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Innovations in breast cancer care

Publication ,  Chapter
Esserman, L; Lane, KT; Ewing, CA; Hwang, ES
June 1, 2005

PURPOSE: To examine the treatment of breast cancer from a historic perspective and explore current therapies and innovations in diagnosis and treatment. EPIDEMIOLOGY: In 2003, 212 600 new cases of breast cancer were diagnosed, and it is estimated that more than 40 000 of those cases will be fatal. The probability of developing invasive breast cancer is age-dependent, ranging from a 1 in 225 (0.44%) chance for women younger than 39 years to a 1 in 14 (7.02%) chance for women aged 60 through 79, with an overall 1 in 8 (12.83%) lifetime risk. REVIEW SUMMARY: From early in recorded history, women and their physicians have been plagued by breast cancer. Currently, breast cancer remains a leading cancer-related cause of death in women, second only to lung cancer. The treatment paradigm has shifted from one mandating radical excision of the breast and all surrounding tissue, to a more systemic view whereby as much breast tissue as possible is conserved and adjuvant therapy is offered to prevent metastasis. Advances in treatment have accelerated over the last few decades and have led and will continue to lead to significant improvements in mortality and morbidity. This article examines an approach to breast cancer management that considers the specific circumstances of each individual woman, guided by tumor biology, age, competing risks of death from other comorbidities, and personal preferences in which survivorship issues have assumed tremendous importance. Finally, future directions in breast cancer care are discussed. TYPE OF AVAILABLE EVIDENCE: Randomized-controlled trials, prospective cohort studies, systematic reviews. GRADE OF AVAILABLE EVIDENCE: Good to excellent. CONCLUSION: Physicians and patients now may select from a myriad of treatments for breast cancer, including surgery (mastectomy vs lumpectomy), radiation therapy, chemotherapy, hormonal therapy, and other biologically targeted therapies. In the future, molecular and imaging markers in combination with clinical parameters will help individually characterize breast cancer type, predict response to therapy, determine prognosis, and ultimately dictate the informed treatment choices women make in conjunction with their physicians.

Duke Scholars

Publication Date

June 1, 2005

Volume

5

Start / End Page

294 / 305

Related Subject Headings

  • General & Internal Medicine
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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ICMJE
MLA
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Esserman, L., Lane, K. T., Ewing, C. A., & Hwang, E. S. (2005). Innovations in breast cancer care (Vol. 5, pp. 294–305).
Esserman, L., K. T. Lane, C. A. Ewing, and E. S. Hwang. “Innovations in breast cancer care,” 5:294–305, 2005.
Esserman L, Lane KT, Ewing CA, Hwang ES. Innovations in breast cancer care. In 2005. p. 294–305.
Esserman, L., et al. Innovations in breast cancer care. Vol. 5, 2005, pp. 294–305.
Esserman L, Lane KT, Ewing CA, Hwang ES. Innovations in breast cancer care. 2005. p. 294–305.

Publication Date

June 1, 2005

Volume

5

Start / End Page

294 / 305

Related Subject Headings

  • General & Internal Medicine
  • 3202 Clinical sciences
  • 1103 Clinical Sciences