Breast cancer: beyond the cutting edge.
Remarkable progress has been made in the treatment of breast cancer over the past 100 years. The ability to probe at the genomic level increased our understanding of the disease but the improved survival outcomes can also be attributed to screening programs, which have altered the pattern of diagnosis and prognosis, and to a number of groundbreaking clinical trials. Indeed, the latter are largely responsible for the most startling paradigm reversals in oncology; namely, that optimal benefit can be achieved with minimal, rather than maximal, intervention. As such, surgical lumpectomy can replace the radical mastectomy, sentinel node biopsy may circumvent the need for complete (axillary) nodal dissection, hormonal therapy--depending on tumor sensitivity to endocrine manipulation--is likely to be beneficial without the addition of chemotherapy, and some targeted therapies can be used selectively in those most likely to benefit. However, despite the advances, controversies remain; patients die; and cure remains elusive.
Higa
Gerald M
GM
West Virginia University, Mary Babb Randolph Cancer Center, Schools of Pharmacy and Medicine, Morgantown, WV 26506-9520, USA. ghiga@hsc.wvu.edu
D000818:Animals; D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000235:genetics / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D002986:Clinical Trials as Topic; D016503:Drug Delivery Systems; D005260:Female; D023281:Genomics; D006801:Humans; D008408:Mastectomy / Q000379:methods; D011379:Prognosis; D015996:Survival Rate
D000970:Antineoplastic Agents