docetaxel 75mg/m2 / cyclophosphamide 600mg/m2 3 weekly x 4 cycles For patients who need chemotherapy but not suitable for anthracycline due to cardiac history. Taxane based chemotherapy preferred [node positive, triple receptor negative or HER2 positive] but not fit enough for FEC > D or > 65 years of age. FEC 100: Fluorouracil 500mg/m2 + Epirubicin 100mg/m2 + Cyclophosphamide 500mg/m2 3 weekly x 6 cycles Pre-operative anthracycline based chemotherapy August 2008 Breast Cancer CMG Version 1.0 8
9 Metastatic Chemotherapy Regimens For full details please refer to relevant WoSCAN chemotherapy protocol The choice of metastatic therapies are dictated by the individual patient s previous therapy, general health, liver/renal/bone marrow function, response to previous treatments and sites of disease. Definitive recommendations can therefore not be made. A. Acceptable regimens : Paclitaxel 80mg/m 2 weekly; Paclitaxel 175mg/m 2 3 weekly; Docetaxel 100mg/m 2 3 weekly. Trastuzumab either 4mg/kg loading dose then 2mg/kg weekly or 8mg/kg loading followed by 6mg/kg 3 weekly. B Acceptable regimens: Epirubicin 30mg/m 2 weekly; Epirubicin 100mg/m 2 3 weekly; FEC 600/60/600mg/m 2 3 weekly. C Acceptable regimens: Capecitabine 1000mg/m 2 bd days 1-14, 3 weekly; Vinorelbine 25mg/m 2 IV or 60 mg/m 2 oral days 1+8, 3 weekly. D Phase 1 or 2 trials should be considered. Otherwise suitable options include: - Vinorelbine or Capecitabine if not previously received - Weekly Paclitaxel if responded to previous Docetaxel - Mitoxantrone - Low-dose oral Cyclophosphamide E Bisphosphonates as per WOS guidelines. August 2008 Breast Cancer CMG Version 1.0 9
10 Algorithm Conservation Offer <60 years or primary/neoadjuvant medical patient 50Gy in 25# with 10Gy in 4# boost Sentinel node de positive Further surgery or radiotherapy to axilla and SCF (4 field) >60 years 50GY in 25# boost de negative radiotherapy to axilla (2 field) 1-3 nodes positive plus one of: LVI Multifocality Grade 3 >10% risk of recurrence Offer Axillary Surgery Axillary Sample 3 nodes recovered (unknown axillary status de positive Further surgery or radiotherapy to axilla and SCF (4 field) to axilla and SCF (4 field) Mastectomy Any one of: T3 or T4 tumour Inadequate clearance (<0.5cm) Residual disease post-surgery Initially inoperable or locally advanced tumour with neoadjuvant systemic therapy 1-3 nodes positive with extra-capsular spread ne of these May still require radiotherapy depending on axillary status, if so: 45Gy in 20# or 50GY in 25# (if reconstruction) 1 or more or 20-40% risk or recurrence Offer 45Gy in 20# or 50Gy in 25# (if reconstruction) Axillary dissection >3 nodes recovered de negative Any one of: 4 nodes positive Extracapsular tumour spread Perinodal invasion Apical lymph node positive Initially inoperable/locally advanced treated with neoadjuvant systemic therapy radiotherapy to axilla (2 field) to medial SCF (3 field) August 2008 Breast Cancer CMG Version
Clinical Management Guideline for Breast Cancer
Initial Evaluation Clinical Stage Pre-Treatment Evaluation Treatment and pathological stage Adjuvant Treatment Less than 4 positive lymph nodes ER Positive HER2 Negative (see page 2 & 3 ) Primary Diagnosis:
More informationDepartment of Endocrine & Breast Surgery Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
Department of Endocrine & Breast Surgery Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India Evidence-Based Pragmatic SGPGI Breast Cancer Management Protocols (Summary) Background:
More informationIt is a malignancy originating from breast tissue
59 Breast cancer 1 It is a malignancy originating from breast tissue including both early stages which are potentially curable, and metastatic breast cancer (MBC) which is usually incurable. Most breast
More informationBreast Cancer. Most common cancer among women in the US. 2nd leading cause of death in women. Mortality rates though have declined
Breast Cancer Most common cancer among women in the US 2nd leading cause of death in women Mortality rates though have declined 1 in 8 women will develop breast cancer Breast Cancer Breast cancer increases
More informationBreast Cancer. Saima Saeed MD
Breast Cancer Saima Saeed MD Breast Cancer Most common cancer among women in the US 2nd leading cause of death in women 1 in 8 women will develop breast cancer Incidence/mortality rates have declined Breast
More informationAppendix 2. Adjuvant Regimens. AC doxorubin 60 mg/m 2 every 3 weeks x 4 cycles Cyclophosphamide 600 mg/m 2
Appendix 2 Adjuvant Regimens AC doxorubin 60 mg/m 2 every 3 weeks x 4 cycles Cyclophosphamide 600 mg/m 2 CMF IV cyclophosphamide 600 mg/m 2 days 1 & 8 every 4 weeks methotrexate 40 mg/m 2 for 6 cycles
More informationAdjuvant Systemic Therapy in Early Stage Breast Cancer
Adjuvant Systemic Therapy in Early Stage Breast Cancer Julie R. Gralow, M.D. Director, Breast Medical Oncology Jill Bennett Endowed Professor of Breast Cancer Professor, Global Health University of Washington
More informationNadia Harbeck Breast Center University of Cologne, Germany
Evidence in Favor of Taxane Based Combinations and No Anthracycline in Adjuvant and Metastatic Settings Nadia Harbeck Breast Center University of Cologne, Germany Evidence in Favor of Taxane Based Combinations
More informationCOME HOME Innovative Oncology Business Solutions, Inc.
Innovative Oncology Business Solutions, Inc. Breast Cancer Diagnostic/Therapeutic Pathway V11, April 2015 Required Structured Data Fields: ICD9 Code Stage Staging Components Performance Status Treatment
More informationBreast Cancer Earlier Disease. Stefan Aebi Luzerner Kantonsspital
Breast Cancer Earlier Disease Stefan Aebi Luzerner Kantonsspital stefan.aebi@onkologie.ch Switzerland Breast Cancer Earlier Disease Diagnosis and Prognosis Local Therapy Surgery Radiation therapy Adjuvant
More informationChapter. Contents Breast Cancer Adjuvant Epirubicin weekly. Docetaxel Copy No:
Chapter 2: Breast Cancer Contents Chapter 2: Breast Cancer... 1 Breast Cancer... 2 Adjuvant...... 2 Epi-CMF... 2 FEC / docetaxel... 3 FEC100... 4 AC/EC/TC... 4 (neo) adjuvant... 5... 5 HER2 positive: TCarboH...
More informationEvolving Practices in Breast Cancer Management
Evolving Practices in Breast Cancer Management The Georgia Tumor Registrars Association 2016 Priscilla R. Strom, MD, FACS Objectives 1. understand newer indications for neoadjuvant treatment 2. understand
More informationSystemic Management of Breast Cancer
Systemic Management of Breast Cancer Why Who When What How long Etc. Vernon Harvey Rotorua, June 2014 Systemic Management of Breast Cancer Metastatic Disease Adjuvant Therapy Aims of therapy Quality of
More informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: (Herceptin) Reference Number: ERX.SPA.42 Effective Date: 07.01.16 Last Review Date: 05/17 Line of Business: Commercial [Prescription Drug Plan] Revision Log See Important Reminder at the
More informationLessons Learnt from Neoadjuvant Hormone Therapy. 10 Lessons Learnt from Neoadjuvant Endocrine Therapy. Lesson 1
Lessons Learnt from Neoadjuvant Hormone Therapy Mike Dixon Clinical Director Breakthrough Research Unit Edinburgh 10 Lessons Learnt from Neoadjuvant Endocrine Therapy 10 Lessons Learnt from Neoadjuvant
More informationTreatment Options for Breast Cancer in Low- and Middle-Income Countries: Adjuvant and Metastatic Systemic Therapy
Women s Empowerment Cancer Advocacy Network (WE CAN) Conference Bucharest, Romania October 2015 Treatment Options for Breast Cancer in Low- and Middle-Income Countries: Adjuvant and Metastatic Systemic
More informationLessons Learnt from Neoadjuvant Hormone Therapy. Mike Dixon Clinical Director Breakthrough Research Unit Edinburgh
Lessons Learnt from Neoadjuvant Hormone Therapy Mike Dixon Clinical Director Breakthrough Research Unit Edinburgh 10 Lessons Learnt from Neoadjuvant Endocrine Therapy 10 Lessons Learnt from Neoadjuvant
More informationObjectives Critically review presentations on 1. Local therapy 2. Adjuvant chemotherapy for isolated local regional recurrence 3. The optimal duration
Objectives Critically review presentations on 1. Local therapy 2. Adjuvant chemotherapy for isolated local regional recurrence 3. The optimal duration of endocrine therapy 4. Advances in HER2 directed
More informationMETASTATIC BREAST CANCER: CONTROLLING THE HERD WHEN THE HORSES ARE OUT OF THE BARN
METASTATIC BREAST CANCER: CONTROLLING THE HERD WHEN THE HORSES ARE OUT OF THE BARN V A L L E R I E G O R D O N B S C, M D, F R C P C M E D I C A L O N C O L O G I S T A S S I S T A N T P R O F E S S O
More informationIdeal neo-adjuvant Chemotherapy in breast ca. Dr Khanyile Department of Medical Oncology, University of Pretoria
Ideal neo-adjuvant Chemotherapy in breast ca Dr Khanyile Department of Medical Oncology, University of Pretoria When is neo-adjuvant Chemo required? Locally advanced breast ca: - Breast conservative surgery
More informationBreast Cancer Basics. Clinical Oncology for Public Health Professionals. Ben Ho Park, MD, PhD
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this
More informationAuthor's response to reviews
Author's response to reviews Title: Effects on quality of life, anti-cancer responses, breast conserving surgery and survival with neoadjuvant docetaxel: A randomised study of sequential weekly versus
More informationEarly and locally advanced breast cancer: diagnosis and management
Early and locally advanced breast cancer: diagnosis and management NICE guideline Draft for consultation, January 0 This guideline covers diagnosing and managing early and locally advanced breast cancer.
More informationNeoadjuvant (Primary) Systemic Therapy
Diagnosis and Treatment of Patients with Primary and Metastatic reast Cancer Neoadjuvant (Primary) Systemic Therapy Neoadjuvant Systemic Therapy Versions 2002 2017: auerfeind / lohmer / Costa / Dall /
More informationSurgery for Breast Cancer
Surgery for Breast Cancer 1750 Mastectomy - Petit 1894 Radical mastectomy Halsted Extended, Super radical mastectomy 1948 Modified radical mastectomy Patey 1950-60 WLE & RT Baclesse, Mustakallio 1981-85
More informationCommon disease 175,000 new cases/year 44,000 deaths/year Less than 10% with newly diagnosed at presentation have stage IV disease Chronic disease,
Chemotherapy for Metastatic Breast Cancer: Recent Results HARMESH R. NAIK, MD. Karmanos Cancer Institute and St. Mary Hospital Metastatic breast cancer (MBC) Common disease 175,000 new cases/year 44,000
More informationWhat is Cancer? Petra Ketterl, MD Medical Oncology and Functional Medicine
What is Cancer? Petra Ketterl, MD Medical Oncology and Functional Medicine What is Cancer? Layman s terms: cancer starts when cells grow out of control (in any place in the body) and crowd out normal cells
More informationClinical Expert Submission Template
Clinical Expert Submission Template Thank you for agreeing to give us a personal statement on your view of the technology and the way it should be used in the NHS. Health care professionals can provide
More informationBreast Cancer. Dr. Andres Wiernik 2017
Breast Cancer Dr. Andres Wiernik 2017 Agenda: The Facts! (Epidemiology/Risk Factors) Biological Classification/Phenotypes of Breast Cancer Treatment approach Local Systemic Agenda: The Facts! (Epidemiology/Risk
More informationBreast Cancer? Breast cancer is the most common. What s New in. Janet s Case
Focus on CME at The University of Calgary What s New in Breast Cancer? Theresa Trotter, MD, FRCPC Breast cancer is the most common malignancy affecting women in Canada, accounting for almost a third of
More informationAdvances in Neoadjuvant and Adjuvant Therapy for Breast Cancer
Advances in Neo and Adjuvant Therapy for Breast Cancer Nicole Kounalakis, MD, and Christina Finlayson, MD OVERVIEW Systemic therapy for breast cancer is evolving rapidly. The medical treatment of cancer
More informationBreast Cancer Treatment
Breast Cancer Treatment Treatment 2 aspects 1. Treatment of the breast itself: Local Treatment 2. Treatment of the whole body = Systemic treatment Local Treatment Surgery +/- Radiation Usually: a. Breast
More informationPregnancy in the middle of adjuvant treatment of Her2 positive breast cancer
ESMO Preceptorship Programme ESMO Preceptorship ADOLESCENTS & YOUNG ADULTS MALIGNANCIES Lugano, Switzerland 11-12 May 2018 Petra Vuković, University Hospital for Tumors, University Hospital Center Sestre
More informationPhilippine Society of Medical Oncology
Philippine Society of Medical Oncology Unit 1418, 14/F, orth Tower, Cathedral Heights Bldg., St. Luke s Medical Center E. Rodriguez Sr. Avenue, Quezon City 1099, Philippines Telefax: (632) 721-9326/ 723-0101
More informationOpen Clinical Trials: What s Out There Now Paula D. Ryan, MD, PhD
Open Clinical Trials: What s Out There Now Paula D. Ryan, MD, PhD Hanahan and Weinberg, 2000 Acquired Capabilities of Cancer Clinical Trials When should I consider a clinical trial? How do I find the right
More informationNeo-adjuvant and adjuvant treatment for HER-2+ breast cancer
Neo-adjuvant and adjuvant treatment for HER-2+ breast cancer Angelo Di Leo «Sandro Pitigliani» Medical Oncology Unit Hospital of Prato Istituto Toscano Tumori Prato, Italy NOAH: Phase III, Open-Label Trial
More information4/13/2010. Silverman, Buchanan Breast, 2003
Tailoring Breast Cancer Treatment: Has Personalized Medicine Arrived? Judith Luce, M.D. San Francisco General Hospital Avon Comprehensive Breast Care Center Outline First, treatment of DCIS Sorting risk
More information亞東紀念醫院 Breast Cancer 化學治療處方集
亞東紀念醫院 Breast Cancer 化學治療處方集 2008-08 制定 最近修改日期 :2015-01 CMF Breast cancer 化學治療處方參考集 Adjuvant Classic CMF Cyclophosphamide 100mg/m2 PO qd; D1-D14 Methotrexate 40mg/m 2 in N/S 100 ml IV drip 30 mins; D1,
More informationLocally Advanced Breast Cancer: Systemic and Local Therapy
Locally Advanced Breast Cancer: Systemic and Local Therapy Joseph A. Sparano, MD Professor of Medicine & Women s Health Albert Einstein College of Medicine Associate Chairman, Department of Oncology Montefiore
More informationNSABP Pivotal Breast Cancer Clinical Trials: Historical Perspective, Recent Results and Future Directions
1 1 NSABP Pivotal Breast Cancer Clinical Trials: Historical Perspective, Recent Results and Future Directions Terry Mamounas, M.D., M.P.H., F.A.C.S. Medical Director, Comprehensive Breast Program UF Health
More informationCancer Endorsement Maintenance 2011-Maintenance Measures
Measure Number Title Description Measure Steward 0210 Proportion receiving chemotherapy in the last 14 days of life 0211 Proportion with more than one emergency room visit in the last days of life 0212
More informationLocally Advanced Breast Cancer: Systemic and Local Therapy
Locally Advanced Breast Cancer: Systemic and Local Therapy Joseph A. Sparano, MD Professor of Medicine & Women s Health Albert Einstein College of Medicine Associate Chairman, Department of Oncology Montefiore
More informationSystemic Treatment of Breast Cancer. Hormone Therapy and Chemotherapy, Curative and Palliative
Systemic Treatment of Breast Cancer Hormone Therapy and Chemotherapy, Curative and Palliative Systemic Therapy Invasive breast cancers Two forms Curative Palliative Curative Systemic Therapy Adjuvant Therapy
More informationInvasive Breast Cancer
Invasive Breast Cancer Eileen Rakovitch MD MSc FRCPC Sunnybrook Health Sciences Centre Medical Director, Louise Temerty Breast Cancer Centre LC Campbell Chair in Breast Cancer Research Associate Professor,
More informationEARLY BREAST CANCER, HER2-POSITIVE
EARLY BREAST CANCER, HER2-POSITIVE CLINICAL CASE DISCUSSION Elżbieta Senkus Medical University of Gdańsk Gdańsk, Poland esmo.org DISCLOSURES Honoraria: Amgen, Astellas, AstraZeneca, Bayer, BMS, Celgene,
More informationConsiderations in Adjuvant Chemotherapy. Joyce O Shaughnessy, MD Baylor Sammons Cancer Center Texas Oncology US Oncology
Considerations in Adjuvant Chemotherapy Joyce O Shaughnessy, MD Baylor Sammons Cancer Center Texas Oncology US Oncology 80 70 60 50 40 30 20 10 0 EBCTCG 2005/6 Overview Control Arms with No Systemic Treatment
More informationEndocrine Therapy of Metastatic Breast Cancer
Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer Endocrine Therapy of Metastatic Breast Cancer Endocrine Therapy of Metastatic Breast Cancer Version 2002: Gerber / Friedrichs
More informationPMRT for N1 breast cancer :CONS. Won Park, M.D., Ph.D Department of Radiation Oncology Samsung Medical Center
PMRT for N1 breast cancer :CONS Won Park, M.D., Ph.D Department of Radiation Oncology Samsung Medical Center DBCG 82 b & c Overgaard et al Radiot Oncol 2007 1152 pln(+), 8 or more nodes removed Systemic
More informationTRANSPARENCY COMMITTEE OPINION. 15 February 2006
The legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION 15 February 2006 Taxotere 20 mg, concentrate and solvent for solution for infusion B/1 vial of Taxotere and 1 vial
More informationAdjuvant Chemotherapy + Trastuzumab
Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer Adjuvant Chemotherapy + Trastuzumab (Optimal Drugs / Dosage / Trastuzumab) Adjuvant Chemotherapy (Optimal Drugs / Optimal Dosage
More informationUK Interdisciplinary Breast Cancer Symposium. Should lobular phenotype be considered when deciding treatment? Michael J Kerin
UK Interdisciplinary Breast Cancer Symposium Should lobular phenotype be considered when deciding treatment? Michael J Kerin Professor of Surgery National University of Ireland, Galway and Galway University
More informationFollow-up Care of Breast Cancer Patients
Follow-up Care of Breast Cancer Patients Dr. Simon D. Baxter, MD, FRCPC Medical Oncologist BC Cancer Kelowna Clinical Instructor, Dept of Medicine University of British Columbia 24 November 2018 Disclosures
More informationBreast Cancer. Breast Cancer. Established breast cancer risk factors. Established breast cancer risk factors. Cancer incidence.
Breast Cancer A buffet of breast cancer topics Wendy Y. Chen, MD MPH Dana-Farber Cancer Institute Brigham and Women s Hospital Disclosures: none Not related to anything presented in this lecture Wendy
More informationHorizon Scanning Centre November Vinflunine (Javlor) monotherapy for advanced breast cancer SUMMARY NIHR HSC ID: 7887
Horizon Scanning Centre November 2012 Vinflunine (Javlor) monotherapy for advanced breast cancer SUMMARY NIHR HSC ID: 7887 This briefing is based on information available at the time of research and a
More informationThe Role of Pathologic Complete Response (pcr) as a Surrogate Marker for Outcomes in Breast Cancer: Where Are We Now?
1 The Role of Pathologic Complete Response (pcr) as a Surrogate Marker for Outcomes in Breast Cancer: Where Are We Now? Terry Mamounas, M.D., M.P.H., F.A.C.S. Medical Director, Comprehensive Breast Program
More informationCHEMOTHERAPY OF BREAST CANCER IN SERBIA DURING THE FIVE-YEAR PERIOD ( ) - A RETROSPECTIVE ANALYSIS
Archive of Oncology 2000;8(Suppl 1):7. SESSION 1 CHEMOTHERAPY OF BREAST CANCER IN SERBIA DURING THE FIVE-YEAR PERIOD (1995-2000) - A RETROSPECTIVE ANALYSIS 7 Archive of Oncology 2000;8(Suppl 1):8. 8 Extended
More informationNorth of Scotland Cancer Network Clinical Management Guideline for Endometrial Cancer
THIS DOCUMENT North of Scotland Cancer Network Clinical Management Guideline for Endometrial Cancer Based on WOSCAN CMG with further extensive consultation within NOSCAN UNCONTROLLED WHEN PRINTED DOCUMENT
More informationMaria João Cardoso, MD, PhD
Locally Advanced Breast Cancer Specific Issues in LocorregionalTreatment Surgery, MD, PhD Head Breast Surgeon Breast Unit, Champalimaud Foundation Lisbon, Portugal 1 Conflict of Interest Disclosure No
More informationTriple Negative Breast Cancer: Part 2 A Medical Update
Triple Negative Breast Cancer: Part 2 A Medical Update April 29, 2015 Tiffany A. Traina, MD Breast Medicine Service Memorial Sloan Kettering Cancer Center Weill Cornell Medical College Overview What is
More informationClinical Management Guideline for Small Cell Lung Cancer
Diagnosis and Staging: Key Points 1. Ensure a CT scan that is
More informationSesiones interhospitalarias de cáncer de mama. Revisión bibliográfica 4º trimestre 2015
Sesiones interhospitalarias de cáncer de mama Revisión bibliográfica 4º trimestre 2015 Selected papers Prospective Validation of a 21-Gene Expression Assay in Breast Cancer TAILORx. NEJM 2015 OS for fulvestrant
More informationOutcomes of patients with inflammatory breast cancer treated by breast-conserving surgery
Breast Cancer Res Treat (2016) 160:387 391 DOI 10.1007/s10549-016-4017-3 EDITORIAL Outcomes of patients with inflammatory breast cancer treated by breast-conserving surgery Monika Brzezinska 1 Linda J.
More informationCase Scenario 1. 2/15/2011 The patient received IMRT 45 Gy at 1.8 Gy per fraction for 25 fractions.
Case Scenario 1 1/3/11 A 57 year old white female presents for her annual mammogram and is found to have a suspicious area of calcification, spread out over at least 4 centimeters. She is scheduled to
More informationDoes HER2/neu overexpression in breast cancer influence adjuvant chemotherapy and hormonal therapy choices by Ontario physicians? A physician survey
MYERS et al. ORIGINAL ARTICLE Does HER2/neu overexpression in breast cancer influence adjuvant chemotherapy and hormonal therapy choices by Ontario physicians? A physician survey J.A. Myers MD FRCPC, G.
More informationA case of male inflammatory breast cancer
Int Canc Conf J (2013) 2:183 187 DOI 10.1007/s13691-013-0087-9 CASE REPORT A case of male inflammatory cancer Miki Hyakudomi Toko Inao Yoshimitsu Minari Masayuki Itakura Riruke Maruyama Yoshitsugu Tajima
More informationA Slow Starvation: Adjuvant Endocrine Therapy of Breast Cancer
A Slow Starvation: Adjuvant Endocrine Therapy of Breast Cancer Dr. Susan Ellard Surgical Oncology Update October 24, 2009 Disclosure slide Participant in various meetings or advisory boards sponsored by
More informationThe Three Ages of Systemic Adjuvant Therapy for EBC
The Three Ages of Systemic Adjuvant Therapy for EBC 1896-2018 Nicholas Wilcken Westmead Hospital Petersham Institute University of Sydney Questions to be answered (concentrating on chemotherapy) Why should
More informationSustained benefits for women with HER2-positive early breast cancer JORGE MADRID BIG GOCCHI PROTOCOLO HERA
Sustained benefits for women with HER2-positive early breast cancer JORGE MADRID BIG GOCCHI PROTOCOLO HERA The fascinating history of Herceptin 1981 1985 1987 1990 1992 1998 2000 2005 2006 2008 2011 Murine
More informationClinical Trial Results Database Page 1
Page 1 Sponsor Novartis UK Limited Generic Drug Name Letrozole/FEM345 Therapeutic Area of Trial Localized ER and/or PgR receptor positive breast cancer Study Number CFEM345EGB07 Protocol Title This study
More informationLANCS & SOUTH CUMBRIA BREAST NSSG REFERENCE MANUAL FOR THE MANAGEMENT OF BREAST CANCER
1 LANCS & SOUTH CUMBRIA BREAST NSSG REFERENCE MANUAL FOR THE MANAGEMENT OF BREAST CANCER Guidelines agreed by: Breast NSSG members January 2014 Version V1 2014 Review date: January 2016 Please destroy
More informationNational Breast Cancer Audit next steps. Martin Lee
National Breast Cancer Audit next steps Martin Lee National Cancer Audits Current Bowel Cancer Head & Neck Cancer Lung cancer Oesophagogastric cancer New Prostate Cancer - undergoing procurement Breast
More informationImpact of BMI on pathologic complete response (pcr) following neo adjuvant chemotherapy (NAC) for locally advanced breast cancer
Impact of BMI on pathologic complete response (pcr) following neo adjuvant chemotherapy (NAC) for locally advanced breast cancer Rachna Raman, MD, MS Fellow physician University of Iowa hospitals and clinics
More informationBristol-Myers Squibb Pharmaceuticals Ltd Taxol Early Breast Cancer SUBMISSION TO THE NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE
SUBMISSION TO THE NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE TAXOL (PACLITAXEL) FOR THE ADJUVANT TREATMENT OF EARLY BREAST CANCER Page 1 of 86 Background The purpose of the background section
More informationFollow-up Care of Breast Cancer Patients
Follow-up Care of Breast Cancer Patients Dr. Simon D. Baxter, MD, FRCPC Medical Oncologist BC Cancer Kelowna Clinical Instructor, Dept of Medicine University of British Columbia 19 April 2018 Disclosures
More informationCases presented with teleradiology and telepathology by the local team
Cases presented with teleradiology and telepathology by the local team W. Demey (oncology), P. Van Dam (surgery), I. Biltjes (radiology), P. Dirix (radiation oncology), C. Colpaert (pathology) 1 Case 1:
More informationESMO Breast Cancer Preceptorship Singapore November Special Issues in Treatment of Young Women with Breast Cancer
ESMO Breast Cancer Preceptorship Singapore November 2017 Special Issues in Treatment of Young Women with Breast Cancer Prudence Francis MD Peter MacCallum Cancer Centre Melbourne, Australia Conflict of
More informationSTEP 2: Identification of recurrence (local, regional or distant metastases) based on electronic health record algorithm using automated databases:
Appendix 1. Specifications for identifying subsequent breast cancer STEP 1: Identification of second primary breast cancer Identification based on key variables from Cancer Registry including date of diagnosis;
More informationJose A Torres, MD 1/12/2017
Jose A Torres, MD 1/12/2017 Background Globally leading cause of cancer related death in women ~249,000 Americans diagnosed with invasive breast cancer ~40,890 will die of their disease Breast cancer risk
More informationLecture 5. Primary systemic therapy: clinical and biological endpoints
Lecture 5 Primary systemic therapy: clinical and biological endpoints Valentina Guarneri, M.D., Ph.D. Primary systemic therapy in breast cancer Firstly introduced d into clinical i l practice in 70s for
More informationA case of a BRCA2-mutated ER+/HER2 breast cancer during pregnancy
ESMO Preceptorship Programme Breast Cancer Lisbon 16,17 September 2016 Emanuela Risi Sandro Pitigliani Medical Oncology Department Hospital of Prato, Istituto Toscano Tumori, Prato, Italy A case of a BRCA2-mutated
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE. Health Technology Appraisal
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Health Technology Appraisal Trastuzumab, as monotherapy and in combination with a taxane, for the treatment of metastatic breast cancer (to include
More informationANNEX 1 OBJECTIVES. At the completion of the training period, the fellow should be able to:
1 ANNEX 1 OBJECTIVES At the completion of the training period, the fellow should be able to: 1. Breast Surgery Evaluate and manage common benign and malignant breast conditions. Assess the indications
More informationNeoadjuvantTreatment In BC When, How, Who?
NeoadjuvantTreatment In BC When, How, Who? Clifford Hudis, M.D. Chief, Breast Cancer Medicine Service, MSKCC Professor of Medicine, Weill Cornell Medical College President, ASCO 15 Potential Benefits Of
More informationTherapy Side Effects
Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer Therapy Side Effects Therapy Side Effects Versions 2004 2011: Albert / Bischoff / Costa / Friedrichs / Göhring / Jackisch/
More informationImplications of Progesterone Receptor Status for the Biology and Prognosis of Breast Cancers
日大医誌 75 (1): 10 15 (2016) 10 Original Article Implications of Progesterone Receptor Status for the Biology and Prognosis of Breast Cancers Naotaka Uchida 1), Yasuki Matsui 1), Takeshi Notsu 1) and Manabu
More informationDR. BOMAN N. DHABHAR Consulting Oncologist Jaslok Hospital, Fortis Hospital Mulund, Wockhardt Hospital Mumbai & BND Onco Centre INDIA
Recent Advances of Docetaxel in Management of Breast Cancer DR. BOMAN N. DHABHAR Consulting Oncologist Jaslok Hospital, Fortis Hospital Mulund, Wockhardt Hospital Mumbai & BND Onco Centre INDIA 1 ADJUVANT
More informationPerjeta (pertuzumab)
Perjeta (pertuzumab) Line(s) of Business: HMO; PPO; QUEST Integration Medicare Advantage Original Effective Date: 10/01/2015 Current Effective Date: 01/01/201809/16/2018 POLICY A. INDICATIONS The indications
More informationIndex. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Adjuvant therapy, for early-stage triple-negative breast cancer, 740 742 in older early-stage breast cancer patients, 790 795 anti-her2-directed
More informationDuctal Carcinoma-in-Situ: New Concepts and Controversies
Ductal Carcinoma-in-Situ: New Concepts and Controversies James J. Stark, MD, FACP Medical Director, Cancer Program and Palliative Care Maryview Medical Center Professor of Medicine, EVMS Case Presentation
More informationChemotherapy for Isolated Locoregional Recurrence
Chemotherapy for Isolated Locoregional Recurrence Michelle Melisko MD Assistant Clinical Professor UCSF Helen Diller Family Comprehensive Cancer Center MBC and Improved Median Survival with New Therapies
More informationTrastuzumab (Herceptin) for HER2 positive early, locally advanced and inflammatory breast cancer neoadjuvant treatment
Trastuzumab (Herceptin) for HER2 positive early, locally advanced and inflammatory breast cancer neoadjuvant treatment August 2010 This technology summary is based on information available at the time
More informationKey Words. Adjuvant therapy Breast cancer Taxanes Anthracyclines
The Oncologist Mayo Clinic Hematology/Oncology Reviews Adjuvant Therapy for Breast Cancer: Recommendations for Management Based on Consensus Review and Recent Clinical Trials BETTY A. MINCEY, a,b FRANCES
More informationThe Neoadjuvant Model as a Translational Tool for Drug and Biomarker Development in Breast Cancer
The Neoadjuvant Model as a Translational Tool for Drug and Biomarker Development in Breast Cancer Laura Spring, MD Breast Medical Oncology Massachusetts General Hospital Primary Mentor: Dr. Aditya Bardia
More informationFigure 1: PALLAS Study Schema. Endocrine adjuvant therapy may have started before randomization and be ongoing at that time.
Figure 1: PALLAS Study Schema Endocrine adjuvant therapy may have started before randomization and be ongoing at that time. Approximately 4600 patients from approximately 500 global sites will be randomized
More informationPositive HER-2 tumor. How to incorporate the new drugs into neoadjuvance
Oncology Department Vall d Hebron University Hospital Barcelona. Spain Positive HER-2 tumor. How to incorporate the new drugs into neoadjuvance Javier Cortés June/2013 MD Anderson experience Buzdar et
More informationEvolving Insights into Adjuvant Chemotherapy. Joyce O Shaughnessy, MD Baylor Sammons Cancer Center Texas Oncology US Oncology
Evolving Insights into Adjuvant Chemotherapy Joyce O Shaughnessy, MD Baylor Sammons Cancer Center Texas Oncology US Oncology 80 70 60 50 40 30 20 10 0 EBCTCG 2005/6 Overview Control Arms with No Systemic
More informationCASE STUDIES CLINICAL CASE SCENARIOS. Matthew J. Ellis, MD, PhD
CLINICAL CASE SCENARIOS Matthew J. Ellis, MD, PhD Clinicians face daily challenges in the management of individual patients with breast cancer who demonstrate different characteristics in terms of estrogen
More informationGUIDELINES FOR RADIOTHERAPY IN EARLY BREAST CANCER
GUIDELINES FOR RADIOTHERAPY IN EARLY BREAST CANCER Authors: Dr N Thorp/ Dr P Robson On behalf of the Breast CNG Written: Originally - December 2008 Reviewed: Updated - December 2011 Agreed: Breast TSG
More informationAdjuvant chemotherapy in older breast cancer patients: how to decide?
Adjuvant chemotherapy in older breast cancer patients: how to decide? H. Wildiers University Hospitals Leuven Belgium Wildiers H, Kunkler I, Lancet Oncol 2007 Biganzoli L, Wildiers H, Lancet Oncol. 2012
More informationCase 1. BREAST CANCER From Diagnosis to Treatment: The Role of Primary Care
BREAST CANCER From Diagnosis to Treatment: The Role of Primary Care Leah Karliner, MD MAS University of California San Francisco Primary Care Medicine Update 2009 April 2009 Case 1 AR, a 60 year old African
More information