title: Managing high-risk breast cancer.
abstract: OBJECTIVE
  To identify breast cancer patients at high risk for recurrence. To describe current evidence for clinical management of early and locally advanced breast cancer and integrate this knowledge into nursing practice.
  
  
  METHODS
  Articles, abstracts, and practice guidelines.
  
  
  CONCLUSIONS
  Recent clinical trials have integrated the biology of breast cancer into individualized systemic therapy. Risk-adjusted treatment is driven by the addition of taxane therapy to systemic therapy, aromatase inhibitors, and trastuzumab into adjuvant therapy strategies.
  
  
  CONCLUSIONS
  The decision to initiate systemic adjuvant therapy requires knowledge of risk of relapse, integration of evidence from clinical trials, and facilitation of patient decision-making.
authors.affiliation: Breast Clinic and Breast Cancer Program, Mayo Clinic, FL 32224, USA. Palmieri.Frances@mayo.edu
authors.forename: Frances M
authors.initials: FM
authors.lastname: Palmieri
authors.forename: Edith A
authors.initials: EA
authors.lastname: Perez
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology
chemical_list: D000970:Antineoplastic Agents