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Adjuvant Therapy for Breast Cancer

:	Monica Castiglione, Martine Piccart
:	Adjuvant Therapy for Breast Cancer
:	Springer-Verlag
:	9780387751153
:	1
:	CHF 199.00
:

:	Klinische Fächer
:	English

:	490
:	Wasserzeichen/DRM
:	PC/MAC/eReader/Tablet
:	PDF

Adj vant treatment is administered prior to or as follow up to surgical procedures for breast cancer. Proven success in using medical therapies allowing for breast conserving procedures or reducing risk of occurrence. Although there has been much progress towards a cure, including the introduction of new targeted therapies, metastasizing cancer remains highly incurable.

	Cancer Treatment and Research	3
	Acknowledgments	6
	Contents	7
	Contributors	10
	Introduction	13
	Part 1: Basics	15
	History of Adjuvant Therapy	16
	The Guiding Principles of Adjuvant Therapy	17
	Trials with Endocrine Therapy	18
	Trials of Chemoendocrine Therapy	19
	Trials with Chemotherapy	20
	Concluding Remarks	22
	References	24
	Prognostic and Predictive Factors	26
	Prognostic Factors	26
	Age	26
	Tumor Size	27
	Axillary Nodes	27
	Tumor Grade	28
	HER2/neu Status	28
	Peritumoral Vascular Invasion	28
	Others	28
	Predictive Factors	29
	Predictive Markers for Adjuvant Hormonal Therapy	30
	Predictive Markers for Adjuvant Chemotherapy	33
	HER-2 as a Predictive Marker	33
	Topoisomerase II Alpha (Topo IIalpha)	35
	Markers Predicting the Activity of Taxane-Based Regimens	37
	Markers Predicting the Activity of Anti-HER-2 Therapies	38
	Conclusions	39
	References	39
	New Perspectives for Therapy Choice	44
	Introduction	44
	‘‘Omics’’ in Cancer Diagnosis and Prognosis	45
	Gene Expression Profiling: Genomics and Transcriptomics	45
	Protein Profiling: Proteomics	46
	Profiling of Metabolic Endproducts: Metabolomics	49
	Nano-Particles in Diagnosis and Therapy	50
	Perspectives	51
	References	52
	Pathology Role in Adjuvant Setting	54
	Introduction	54
	Examination of Pathology Specimens	54
	Core Needle Biopsy - Preoperative Diagnosis	54
	Surgical Specimens	55
	Frozen Sections	56
	Tissue Banks	56
	Tumor Classification	57
	Histopathologic Prognostic Factors	57
	Tumor and Axillary Lymph Node Staging	57
	Lymph and Blood Vessel Invasion	59
	Tumor Size	60
	Tumor Grading	61
	Immunhistochemical Assays	62
	Steroid Hormone Receptors	63
	HER-2/neu	65
	HER-2 Immunohistochemistry	65
	HER-2 FISH	66
	Interpretation and Scoring	66
	Immunohistochemistry	66
	FISH	67
	Which Score to Be Used?	68
	Future Aspects	68
	Microarray Technology	68
	References	70
	Guidelines, Consensus Conferences and Overviews (Meta-analysis)	75
	Introduction	75
	Meta-analysis or Overviews	76
	Consensus Meetings and Documents	84
	Clinical Practice Guidelines	85
	Summary	87
	References	87
	Statistical Issues and Challenges	89
	Learning from the Past	90
	Planning for the Future	97
	References	101
	Part 2: Treatments	103
	Multidisciplinary Care: Optimising Team Performance	104
	Introduction	104
	Sharing Goals and Strategies	105
	Effective Team Meetings	105
	Troubleshooting	106
	Development and Coaching	106
	Inspirational Leadership	107
	Strengthening Commitment	108
	Managing Conflict and Poor Performance	108
	Preventing Burnout	109
	Improving Communication with Patients	110
	Conclusions	110
	References	111
	Preoperative Chemo- and Endocrine Therapy	113
	Primary Systemic Therapy: Rationale and State of the Art	113
	The Role pf pCR	115
	Anthracyclines and Taxanes: Which is the Gold Standard?	117
	Primary Treatment of Endocrine Responsive Tumours	120
	Open Issues	123
	Identifying Powerful Predictors of Response	123
	Beyond pCR	124
	Integrating Targeted Agents	124
	Conclusions	126
	References	126
	Adjuvant Chemotherapy	131
	Anthracyclines in Adjuvant Therapy	132
	Duration of treatment	134
	Dose Intensity	135
	Randomized Studies of High-Dose Adjuvant Chemotherapy with Hematopoietic Stem Cell Transplantation	135
	Sequential Regimens	135
	Taxanes in the Adjuvant Setting	136
	Paclitaxel	137
	Other Drugs in Adjuvant Setting	139
	Late Adverse Effects of Breast Cancer Adjuvant Chemotherapy	140
	Cardiac Toxicity	140
	Hematological Complications - Acute Myeloid Leukemia and Myelodysplastic Syndrome	140
	Pulmonary Toxicity	141
	Gonadal Dysfunction	141
	Quality of Life	141
	Recommendations for the Use of Adjuvant Chemotherapy	142
	Conclusions	143
	References	143
	Postoperative Endocrine Therapy for Invasive Breast Cancer	148
	Introduction	148
	Adjuvant Endocrine Therapy for Premenopausal Women with Early Breast Cancer	149
	Tamoxifen Alone	150
	Tamoxifen plus Chemotherapy	150
	Ovarian Ablation/Suppression Alone	152
	Ovarian Ablation/Ovarian Suppression Compared to Chemotherapy	153
	Ovarian Suppression Combined with Chemotherapy	156
	Ovarian Ablation Combined with Tamoxifen	157
	Emerging Data Regarding Endocrine Therapy for Premenopausal Women	158
	Adjuvant Endocrine Therapy in Postmenopausal Women	159
	Aromatase Inhibitors Instead of Tamoxifen	160
	Aromatase Inhibitors After Tamoxifen	161
	Recommendations for Adjuvant Endocrine Therapy from Consensus Meetings	165
	Lingering Questions, Emerging Considerations and Future Dir