How does biology affect local therapy decisions?
Breast cancer represents a biologically diverse set of diseases. Previous data suggest that the estrogen/progesterone receptor (ER/PR) status and HER2/neu status are important determinants of prognosis and response to various systemic treatments. Recent data also suggest that these receptors correlate with outcomes of local-regional therapies. Specifically, patients with ER-positive HER2/neu-negative disease have an excellent outcome with radiation treatments, either given as a component of breast-conservative therapy (BCT) or for those with more advanced disease, when given after mastectomy. For patients with triple-negative disease, data suggest that the proportional benefits offered from radiation in reducing local-regional recurrences may be less. This article will highlight some of these data and discuss strategies for new local-regional research avenues that are based on breast cancer biologic subtype.
From the Division of Radiation Oncology, Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX.
Thomas A
TA
Buchholz