RESUMEN
Patients with metastatic breast cancer should be offered comprehensive and personalized medical attention including, but not limited to, psychosocial, supportive and symptom-related interventions. A large number of treatment options are available and several prognostic and predictive factors are useful to identify the best therapeutic options individually.
Asunto(s)
Neoplasias de la Mama/patología , Neoplasias de la Mama/terapia , Antineoplásicos Hormonales/uso terapéutico , Neoplasias Óseas/secundario , Neoplasias Óseas/terapia , Neoplasias de la Mama/genética , Neoplasias del Sistema Nervioso Central/secundario , Neoplasias del Sistema Nervioso Central/terapia , Quimioterapia Adyuvante , Femenino , Genes erbB-2 , Humanos , Terapia Neoadyuvante , Metástasis de la Neoplasia , Posmenopausia , Receptores de Estrógenos/genética , RecurrenciaRESUMEN
This section focuses on different aspects of the individualization of hormone treatment in breast cancer. This includes tumor-related biological factors such as expression of hormone receptors, HER-2, and Ki-67; host-related factors such as CYP2D6 or body mass index, and risk and/or development of specific toxicities and treatment adherence. The best predictor of response to hormonal interventions is the expression of hormone receptors, in particular, estrogen receptors. Treatment adherence and compliance are key factors and strategies aiming to identify and intervene when patients are at risk of abandoning treatment. Currently, routine assessment of CYP2D6 is not recommended to guide tamoxifen treatment. Likewise, there are no criteria regarding bone mass density, lipid profile, or arthralgias to recommend one class of agent versus another. Aromatase inhibitors should not be administered to patients who are pre- or perimenopausal.