Medical management of early-stage breast cancer

摘要: Abstract With improved screening and education, a greater proportion of breast cancer is detected at an early stage. Although the prognosis for many these patients excellent following definitive local therapy alone, some subsets node-negative have 30% chance eventually developing metastatic disease that will be incurable with current therapy. Thus, increasing early-stage are being offered form adjuvant therapy, expectation relapse-free survival, possibly overall survival. Efforts been made to base selection on specific prognostic factors. Meanwhile, scope complexity putative factors continues widen, now includes such items as presence occult microscopic metastases, DNA ploidy proliferative fraction, cytogenetic abnormalities, oncogene expression, growth factor receptors, expression hormonally regulated proteins. In addition, there considerable range options regard composition, dose intensity, sequence multimodality Data regarding classification, significance, interpretation reviewed together development, status, recommendations cancer. For 1991, National Cancer Institute (NCI) has estimated 175,000 new cases diagnosed in American women. It also 44,500 women die Unfortunately, age-adjusted death rate from shown no change 1930 through 1987. However, effective techniques continue identify percentage tumors, which should exceed 50% all tumors 1991. Ultimately, our understanding environmental genetic risk may ways reduce impact this disease. interim, development application systemic chemotherapy hormonal become increasingly important. There question less extensive choice regimens, remained controversial. Analysis multiple performed not only context cooperative investigational trials, but more often offices individual physicians caring patients. Tumor biopsies can routinely sent specialized laboratories performance complex assays potential information, although results reference patient uncertain. Conveying therapeutic information subject bias misperception. than half eligible opportunity participate randomized clinical trials choose do so, reflecting doctor-patient communication expectations. This review analyze significance explore role