In a nutshell
This paper is a document that was developed at a breast cancer conference by a number of experts in the field. It outlines suggested treatment for early-stage breast cancer. The experts concluded that patients and doctors should work together and discuss the benefit of treating early-stage breast cancer in comparison with the potential side effects.
There are many different ways to approach treating early-stage breast cancer. There is some evidence that long term consequences of cancer treatment might negatively impact patients. There are also new treatments that might work just as well as older ones while causing fewer side effects.
Some studies have shown that many treatments for early-stage breast cancer all result in the same outcomes for the patients. It is now becoming clear that it is more important to make decisions about treatment by looking at all aspects of the patient.
Methods & findings
A panel of experts in treating early-stage breast cancer discussed common cancers and treatments.
The Panel noted that patients undergoing surgery should have all tumor removed. They suggested that previous recommendations of wider margins at tumor removal were no longer necessary. Patients with affected lymph nodes in the axilla (armpit) need the removal of these nodes. If only 1-2 nodes are affected, the Panel suggested that surgery in the axilla could be omitted if radiotherapy is planned. Patients who have only the tumor removed (breast-conserving surgery; BCS) are strongly recommended to undergo radiation afterward.
In patients with hormone-receptor-positive breast cancer, the Panel recommended hormonal therapy 2-5 years after surgery. In patients with triple-negative breast cancer, the Panel recommended chemotherapy before and/or after surgery as standard treatment. In those with HER2-positive breast cancer, anti-HER2 therapy with chemotherapy are recommended along with surgery.
The Panel noted that chemotherapy may not have any impact on the cancer coming back in some patients. The Panel strongly recommended that patients and doctors discuss treatment thoroughly before it is started. The Panel also noted that the guidelines for treatment focus on common types of breast cancer, and special cancers need to be considered differently.
The bottom line
The Panel noted that treatment of early-stage breast cancer can have long term effects which need to be considered by the patient and the doctor together.
Published By :
Annals of oncology: official journal of the European Society for Medical Oncology
Aug 02, 2019
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