Local Breast Irradiation Controversies Following Neoadjuvant Chemotherapy: Can Radiotherapy Be Downstaged As Well?

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Local Breast Irradiation Controversies Following Neoadjuvant Chemotherapy: Can Radiotherapy Be Downstaged As Well?"

Transcription

1 Local Breast Irradiation Controversies Following Neoadjuvant Chemotherapy: Can Radiotherapy Be Downstaged As Well? Nancy Wiggers, MD Northside Radiation Oncology Consultants Atlanta, Georgia

2 Approximately 25 years ago, Gilbert Fletcher and Eleanor Montague, two leading experts in breast cancer radiation treatments, wrote, there is, perhaps, no more controversial subject in the management of cancer than the use of postoperative irradiation in conjunction with mastectomy

3 Advantages of Performing Surgery First Reduces the interval between diagnosis and effective treatment for patients with disease that is resistant to chemotherapy Provides clear information concerning the original extent of disease Provides clear prognostic information concerning the risk of recurrence after mastectomy and therefore the indications for using postmastectomy radiation Advantages of Neoadjuvant Chemotherapy May allow breast conservation after effecting a disease response Allows an in vivo assessment of sensitivity to a chemotherapy regimen Allows chemotherapy to be changed if the disease proves resistant Permits an assessment of pathologic disease response, which allows for the further stratification of an individual patient s prognosis Allows direct comparison of different treatment regimens in clinical trials with a short-term study endpoint (pathologic complete response) Allows serial biopsies and images of tumor to be obtained during treatment to gain insight into the molecular mechanisms of tumor sensitivity and resistance

4

5 Tools Clinical exam Mammogram US MRI Biopsy PET

6 Clinical Exam In a breast cancer patient with a clinically + axilla, there is a 25% chance that the axilla is negative In a patient with a T1 - T2 breast cancer and a clinically negative axilla, there is a 30% chance of pathologic axillary involvement

7 SLN Biopsy The practice of performing an SLN biopsy prior to neoadjuvant chemotherapy is a focus of debate Presence of axillary disease markedly affects prognosis, recommendations for postmastectomy radiation therapy, and breast reconstruction Assessment of the axilla prior to initiating systemic therapy is preferred, and preoperative axillary staging with ultrasonography and fine-needle aspiration (FNA) or core needle biopsy is being used

8 MRI MRI tumor size correlates with pathology size; however, a significant overestimation exists, particularly for tumors >2.0 cm.

9 PET Pre-chemotherapy 18F-FDG PET/CT upstages nodal stage in stage II-III breast cancer patients treated with neoadjuvant chemotherapy. In a study by Koolen, they found 23% of patients treated with NAC were upstaged to the high-risk group based on PET/CT information, potentially benefiting from regional radiotherapy. Koolen BB, et al. Breast Cancer Res Treat. 2013;141(2):

10 Risk of Local Recurrence Low risk - LRF rate 10% Intermediate risk - LRF rate 11%-19% High risk 20%

11 PMRT (Before There Was Neoadjuvant Chemotherapy) Consensus 4 axillary LN + margins T4 disease Strong Consideration Triple negative >5-cm tumor 1-3 LN Close margin

12 Postmastectomy Radiation Improves Local-Regional Control and Survival for Selected Patients With Locally Advanced Breast Cancer Treated With Neoadjuvant Chemotherapy and Mastectomy PURPOSE: To evaluate the efficacy of radiation in patients treated with neoadjuvant chemotherapy and mastectomy. Retrospectively analyzed the outcomes of 542 patients treated on six consecutive institutional prospective trials with neoadjuvant chemotherapy, mastectomy, and radiation. These data were compared to those of 134 patients who received similar treatment in these same trials but without radiation. Huang EH, et al. J Clin Oncol. 2004;22(23):

13 Postmastectomy Radiation Improves Local-Regional Control and Survival for Selected Patients With Locally Advanced Breast Cancer Treated With Neoadjuvant Chemotherapy and Mastectomy Patients with stage II or IV disease who achieved a pcr had LRR benefit from RT- (33% vs 3% at 10-year rates) RT reduced LRR for patients with clinical T3 or T4, stage IIB disease, path tumor size >2 cm, or 4 or more positive nodes Huang EH, et al. J Clin Oncol. 2004;22(23):

14 Locally Advanced Breast Cancer Treated With Neoadjuvant Chemotherapy and Mastectomy Huang EH, et al. J Clin Oncol. 2004;22(23):

15 Postmastectomy Radiation Improves Local-Regional Control and Survival for Selected Patients With Locally Advanced Breast Cancer Treated With Neoadjuvant Chemotherapy and Mastectomy Comprehensive radiation was found to benefit both local control and survival for patients presenting with clinical T3 tumors or stage III-IV (ipsilateral supraclavicular nodal) disease and for patients with four or more positive nodes. Radiation should be considered for these patients regardless of their response to initial chemotherapy. Huang EH, et al. J Clin Oncol. 2004;22(23):

16 LRR For Patients With Stage II Breast Cancer and One to Three Positive Lymph Nodes Extracapsular extension greater than 2 mm Tumor size over 4 cm Positive or close (2 mm) surgical margins Resection of less than 10 lymph nodes (19%), Lymphovascular space invasion (15%), or invasion of the skin, nipple, or pectoralis muscle (19%) Most important predictor of LRR was a 20% or greater lymph node involvement 10-year LRR 0-1 factors 4%, 2 factors 8%, 3+ factors 28%

17 According to the American Society of Clinical Oncology (ASCO) guidelines on post-mastectomy radiotherapy (PMRT), there is insufficient evidence to make recommendations or suggestions on whether all patients initially treated with preoperative systemic therapy should be given PMRT after surgery. However, ASCO recommended that, in general, patients who require mastectomy after systemic therapy receive PMRT. The rationale for this is based on the inability to accurately know initial pathologic stage, including tumor size and axillary lymph node status. March 2013

18 NSABP B-18 and B-27 Largest prospectively collected cohort of patients with operable breast cancer treated with neoadjuvant chemotherapy Regional radiation was not permitted 335 LRR events after 10 yrs f/u. In mastectomy pts (treated w/o RT), 10-yr cumulative LRR 12.3%. In lumpectomy pts (+RT), LRR 10.3%. Mamounas EP, et al. J Clin Oncol. 2012;30(32):

19 CONSORT Diagram for National Surgical Adjuvant Breast and Bowel Project (NSABP) B-18 and B-27 Trials (T1-3, N0-1, M0) (T1-3, N0-1, M0) 3088 patients Mamounas EP, et al. J Clin Oncol. 2012;30(32):

20 Nomogram to Predict 10-Year Risk of Locoregional Recurrence (LRR) in Patients Treated With Mastectomy After Neoadjuvant Chemotherapy Mamounas EP, et al. J Clin Oncol. 2012;30(32):

21 Nomogram to Predict 10-Year Risk of Locoregional Recurrence (LRR) in Patients Treated With Lumpectomy Plus Breast External Radiotherapy (XRT) After Neoadjuvant Chemotherapy Mamounas EP, et al. J Clin Oncol. 2012;30(32):

22 Recurrence After Neoadjuvant Chemotherapy Without PMRT NSABP Conclusion: "In patients treated with NC, age, clinical tumor characteristics before NC, and pathologic nodal status/breast tumor response after NC can be used to predict risk for LRR and to optimize the use of adjuvant radiotherapy." Mamounas EP, et al. J Clin Oncol. 2012;30(32):

23

24 Role of Postmastectomy Radiation After Neoadjuvant Chemotherapy in Stage II-III Breast Cancer Seven breast cancer physicians from the University of California cancer centers created 14 hypothetical clinical case scenarios, Formulated evidence tables with endpoints of LRF, disease-free survival, and overall survival. Using the American College of Radiology appropriateness criteria methodology, appropriateness ratings for postmastectomy radiation were assigned for each scenario. Finally, an overall summary risk assessment table was developed. CONCLUSIONS: In the absence of randomized trial results, existing data can be used to guide the use of PMRT in the neoadjuvant chemotherapy setting.. Fowble BL, et al. Int J Radiat Oncol Biol Phys. 2012;83(2):

25 Nonrandomized Data for Overall Survival A statistically significant survival benefit with PMRT was reported in clinical stage III disease, those with 4 positive nodes or LVI, and in women aged <35 years. Small numbers of patients constituted many of the subgroups. Fowble BL, et al. Int J Radiat Oncol Biol Phys. 2012;83(2):

26 Summary of Risk Categories Suggest that clinical stage II (T1N0-1, T2N0) patients aged >40 years, with ER-positive disease who have a pcr or 0-3 positive axillary nodes without LVI or ECE, have little or no benefit from PMRT. Young patient age, advanced clinical or pathologic stage and triple-negative receptor status, and presence of LVI and/or ECE emerged as high-risk features that should warrant consideration of PMRT after NAC.

27 How Important Is pcr? Postmastectomy radiation therapy provides a significant clinical benefit for breast cancer patients who present with clinical stage III disease and achieve a pcr after neoadjuvant chemotherapy. Residual disease after NAC seems to have a greater implication for outcome for those in whom systemic therapy would have been expected to produce a more favorable response (ie, ER-negative, triple-negative, or HER2-positive disease treated with trastuzumab.) In series from MDACC, clinical stage II TN who had a pcr or neg axillary nodes had a 0%-1% 5-year risk of LRF after mast without RT, whereas those with 1-3 LN had a 37% risk LRF.

28

29 Indications for RT - NCCN

30 NCIC CTG MA.20 Whelan TJ, et al. J Clin Oncol. 2011;29(Suppl): Abstract LBA1003.

31 NCIC CTG MA.20 Whelan TJ, et al. J Clin Oncol. 2011;29(Suppl): Abstract LBA1003.

32 NCIC CTG MA.20 Whelan TJ, et al. J Clin Oncol. 2011;29(Suppl): Abstract LBA1003.

33 Role Of Regional Lymph Node Irradiation In Patients With Negative Pathologic Node Status After Neoadjuvant Chemotherapy Chest wall and comprehensive nodal radiation were routinely used in the series from MDACC MA.20 suggests improved outcome with comprehensive regional nodal radiation NSABP B-18 and B-27 trials suggest that neoadjuvant chemotherapy leads to complete eradication of disease within lymph nodes in 20% 40% of patients. The rate of regional node failures in these trials for patients undergoing mastectomy without radiation was <5%. Buchholz and colleagues 1 also showed that omission of regional node irradiation in patients who were clinically and pathologically node negative did not result in an increased risk of regional failure or a decreased DFS or OS Buchholz TA, et al. J Clin Oncol. 2002;20(1):17-23.

34 Summary All locally advanced patients will benefit from RT even if pcr Radiation should be recommended on the basis of the initial extent of disease Data suggest that clinical stage II (T1N0-1, T2N0) patients aged >40 years, with ER-positive disease who have a pcr or 0-3 positive axillary nodes without LVI or ECE receive little or no benefit from PMRT.

Departments, Divisions, Operational Areas. Breast Surgery Medical Oncology Radiation Oncology

Departments, Divisions, Operational Areas. Breast Surgery Medical Oncology Radiation Oncology Oncology Clinical Service Line System-wide Consensus Guidelines: Postmastectomy Radiation for Patients with 1-3 Positive Lymph Nodes These guidelines apply to clinical interventions that have well-documented

More information

Principles of Radiation Therapy A Bapsi Chakravarthy, MD Associate e P rofessor Professor Radiation Oncology

Principles of Radiation Therapy A Bapsi Chakravarthy, MD Associate e P rofessor Professor Radiation Oncology Principles of Radiation Therapy A Bapsi Chakravarthy, MD Associate Professor Radiation Oncology Disclosure Information I have no financial relationships to disclose relevant to the conten of this presentation.

More information

Management of Postmenopausal Women with T1 ER+ Tumors: Options and Tradeoffs. Case Study. Surgery. Lumpectomy and Radiation

Management of Postmenopausal Women with T1 ER+ Tumors: Options and Tradeoffs. Case Study. Surgery. Lumpectomy and Radiation Management of Postmenopausal Women with T1 ER+ Tumors: Options and Tradeoffs Michael Alvarado, MD Associate Professor of Surgery University of California San Francisco Case Study 59 yo woman with new palpable

More information

NOTTINGHAM UNIVERSITY NHS TRUST BREAST INSTITUTE GUIDELINE NEOADJUVANT CHEMOTHERAPY (NACT) FOR BREAST CANCER

NOTTINGHAM UNIVERSITY NHS TRUST BREAST INSTITUTE GUIDELINE NEOADJUVANT CHEMOTHERAPY (NACT) FOR BREAST CANCER NOTTINGHAM UNIVERSITY NHS TRUST BREAST INSTITUTE GUIDELINE NEOADJUVANT CHEMOTHERAPY (NACT) FOR BREAST CANCER Definitions: NACT is recommended initial treatment for inflammatory breast cancer and inoperable

More information

Loco-regional Recurrence

Loco-regional Recurrence Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer AGO AGO e. e. V. V. Loco-regional Recurrence Loco-regional Recurrence Version 2002: Brunnert / Simon Versions 2003 2012: Audretsch

More information

Rotation Specific Goals & Objectives: University Health Network-Princess Margaret Hospital/ Sunnybrook Breast/Melanoma

Rotation Specific Goals & Objectives: University Health Network-Princess Margaret Hospital/ Sunnybrook Breast/Melanoma Rotation Specific Goals & Objectives: University Health Network-Princess Margaret Hospital/ Sunnybrook Breast/Melanoma Medical Expert: Breast Rotation Specific Competencies/Objectives 1.0 Medical History

More information

Breast Cancer Treatment Guidelines

Breast Cancer Treatment Guidelines Breast Cancer Treatment Guidelines DCIS Stage 0 TisN0M0 Tamoxifen for 5 years for patients with ER positive tumors treated with: -Breast conservative therapy (lumpectomy) and radiation therapy -Excision

More information

PATIENT SUBSETS WITH T1-T2, NODE-NEGATIVE BREAST CANCER AT HIGH LOCOREGIONAL RECURRENCE RISK AFTER MASTECTOMY

PATIENT SUBSETS WITH T1-T2, NODE-NEGATIVE BREAST CANCER AT HIGH LOCOREGIONAL RECURRENCE RISK AFTER MASTECTOMY doi:10.1016/j.ijrobp.2004.09.013 Int. J. Radiation Oncology Biol. Phys., Vol. 62, No. 1, pp. 175 182, 2005 Copyright 2005 Elsevier Inc. Printed in the USA. All rights reserved 0360-3016/05/$ see front

More information

Ductal Carcinoma in Situ (DCIS)

Ductal Carcinoma in Situ (DCIS) Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer Ductal Carcinoma in Situ (DCIS) Ductal Carcinoma in Situ DCIS Version 2002: Gerber Version 2003 2009: Audretsch / Brunnert

More information

TNM staging and prognosis. Alexandru Eniu, MD, PhD Medical Oncologist Department of Breast Tumors Cancer Institute Ion Chiricuţă Cluj-Napoca, Romania

TNM staging and prognosis. Alexandru Eniu, MD, PhD Medical Oncologist Department of Breast Tumors Cancer Institute Ion Chiricuţă Cluj-Napoca, Romania TNM staging and prognosis Alexandru Eniu, MD, PhD Medical Oncologist Department of Breast Tumors Cancer Institute Ion Chiricuţă Cluj-Napoca, Romania The Basics of TNM Staging Premises: Cancers of the same

More information

Guidelines for the treatment of breast cancer with radiotherapy

Guidelines for the treatment of breast cancer with radiotherapy London Cancer Guidelines for the treatment of breast cancer with radiotherapy March 2013 Review March 2014 Version 1.0 Contents 1. Introduction... 3 2. Indications and dosing schedules... 3 2.1. Ductal

More information

The clinical value of adjuvant radiotherapy in patients with early stage breast cancer with 1 to 3 positive lymph nodes after mastectomy

The clinical value of adjuvant radiotherapy in patients with early stage breast cancer with 1 to 3 positive lymph nodes after mastectomy 窑 Original Article 窑 Chinese Journal of Cancer The clinical value of adjuvant radiotherapy in patients with early stage breast cancer with 1 to 3 positive lymph nodes after mastectomy San Gang Wu 1,2,3,

More information

Pathologic Assessment Of The Breast And Axilla After Preoperative Therapy

Pathologic Assessment Of The Breast And Axilla After Preoperative Therapy Pathologic Assessment Of The Breast And Axilla After Preoperative Therapy W. Fraser Symmans, M.D. Associate Professor of Pathology UT M.D. Anderson Cancer Center Pathologic Complete Response (pcr) Proof

More information

Neoadjuvant radiotherapy: Necessary for treatment of rectal cancer. Shannon Acker April 4, 2011

Neoadjuvant radiotherapy: Necessary for treatment of rectal cancer. Shannon Acker April 4, 2011 Neoadjuvant radiotherapy: Necessary for treatment of rectal cancer Shannon Acker April 4, 2011 Rectal Cancer 40,870 new cases in the US in 2009 49,920 deaths from colorectal cancer Second leading cause

More information

Charlotte Dai Kubicky, MD, PhD,* and Solange Mongoue-Tchokote, MS y. Clinical Investigation

Charlotte Dai Kubicky, MD, PhD,* and Solange Mongoue-Tchokote, MS y. Clinical Investigation International Journal of Radiation Oncology biology physics www.redjournal.org Clinical Investigation Prognostic Significance of the Number of Lymph Nodes in Women With T1-2N1 Breast Cancer Treated With

More information

Current Status and Perspectives of Radiation Therapy for Breast Cancer

Current Status and Perspectives of Radiation Therapy for Breast Cancer Breast Cancer Current Status and Perspectives of Radiation Therapy for Breast Cancer JMAJ 45(10): 434 439, 2002 Masahiro HIRAOKA, Masaki KOKUBO, Chikako YAMAMOTO and Michihide MITSUMORI Department of Therapeutic

More information

Ductal Carcinoma in Situ (DCIS)

Ductal Carcinoma in Situ (DCIS) Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer Ductal Carcinoma in Situ (DCIS) Ductal Carcinoma in Situ DCIS Version 2002: Gerber Versions 2003 2012: Audretsch / Brunnert

More information

Prognostic and Predictive Factors in Oncology. Mustafa Benekli, M.D.

Prognostic and Predictive Factors in Oncology. Mustafa Benekli, M.D. Prognostic and Predictive Factors in Oncology Mustafa Benekli, M.D. NCI Definitions ESMO Course -Essentials of Medical Oncology -Istanbul 2 Prognostic factor: NCI Definition A situation or condition, or

More information

Positività per HER-2 nei carcinomi subcentimetrici

Positività per HER-2 nei carcinomi subcentimetrici Positività per HER-2 nei carcinomi Antonella Ferro U.O. Oncologia Medica Trento Small Tumors Small tumors are becoming increasingly common with the use of mammography > screening Some of these tumors,

More information

Impact of radiation therapy on survival in patients with triple negative breast cancer

Impact of radiation therapy on survival in patients with triple negative breast cancer 548 Impact of radiation therapy on survival in patients with triple negative breast cancer LAUREN T. STEWARD 1, FENG GAO 2, MARIE A. TAYLOR 3 and JULIE A. MARGENTHALER 1 1 Department of Surgery; 2 Division

More information

The evolution of rectal cancer therapy. Objectives

The evolution of rectal cancer therapy. Objectives The evolution of rectal cancer therapy Hagen Kennecke MD MHA FRCPC Western Canada Consensus Conference September 5, 2014 Objectives Identify standard therapy: stage II/III rectal cancer Update recent adjuvant

More information

Review of Breast Cancer Clinical Trials Conducted by the National Surgical Adjuvant Breast Project

Review of Breast Cancer Clinical Trials Conducted by the National Surgical Adjuvant Breast Project Surg Clin N Am 87 (2007) 279 305 Review of Breast Cancer Clinical Trials Conducted by the National Surgical Adjuvant Breast Project Lisa A. Newman, MD, MPH, FACS a, *, Eleftherios P. Mamounas, MD, MPH,

More information

Breast Cancer. Mary Yamashita, M.D. Assistant Professor of Radiology Breast Imaging University of Southern California Keck School of Medicine

Breast Cancer. Mary Yamashita, M.D. Assistant Professor of Radiology Breast Imaging University of Southern California Keck School of Medicine Breast Cancer Mary Yamashita, M.D. Assistant Professor of Radiology Breast Imaging University of Southern California Keck School of Medicine DISCLOSURE Neither I nor my spouse has any relevant financial

More information

Hereditary Multifocal Breast Cancer. Farin Amersi M.D., F.A.C.S Division of Surgical Oncology Department of Surgery Cedar Sinai Medical Center

Hereditary Multifocal Breast Cancer. Farin Amersi M.D., F.A.C.S Division of Surgical Oncology Department of Surgery Cedar Sinai Medical Center Hereditary Multifocal Breast Cancer Farin Amersi M.D., F.A.C.S Division of Surgical Oncology Department of Surgery Cedar Sinai Medical Center CASE STUDY 30 year old Ashkenazi Jewish woman Nulliparous Felt

More information

Breast Cancer. NCCN Guidelines for Patients. Version 2010. Made possible by a generous charitable contribution from Susan G. Komen for the Cure

Breast Cancer. NCCN Guidelines for Patients. Version 2010. Made possible by a generous charitable contribution from Susan G. Komen for the Cure Breast Cancer NCCN Guidelines for Patients Version 2010 Made possible by a generous charitable contribution from Susan G. Komen for the Cure Also available at NCCN.com Breast Cancer Table of Contents Map

More information

Recommendations for cross-sectional imaging in cancer management, Second edition

Recommendations for cross-sectional imaging in cancer management, Second edition www.rcr.ac.uk Recommendations for cross-sectional imaging in cancer management, Second edition Breast cancer Faculty of Clinical Radiology www.rcr.ac.uk Contents Breast cancer 2 Clinical background 2 Who

More information

The Triad Breast Cancer Screening. Mary Helen Hackney, MD FACP VCU Massey Cancer Center March 2016

The Triad Breast Cancer Screening. Mary Helen Hackney, MD FACP VCU Massey Cancer Center March 2016 The Triad Breast Cancer Screening Mary Helen Hackney, MD FACP VCU Massey Cancer Center March 2016 I have no financial disclosures I am a medical oncologist with a practice focused on breast cancer The

More information

Breast Cancer Educational Program. June 5-6, 2015

Breast Cancer Educational Program. June 5-6, 2015 Breast Cancer Educational Program June 5-6, 2015 Adjuvant Systemic Therapy For Early Breast Cancer: Who, What and for How Long? Debjani Grenier MD, FRCPC Medical Oncologist Disclosures Advisory Board Member:

More information

Breast cancer close to the nipple: Does this carry a higher risk ofaxillary node metastasesupon diagnosis?

Breast cancer close to the nipple: Does this carry a higher risk ofaxillary node metastasesupon diagnosis? Breast cancer close to the nipple: Does this carry a higher risk ofaxillary node metastasesupon diagnosis? Erin I. Lewis, BUSM 2010 Cheri Nguyen, BUSM 2008 Priscilla Slanetz, M.D., MPH Al Ozonoff, Ph.d.

More information

Protein kinase C alpha expression and resistance to neo-adjuvant gemcitabine-containing chemotherapy in non-small cell lung cancer

Protein kinase C alpha expression and resistance to neo-adjuvant gemcitabine-containing chemotherapy in non-small cell lung cancer Protein kinase C alpha expression and resistance to neo-adjuvant gemcitabine-containing chemotherapy in non-small cell lung cancer Dan Vogl Lay Abstract Early stage non-small cell lung cancer can be cured

More information

Articles. Early Breast Cancer Trialists Collaborative Group (EBCTCG)* www.thelancet.com Vol 366 December 17/24/31, 2005 2087

Articles. Early Breast Cancer Trialists Collaborative Group (EBCTCG)* www.thelancet.com Vol 366 December 17/24/31, 2005 2087 Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials Early Breast Cancer Trialists

More information

ORIGINAL ARTICLE THORACIC ONCOLOGY

ORIGINAL ARTICLE THORACIC ONCOLOGY Ann Surg Oncol (2013) 20:1934 1940 DOI 10.1245/s10434-012-2800-x ORIGINAL ARTICLE THORACIC ONCOLOGY Predictors for Locoregional Recurrence for Clinical Stage III-N2 Non-small Cell Lung Cancer with Nodal

More information

PET/CT Imaging in Lung Cancer

PET/CT Imaging in Lung Cancer PET/CT Imaging in Lung Cancer Mylene T. Truong, MD Mylene T. Truong M.D. Objectives To discuss the role of PET/CT in the staging of lung cancer To review the recommendations from American Society of Clinical

More information

Understanding ductal carcinoma in situ (DCIS) and deciding about treatment

Understanding ductal carcinoma in situ (DCIS) and deciding about treatment Understanding ductal carcinoma in situ (DCIS) and deciding about treatment Developed by National Breast and Ovarian Cancer Centre Funded by the Australian Government Department of Health and Ageing Understanding

More information

Overview of Breast Cancer. Donna Graham Medical Oncology SpR

Overview of Breast Cancer. Donna Graham Medical Oncology SpR Overview of Breast Cancer Donna Graham Medical Oncology SpR Learning Points Epidemiology Risk Factors Diagnosis Prognostic Markers Stage 0 III disease Stage IV disease Surveillance Incidence in Ireland

More information

SAMO FoROMe Post-ESMO 2013 Breast Cancer

SAMO FoROMe Post-ESMO 2013 Breast Cancer SAMO FoROMe Post-ESMO 2013 Breast Cancer Dr. med. Manuela Rabaglio Klinik und Poliklinik für Medizinische Onkologie Breast Cancer Track 300 Abstracts 142 Poster 11 Proffered paper 4 late breaking news

More information

Breast Cancer. Measurability of Quality Performance Indicators Version 1.0: April 2012

Breast Cancer. Measurability of Quality Performance Indicators Version 1.0: April 2012 Breast Cancer Measurability of Quality Performance Indicators Version 1.0: April 2012 (to be read in conjunction with the Breast Cancer Clinical Quality Performance Indicators Engagement Document v1.0

More information

Chapter 2 Staging of Breast Cancer

Chapter 2 Staging of Breast Cancer Chapter 2 Staging of Breast Cancer Zeynep Ozsaran and Senem Demirci Alanyalı 2.1 Introduction Five decades ago, Denoix et al. proposed classification system (tumor node metastasis [TNM]) based on the dissemination

More information

A Checklist for Patients with Breast Cancer

A Checklist for Patients with Breast Cancer A Checklist for Patients with Breast Cancer Questions to Ask the Doctor 1 and Quick Help Resources 1 Adapted from: American Cancer Society. Detailed Guide: Breast Cancer - What Should You Ask Your Doctor

More information

Breast Health Program

Breast Health Program Breast Health Program Working together, for your health. Breast Health Program The Breast Health Program at The University of Arizona Cancer Center offers patients a personalized approach to breast cancer,

More information

Original Article. Shanghai, China; University Shanghai, China. The first 2 authors contributed equally to this work.

Original Article. Shanghai, China; University Shanghai, China. The first 2 authors contributed equally to this work. Analysis in Early Stage Triple-Negative Breast Cancer Treated With Mastectomy Without Adjuvant Radiotherapy: Patterns of Failure and Prognostic Factors Xingxing Chen, MD 1,2 ; Xiaoli Yu, MD 1,2 ; Jiayi

More information

American College of Radiology ACR Appropriateness Criteria POSTMASTECTOMY RADIOTHERAPY

American College of Radiology ACR Appropriateness Criteria POSTMASTECTOMY RADIOTHERAPY American College of Radiology ACR Appropriateness Criteria Date of origin: 1996 Last review date: 2012 POSTMASTECTOMY RADIOTHERAPY Expert Panel on Radiation Oncology Breast: Kathleen C. Horst, MD 1 ; Bruce

More information

Does my patient need more therapy after prostate cancer surgery?

Does my patient need more therapy after prostate cancer surgery? Does my patient need more therapy after prostate cancer surgery? Contact the GenomeDx Patient Care Team at: 1.888.792.1601 (toll-free) or e-mail: client.service@genomedx.com Prostate Cancer Classifier

More information

ASTRO Spring Refresher Course 2013: Early Breast Cancer

ASTRO Spring Refresher Course 2013: Early Breast Cancer ASTRO Spring Refresher Course 2013: Early Breast Cancer Eleanor Harris, MD Professor and Chair Department of Radiation Oncology Brody School of Medicine East Carolina University Objectives: Early Breast

More information

U.S. Department of Health and Human Services Food and Drug Administration Center for Drug Evaluation and Research (CDER)

U.S. Department of Health and Human Services Food and Drug Administration Center for Drug Evaluation and Research (CDER) Guidance for Industry Pathological Complete Response in Neoadjuvant Treatment of High-Risk Early-Stage Breast Cancer: Use as an Endpoint to Support Accelerated Approval U.S. Department of Health and Human

More information

PET/CT for Melanoma. Sarajevo (Bosnia & Hercegovina) Wednesday, June :40 10:20

PET/CT for Melanoma. Sarajevo (Bosnia & Hercegovina) Wednesday, June :40 10:20 Sarajevo (Bosnia & Hercegovina) Wednesday, June 18 2014 09:40 10:20 PET/CT for Melanoma The Trundholm Sun Chariot, anterior view app 1350 BC The National Museum of Denmark, Copenhagen 54 x 35 x 29 cm (width,

More information

THE BREAST COURSE 2013

THE BREAST COURSE 2013 THE BREAST COURSE 2013 Learning objectives At the end of The Breast Course, the participant should be able to: 1. Explain the major pathologies affecting the breast; 2. Explain existing, novel and state-of-the-art

More information

Breast Conservation in the Setting of Contemporary Multimodality Treatment Provides Excellent Outcomes for Patients with Occult Primary Breast Cancer

Breast Conservation in the Setting of Contemporary Multimodality Treatment Provides Excellent Outcomes for Patients with Occult Primary Breast Cancer Ann Surg Oncol DOI 10.1245/s10434-014-3991-0 ORIGINAL ARTICLE BREAST ONCOLOGY Breast Conservation in the Setting of Contemporary Multimodality Treatment Provides Excellent Outcomes for Patients with Occult

More information

Management of low grade glioma s: update on recent trials

Management of low grade glioma s: update on recent trials Management of low grade glioma s: update on recent trials M.J. van den Bent The Brain Tumor Center at Erasmus MC Cancer Center Rotterdam, the Netherlands Low grades Female, born 1976 1 st seizure 2005,

More information

A Gynecologic Cancer Intergroup (GCIG) Trial led by the NCIC CTG. GCIG Trial Designation: The SHAPE Trial NCIC CTG Protocol Number: CX.

A Gynecologic Cancer Intergroup (GCIG) Trial led by the NCIC CTG. GCIG Trial Designation: The SHAPE Trial NCIC CTG Protocol Number: CX. A RANDOMIZED TRIAL COMPARING RADICAL HYSTERECTOMY AND PELVIC NODE DISSECTION VS SIMPLE HYSTERECTOMY AND PELVIC NODE DISSECTION IN PATIENTS WITH LOW RISK EARLY STAGE CERVICAL CANCER A Gynecologic Cancer

More information

TITLE: Comparison of the dosimetric planning of partial breast irradiation with and without the aid of 3D virtual reality simulation (VRS) software.

TITLE: Comparison of the dosimetric planning of partial breast irradiation with and without the aid of 3D virtual reality simulation (VRS) software. SAMPLE CLINICAL RESEARCH APPLICATION ABSTRACT: TITLE: Comparison of the dosimetric planning of partial breast irradiation with and without the aid of 3D virtual reality simulation (VRS) software. Hypothesis:

More information

New Clinical Trials Open for the Treatment of Breast Cancer with Proton Beam Therapy

New Clinical Trials Open for the Treatment of Breast Cancer with Proton Beam Therapy ROC Newsletter August 2013 New Clinical Trials Open for the Treatment of Breast Cancer with Proton Beam Therapy There is a large body of evidence suggesting an association between breast radiotherapy and

More information

RESEARCH EDUCATE ADVOCATE. Just Diagnosed with Melanoma Now What?

RESEARCH EDUCATE ADVOCATE. Just Diagnosed with Melanoma Now What? RESEARCH EDUCATE ADVOCATE Just Diagnosed with Melanoma Now What? INTRODUCTION If you are reading this, you have undergone a biopsy (either of a skin lesion or a lymph node) or have had other tests in which

More information

Integrating Chemotherapy and Liver Surgery for the Management of Colorectal Metastases

Integrating Chemotherapy and Liver Surgery for the Management of Colorectal Metastases I Congresso de Oncologia D Or July 5-6, 2013 Integrating Chemotherapy and Liver Surgery for the Management of Colorectal Metastases Michael A. Choti, MD, MBA, FACS Department of Surgery Johns Hopkins University

More information

Sybile Val, MD Department of Surgery. October 29, 2009

Sybile Val, MD Department of Surgery. October 29, 2009 Soft Tissue Tumors Sybile Val, MD Department of Surgery SUNY Downstate Medical Center October 29, 2009 Case Presentation 52 YOM presented to ED on 7/22 with 52 YOM presented to ED on 7/22 with abdominal

More information

CANCER PULMON: ESTADIOS INICIALES POSTMUNDIAL PULMON DENVER 2015. 8-10-2015.Manuel Cobo Dols S. Oncología Médica HU Málaga Regional y VV

CANCER PULMON: ESTADIOS INICIALES POSTMUNDIAL PULMON DENVER 2015. 8-10-2015.Manuel Cobo Dols S. Oncología Médica HU Málaga Regional y VV CANCER PULMON: ESTADIOS INICIALES POSTMUNDIAL PULMON DENVER 2015 8-10-2015.Manuel Cobo Dols S. Oncología Médica HU Málaga Regional y VV Meta-analisis LACE: adyuvancia vs no adyuvancia Pignon JP, et al.

More information

www.downstatesurgery.org

www.downstatesurgery.org Male Breast Cancer Rabih Nemr MD Kings County Hospital August 2008 ACGME Core Competencies 1 Patient t Care Medical Knowledge 2 g 3 4 Practice Based Learning/Improvement Interpersonal Communication Skills

More information

Non-Small Cell Lung Cancer Treatment Comparison to NCCN Guidelines

Non-Small Cell Lung Cancer Treatment Comparison to NCCN Guidelines Non-Small Cell Lung Cancer Treatment Comparison to NCCN Guidelines April 2008 (presented at 6/12/08 cancer committee meeting) By Shelly Smits, RHIT, CCS, CTR Conclusions by Dr. Ian Thompson, MD Dr. James

More information

Table of Contents. Data Supplement 1: Summary of ASTRO Guideline Statements. Data Supplement 2: Definition of Terms

Table of Contents. Data Supplement 1: Summary of ASTRO Guideline Statements. Data Supplement 2: Definition of Terms Definitive and Adjuvant Radiotherapy in Locally Advanced Non-Small-Cell Lung Cancer: American Society of Clinical Oncology Clinical Practice Guideline Endorsement of the American Society for Radiation

More information

Breast Cancer Screening in Low- and Middle-Income Countries A Framework To Choose Screening Strategies

Breast Cancer Screening in Low- and Middle-Income Countries A Framework To Choose Screening Strategies Breast Cancer Screening in Low- and Middle-Income Countries A Framework To Choose Screening Strategies Richard Wender, MD Session code: www.worldcancercongress.org A Five Step Framework to Guide Screening

More information

Modeling the Patterns of Breast Cancer Early Metastases

Modeling the Patterns of Breast Cancer Early Metastases Modeling the Patterns of Breast Cancer Early Metastases UFHCC Gainesville and Univ. of Miami Sylvester CCC Cristiane Takita (Co-PI), MD, MBA Youssef Zeidan, MD, PhD Ross Kuker, MD Marc Lippman, MD Doris

More information

Outcome analysis of breast cancer patients who declined evidence-based treatment

Outcome analysis of breast cancer patients who declined evidence-based treatment Joseph et al. World Journal of Surgical Oncology 2012, 10:118 WORLD JOURNAL OF SURGICAL ONCOLOGY RESEARCH Open Access Outcome analysis of breast cancer patients who declined evidence-based treatment Kurian

More information

Stomach (Gastric) Cancer. Prof. M K Mahajan ACDT & RC Bathinda

Stomach (Gastric) Cancer. Prof. M K Mahajan ACDT & RC Bathinda Stomach (Gastric) Cancer Prof. M K Mahajan ACDT & RC Bathinda Gastric Cancer Role of Radiation Layers of the Stomach Mucosa Submucosa Muscularis Serosa Stomach and Regional Lymph Nodes Stomach and Regional

More information

Carcinoma of the Cervix. Kathleen M. Schmeler, MD Associate Professor Department of Gynecologic Oncology

Carcinoma of the Cervix. Kathleen M. Schmeler, MD Associate Professor Department of Gynecologic Oncology Carcinoma of the Cervix Kathleen M. Schmeler, MD Associate Professor Department of Gynecologic Oncology Cervical Cancer Treatment Treatment Microinvasive (Stage IA1): Simple (extrafascial) hysterectomy/cone

More information

PET/CT in Breast Cancer

PET/CT in Breast Cancer PET/CT in Breast Cancer Rodolfo Núñez Miller, M.D. Nuclear Medicine and Diagnostic Imaging Section Division of Human Health International Atomic Energy Agency Vienna, Austria Overview Introduction Locorregional

More information

Basics and limitations of adjuvant online an internet based decision tool

Basics and limitations of adjuvant online an internet based decision tool Basics and limitations of adjuvant online an internet based decision tool J. Huober SAKK, Bern 31.10.2013 Univ.-Frauenklinik Ulm Integratives Tumorzentrum des Universitätsklinikums und der Medizinischen

More information

ductal carcinoma in situ (DCIS)

ductal carcinoma in situ (DCIS) Understanding ductal carcinoma in situ (DCIS) and deciding about treatment Understanding ductal carcinoma in situ (DCIS) and deciding about treatment Developed by National Breast and Ovarian Cancer Centre

More information

Avastin in breast cancer: Summary of clinical data

Avastin in breast cancer: Summary of clinical data Avastin in breast cancer: Summary of clinical data Worldwide, over one million people are diagnosed with breast cancer every year 1. It is the most frequently diagnosed cancer in women 1,2, and the leading

More information

Local control in ductal carcinoma in situ treated by excision alone: incremental benefit of larger margins

Local control in ductal carcinoma in situ treated by excision alone: incremental benefit of larger margins The American Journal of Surgery 190 (2005) 521 525 George Peter s Award Winner Local control in ductal carcinoma in situ treated by excision alone: incremental benefit of larger margins Heather R. MacDonald,

More information

Rectal Cancer. To Radiate or not to radiate? Q: Should rectal cancer RT/CRT decisions be based solely on stage? 11/09/2014

Rectal Cancer. To Radiate or not to radiate? Q: Should rectal cancer RT/CRT decisions be based solely on stage? 11/09/2014 Rectal Cancer To Radiate or not to radiate?? Dr. Corinne Doll Radiation Oncologist Tom Baker Cancer Centre Calgary, Alberta Q: Should rectal cancer RT/CRT decisions be based solely on stage? 1 Q: Can RT/CRT

More information

Prognostic Factors for Triple-Negative Breast Cancer Patients Receiving Preoperative Systemic Chemotherapy

Prognostic Factors for Triple-Negative Breast Cancer Patients Receiving Preoperative Systemic Chemotherapy Original Study Prognostic Factors for Triple-Negative Breast Cancer Patients Receiving Preoperative Systemic Chemotherapy Sota Asaga, Takayuki Kinoshita, Takashi Hojo, Junko Suzuki, Kenjiro Jimbo, Hitoshi

More information

Male Breast Cancer Edward Yu, MD PhD, FRCPC. Department of Oncology, Western University, London, Ontario, Canada

Male Breast Cancer Edward Yu, MD PhD, FRCPC. Department of Oncology, Western University, London, Ontario, Canada 1 Male Breast Cancer Edward Yu, MD PhD, FRCPC. Department of Oncology, Western University, London, Ontario, Canada Epidemiology Male breast cancer (MBC) is a rare disease worldwide. MBC accounts for approximately

More information

One of the most mature trials that examined PROCEEDINGS. Hormone Therapy in Postmenopausal Women With Breast Cancer * William J.

One of the most mature trials that examined PROCEEDINGS. Hormone Therapy in Postmenopausal Women With Breast Cancer * William J. Hormone Therapy in Postmenopausal Women With Breast Cancer * William J. Gradishar, MD ABSTRACT *Based on a presentation given by Dr Gradishar at a roundtable symposium held in Baltimore on June 28, 25.

More information

Avastin in breast cancer: Summary of clinical data

Avastin in breast cancer: Summary of clinical data Avastin in breast cancer: Summary of clinical data Worldwide, over one million people are diagnosed with breast cancer every year 1. It is the most frequently diagnosed cancer in women 1,2, and the leading

More information

Understanding Your Surgical Options For Breast Cancer

Understanding Your Surgical Options For Breast Cancer RADIATION THERAPY SYMPTOM MANAGEMENT CANCER INFORMATION Understanding Your Surgical Options For Breast Cancer In this booklet you will learn about: Role of surgery in breast cancer diagnosis and treatment

More information

Florida Breast Health Specialists Breast Cancer Information and Facts

Florida Breast Health Specialists Breast Cancer Information and Facts Definition Breast cancer is a cancer that starts in the tissues of the breast. There are two main types of breast cancer: Ductal carcinoma starts in the tubes (ducts) that move milk from the breast to

More information

Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background

Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background Imaging of Pleural Tumors Mylene T. Truong, MD Imaging of Pleural Tumours Mylene T. Truong, M. D. University of Texas M.D. Anderson Cancer Center, Houston, TX Objectives To review tumors involving the

More information

X-Plain Breast Cancer Reference Summary

X-Plain Breast Cancer Reference Summary X-Plain Breast Cancer Reference Summary The risk of breast cancer among Asian Americans living in the U.S. is relatively low compared to caucasian women. However, there is concern that the risk of breast

More information

GUIDELINES ADJUVANT SYSTEMIC BREAST CANCER

GUIDELINES ADJUVANT SYSTEMIC BREAST CANCER GUIDELINES ADJUVANT SYSTEMIC BREAST CANCER Author: Dr Susan O Reilly On behalf of the Breast CNG Written: December 2008 Agreed at CNG: June 2009 & June 2010 Review due: June 2011 Guidelines Adjuvant Systemic

More information

Breast Cancer Update 2014 Prevention, Risk, and Treatment of Early Stage Breast Cancer. Kevin R. Fox, MD University of Pennsylvania

Breast Cancer Update 2014 Prevention, Risk, and Treatment of Early Stage Breast Cancer. Kevin R. Fox, MD University of Pennsylvania Breast Cancer Update 2014 Prevention, Risk, and Treatment of Early Stage Breast Cancer Kevin R. Fox, MD University of Pennsylvania Prevention of Breast Cancer Accepted treatments Tamoxifen (premenopausal

More information

PET/CT in Lung Cancer

PET/CT in Lung Cancer PET/CT in Lung Cancer Rodolfo Núñez Miller, M.D. Nuclear Medicine and Diagnostic Imaging Section Division of Human Health International Atomic Energy Agency Vienna, Austria GLOBOCAN 2012 #1 #3 FDG-PET/CT

More information

Breast Cancer Treatment: A Multidisciplinary Approach Maihgan Kavanagh, MD, MPH Kaiser Santa Clara Medical Center

Breast Cancer Treatment: A Multidisciplinary Approach Maihgan Kavanagh, MD, MPH Kaiser Santa Clara Medical Center Breast Cancer Treatment: A Multidisciplinary Approach Maihgan Kavanagh, MD, MPH Kaiser Santa Clara Medical Center Santa Clara Medical Center What is Multidisciplinary Breast Cancer Care? An integrated

More information

Goals and Objectives: Breast Cancer Service Department of Radiation Oncology

Goals and Objectives: Breast Cancer Service Department of Radiation Oncology Goals and Objectives: Breast Cancer Service Department of Radiation Oncology The breast cancer service provides training in the diagnosis, management, treatment, and follow-up of breast malignancies, including

More information

Should a Routine Metastatic Workup Be Performed for all Patients with Pathologic N2/N3 Breast Cancer?

Should a Routine Metastatic Workup Be Performed for all Patients with Pathologic N2/N3 Breast Cancer? Should a Routine Metastatic Workup Be Performed for all Patients with Pathologic N2/N3 Breast Cancer? Quyen D Chu, MD, FACS, Amanda Henderson, MD, Roger H Kim, MD, J Karen Miller, MA, Gary Burton, MD,

More information

Ductal Carcinoma In Situ Treated With Breast-Conserving Surgery and Radiotherapy: A Comparison With ECOG Study 5194

Ductal Carcinoma In Situ Treated With Breast-Conserving Surgery and Radiotherapy: A Comparison With ECOG Study 5194 Ductal Carcinoma In Situ Treated With Breast-Conserving Surgery and Radiotherapy: A Comparison With ECOG Study 5194 Sabin B. Motwani, MD 1 ; Sharad Goyal, MD 1 ; Meena S. Moran, MD 2 ; Arpit Chhabra, BS

More information

GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER

GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER BY Ali Shamseddine, MD (Coordinator); as04@aub.edu.lb Fady Geara, MD Bassem Shabb, MD Ghassan Jamaleddine, MD CLINICAL PRACTICE GUIDELINES FOR THE TREATMENT

More information

HAVE YOU BEEN NEWLY DIAGNOSED with DCIS?

HAVE YOU BEEN NEWLY DIAGNOSED with DCIS? HAVE YOU BEEN NEWLY DIAGNOSED with DCIS? Jen D. Mother and volunteer. Diagnosed with DCIS breast cancer in 2012. An educational guide prepared by Genomic Health This guide is designed to educate women

More information

Breast Cancer. Sometimes cells keep dividing and growing without normal controls, causing an abnormal growth called a tumor.

Breast Cancer. Sometimes cells keep dividing and growing without normal controls, causing an abnormal growth called a tumor. Breast Cancer Introduction Cancer of the breast is the most common form of cancer that affects women but is no longer the leading cause of cancer deaths. About 1 out of 8 women are diagnosed with breast

More information

SUNY DOWNSTATE MEDICAL CENTER SURGERY GRAND ROUNDS February 28, 2013 VERENA LIU, MD ROSEANNA LEE, MD

SUNY DOWNSTATE MEDICAL CENTER SURGERY GRAND ROUNDS February 28, 2013 VERENA LIU, MD ROSEANNA LEE, MD SUNY DOWNSTATE MEDICAL CENTER SURGERY GRAND ROUNDS February 28, 2013 VERENA LIU, MD ROSEANNA LEE, MD Case Presentation 35 year old male referred from PMD with an asymptomatic palpable right neck mass PMH/PSH:

More information

Surgical guidelines for the management of breast cancer

Surgical guidelines for the management of breast cancer Available online at www.sciencedirect.com EJSO xx (2009) S1eS22 www.ejso.com Guidelines Surgical guidelines for the management of breast cancer Contents Association of Breast Surgery at BASO 2009 Introduction...

More information

Treatment Volume and Technique

Treatment Volume and Technique RADIATION THERAPY The standard of care for early lesions is surgical resection; however, selected patients with small central lesions may be considered for definitive radiation, particularly when the lesions

More information

Breast cancer. A guide for journalists on breast cancer and its treatment

Breast cancer. A guide for journalists on breast cancer and its treatment Breast cancer A guide for journalists on breast cancer and its treatment Contents Contents 2 3 Section 1: Breast Cancer 4 i. What is breast cancer? 4 ii. Types of breast cancer 4 iii. Causes and risk factors

More information

American College of Radiology ACR Appropriateness Criteria DUCTAL CARCINOMA IN SITU

American College of Radiology ACR Appropriateness Criteria DUCTAL CARCINOMA IN SITU American College of Radiology ACR Appropriateness Criteria Date of origin: 1996 Last review date: 2014 DUCTAL CARCINOMA IN SITU Expert Panel on Radiation Oncology Breast: Seth A. Kaufman, MD 1 ; Eleanor

More information

Lung Cancer Treatment Guidelines

Lung Cancer Treatment Guidelines Updated June 2014 Derived and updated by consensus of members of the Providence Thoracic Oncology Program with the aid of evidence-based National Comprehensive Cancer Network (NCCN) national guidelines,

More information

Metastatic Breast Cancer 201. Carolyn B. Hendricks, MD October 29, 2011

Metastatic Breast Cancer 201. Carolyn B. Hendricks, MD October 29, 2011 Metastatic Breast Cancer 201 Carolyn B. Hendricks, MD October 29, 2011 Overview Is rebiopsy necessary at the time of recurrence or progression of disease? How dose a very aggressive treatment upfront compare

More information

When it comes to treating breast cancer, doing less does more October is Breast Cancer Awareness Month

When it comes to treating breast cancer, doing less does more October is Breast Cancer Awareness Month For Immediate Release Oct. 8, 2012 When it comes to treating breast cancer, doing less does more October is Breast Cancer Awareness Month SEATTLE Oncologists and researchers are discovering that when it

More information

Evaluation and Management of the Breast Mass. Gary Dunnington,, M.D. Department of Surgery Internal Medicine Ambulatory Conference December 4, 2003

Evaluation and Management of the Breast Mass. Gary Dunnington,, M.D. Department of Surgery Internal Medicine Ambulatory Conference December 4, 2003 Evaluation and Management of the Breast Mass Gary Dunnington,, M.D. Department of Surgery Internal Medicine Ambulatory Conference December 4, 2003 Common Presentations of Breast Disease Breast Mass Abnormal

More information

Targeted Therapy What the Surgeon Needs to Know

Targeted Therapy What the Surgeon Needs to Know Targeted Therapy What the Surgeon Needs to Know AATS Focus in Thoracic Surgery 2014 David R. Jones, M.D. Professor & Chief, Thoracic Surgery Memorial Sloan Kettering Cancer Center I have no disclosures

More information

Breakthrough Treatment Options for Breast Cancer

Breakthrough Treatment Options for Breast Cancer Breakthrough Treatment Options for Breast Cancer Guest Expert: Lyndsay, MD Associate Professor of Medical Oncology, Yale Cancer Center www.wnpr.org www.yalecancercenter.org Welcome to Yale Cancer Center

More information

Breast. Patient information. cancer clinical pathway

Breast. Patient information. cancer clinical pathway Breast Patient information cancer clinical pathway This leaflet was written to properly inform people following breast cancer treatment plan. It doesn t replace the dialogue with healthcare staff; it rather

More information