Ahmad, A. (2013). Pathways to Breast Cancer Recurrence. ISRN Oncology, 2013, 1-16. http://dx.doi.org/10.1155/2013/290568
In his article, Ahmed gives an overview of the current knowledge regarding the recurrence of breast cancer after treatment and the challenges. He reviews existing literature on epithelial-mesenchymal transition (EMT), cancer stem cells (CSCs), various signaling pathways such as microRNAs (miRNAs) and Notch/Wnt/Hedgehog. Also, he also examined the hypotheses that are currently undergoing an investigation to determine the prevention of breast cancer recurrence (Ahmad, 2013).
Andre, F. & Zielinski, C. (2012). Optimal strategies for the treatment of metastatic triple-negative breast cancer with currently approved agents. Annals of Oncology, 23(Suppl 6), vi46-vi51. http://dx.doi.org/10.1093/annonc/mds195
Andre and Zielinski (2012) provide a review of treatments strategies that produce the optimal outcomes. The study analyzes an aggressive type of breast cancer, ripple-negative breast cancer (TNBC). TNBC has few treatment options and its prognosis very poor following after progressive standard regimens of chemotherapy. This cancer resists treatments such as taxanes or anthracyclines or taxanes limiting its treatment options. TNBC response to treatment is short-lived with a median of only thirteen months. The study proposes a new agent, eribulin which has shown an improved survival benefit in patients. Also, Platinum-based regimens and angiogenic treatment with bevacizumab or anti-epidermal growth factor receptor treatment with cetuximab can be used. Improved treatment may be facilitated by a biomarker-led understanding of subgroup molecular targets, which may predict benefit from currently approved agents, as well as newer targeted drugs (Andre & Zielinski, 2012).
Barrios, C., Sampaio, C., Vinholes, J., & Caponero, R. (2009). What is the role of chemotherapy in estrogen receptor-positive, advanced breast cancer? Annals of Oncology, 20(7), 1157-1162. http://dx.doi.org/10.1093/annonc/mdn756
The Female sex hormones determine the growth and development most breast tumors. This fact is the reason endocrine therapy is used with patients with good prognostic features and chemotherapy on the visceral crisis. The literature review suggests that endocrine agents should be an option for the initial treatment of metastatic breast cancer since it has been proven to be efficient. Despite some chemotherapy regimens inducing higher response rates, the use of chemotherapy at the initial stages does not seem to influence the overall outcome of the disease (Barrios, Sampaio, Vinholes, & Caponero, 2009).
Gnerlich, J., Jeffe, D., Deshpande, A., Beers, C., Zander, C., & Margenthaler, J. (2007). Surgical Removal of the Primary Tumor Increases Overall Survival in Patients with Metastatic Breast Cancer: Analysis of the 1988–2003 SEER Data. Annals of Surgical Oncology, 14(8), 2187-2194. http://dx.doi.org/10.1245/s10434-007-9438-0
Radiation and chemotherapy are the Primary treatments for stage IV breast cancer, whereas surgery is reserved for tumor-related complications. The study sought to determine the impact of removing the primary tumor on the survival for women with metastatic breast cancer. A retrospective, population-based cohort study was conducted on the 1988–2003 Surveillance, Epidemiology, and End Results (SEER) program data. The multivariate Cox regression models were used to compare women who underwent surgical excision of their breast tumor with women who did not, controlling for potentially confounding demographic, tumor- and treatment-related variables. Median survival was longer for women who had surgery than for women who did not, both among women who were alive at the end of the study. After adjustments of variables, patients who underwent surgery were less likely to die during the study period compared with women who did not undergo surgery. The study concluded that the removal of the primary tumor in the breast reduced the chances of dying (Gnerlich et al., 2007).
Nishimura, R., Osako, T., Okumura, Y., Tashima, R., Toyozumi, Y., & Arima, N. (2011). Changes in the ER, PgR, HER2, p53 and Ki-67 biological markers between primary and recurrent breast cancer: discordance rates and prognosis. World J Surg Onc, 9(1), 131. http://dx.doi.org/10.1186/1477-7819-9-131
ER/PgR, HER2, and Ki-67 are the biological markers used in the prediction of a prognosis and choosing a treatment remedy. The study investigated the markers changes and their correlations with prognosis.The lesion of 97 patients with a relapse from 1997 to March 2011, was there were 97 consecutive patients from whom wounds were cut out and evaluated by immunostaining.ER, HER2, PgR, p53, and Ki-67 were the markers sought. A relapse caused the decrease in estrogen receptor, and PgR decreased and increased Ki-67 increased. However, the Ki-67 and PgR change rate were high for PgR and Ki-67. Change in the subtypes was seen in 25%. Also, Ki-67 at primary tumor and PgR at relapse were major factors for post-relapse prognosis while a negative PgR was a poor prognostic factor. These results facilitate the decision making of an optimum treatment (Nishimura et al., 2011).
Wood, A. & Hortobagyi, G. (1998). Treatment of Breast Cancer. New England Journal of Medicine, 339(14), 974-984. http://dx.doi.org/10.1056/nejm199810013391407
Wood & Hortobagyi (1998) reviews the subject of breast cancer in detail regarding new biologic information, clinical trials, and new diagnostic and therapeutic tools. The article covers the biologic behavior of this cancer, risk factors, and prognostic factors. The researchers identified several molecular genetic abnormalities that cause the growth and development of invasive breast cancer and treatment response. Diagnostic and therapeutic methods have improved; decreasing breast cancer mortality with early diagnosis accounting for 30 percent. Breast-conserving local treatments, systemic hormone therapy and chemotherapy reduce mortality risk by 25 to 50 percent. Also, several new less toxic drugs that are more effective have been introduced in the regimen (Wood & Hortobagyi, 1998).
References
Ahmad, A. (2013). Pathways to Breast Cancer Recurrence. ISRN Oncology, 2013, 1-16. http://dx.doi.org/10.1155/2013/290568
Andre, F. & Zielinski, C. (2012). Optimal strategies for the treatment of metastatic triple-negative breast cancer with currently approved agents. Annals of Oncology, 23 (Suppl 6), vi46-vi51. http://dx.doi.org/10.1093/annonc/mds195
Barrios, C., Sampaio, C., Vinholes, J., & Caponero, R. (2009). What is the role of chemotherapy in estrogen receptor-positive, advanced breast cancer? Annals Of Oncology, 20(7), 1157-1162. http://dx.doi.org/10.1093/annonc/mdn756
Gnerlich, J., Jeffe, D., Deshpande, A., Beers, C., Zander, C., & Margenthaler, J. (2007). Surgical Removal of the Primary Tumor Increases Overall Survival in Patients With Metastatic Breast Cancer: Analysis of the 1988–2003 SEER Data. Annals Of Surgical Oncology, 14(8), 2187-2194. http://dx.doi.org/10.1245/s10434-007-9438-0
Nishimura, R., Osako, T., Okumura, Y., Tashima, R., Toyozumi, Y., & Arima, N. (2011). Changes in the ER, PgR, HER2, p53 and Ki-67 biological markers between primary and recurrent breast cancer: discordance rates and prognosis. World J Surg Onc, 9(1), 131. http://dx.doi.org/10.1186/1477-7819-9-131
Wood, A. & Hortobagyi, G. (1998). Treatment of Breast Cancer. New England Journal of Medicine, 339(14), 974-984. http://dx.doi.org/10.1056/nejm199810013391407
