Although the metastasic breast cancer is still an incurable disease, recent advances have increased significantly the time to progression and the overall survival. However, too much information has been produced in the last 2 years, so a well-based guideline is a valuable document in treatment decision making. The SEOM guidelines are intended to make evidence-based recommendations on how to manage patients with advanced and recurrent breast cancer to achieve the best patient outcomes based on a rational use of the currently available therapies. To assign a level of certainty and a grade of recommendation the United States Preventive Services Task Force guidelines methodology was selected as reference.
Breast Neoplasms/therapy , Neoplasm Recurrence, Local/therapy , Practice Guidelines as Topic/standards , Breast Neoplasms/pathology , Clinical Trials as Topic , Combined Modality Therapy , Disease Management , Female , Humans , Neoplasm Recurrence, Local/pathology , Prognosis , Societies, Medical
Although the metastasic breast cancer is still an incurable disease, recent advances have increased significantly the time to progression and the overall survival. However, too much information has been produced in the last 2 years, so a well-based guideline is a valuable document in treatment decision making. The SEOM guidelines are intended to make evidence-based recommendations on how to manage patients with advanced and recurrent breast cancer to achieve the best patient outcomes based on a rational use of the currently available therapies. To assign a level of certainty and a grade of recommendation the United States Preventive Services Task Force guidelines methodology was selected as reference
No disponible
Humans , Female , Breast Neoplasms/pathology , Neoplasm Recurrence, Local/pathology , Neoplasm Metastasis/pathology , Neoplasm Recurrence, Local/therapy , Breast Neoplasms/therapy , Quality of Life/psychology , Practice Patterns, Physicians'
This section considers the treatment options for perimenopausal women with breast cancer. The perimenopause period begins in the so-called stage 2 of menopausal transition (early menopausal transition, where the length of the cycles changes by 7 days or more) and ends after 12 months of amenorrhea. It is characterized by an early increase in follicle-stimulating hormone and is associated with the presence of anovulatory cycles, irregular periods, and loss of menstrual cycles. The recommended treatment is tamoxifen (TAM) with or without ovarian ablation for 2 or 3 years followed by a re-evaluation. TAM should be maintained if the patient is premenopausal and aromatase inhibitors (AI) are recommended once the menopausal status is confirmed. Ovarian suppression is an acceptable adjuvant therapy in those patients with hormone-sensitive tumors. AI should only be used in postmenopausal women or in combination with chemical castration in premenopausal women. This supplement paper includes the key points of roundtable presentations and discussions of hormonal therapy in breast cancer.
Antineoplastic Agents, Hormonal/administration & dosage , Aromatase Inhibitors/administration & dosage , Breast Neoplasms/drug therapy , Breast Neoplasms/mortality , Perimenopause/drug effects , Adult , Age Factors , Antineoplastic Agents, Hormonal/adverse effects , Aromatase Inhibitors/adverse effects , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Chemotherapy, Adjuvant , Disease-Free Survival , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Humans , Mastectomy/methods , Middle Aged , Neoplasm Invasiveness/pathology , Neoplasm Staging , Patient Selection , Perimenopause/physiology , Prognosis , Randomized Controlled Trials as Topic , Risk Assessment , Survival Analysis , Tamoxifen/administration & dosage , Tamoxifen/adverse effects , Treatment Outcome
Breast cancer growth and dissemination is regulated by estrogen and different growth factor receptor signalling pathways. The increasing knowledge of the biology of breast cancer regarding the interaction of these signalling pathways provides a tool to understand endocrine therapies response and resistance mechanisms. In patients with slowly progressive disease, no visceral involvement, and minimal symptoms, endocrine therapy could be the strategy of choice, even if the tumor has low estrogen receptor expression. Ovarian suppression and tamoxifen are recommended for premenopausal patients whether aromatase inhibitors are the option for postmenopausal ones. Chemotherapy still remains as the right alternative for hormone unresponsive or resistant patients. This is a review focused on the different strategies and combinations of endocrine therapies for metastatic breast cancer patients considering the potential strategies clinically tested to overcome resistance and the different treatments of choice available for each scenario of disseminated disease (AU)
No disponible
Humans , Female , Antineoplastic Agents, Hormonal/metabolism , Antineoplastic Agents, Hormonal/therapeutic use , Aromatase Inhibitors/therapeutic use , Clinical Trials as Topic , Breast Neoplasms/drug therapy , Breast Neoplasms/pathology , Breast Neoplasms/secondary , Receptors, Estrogen/administration & dosage , Receptors, Estrogen/antagonists & inhibitors , Receptors, Estrogen/metabolism , Neoplasms, Hormone-Dependent/drug therapy , Neoplasms, Hormone-Dependent/pathology
Antineoplastic Agents/adverse effects , Interferon-alpha/adverse effects , Lung Diseases, Interstitial/diagnosis , Melanoma/drug therapy , Skin Neoplasms/drug therapy , Aged , Aged, 80 and over , Diabetes Mellitus, Type 2 , Diagnosis, Differential , Female , Humans , Interferon alpha-2 , Lung Diseases, Interstitial/chemically induced , Lung Diseases, Interstitial/diagnostic imaging , Lung Diseases, Interstitial/pathology , Parkinson Disease , Pulmonary Fibrosis/chemically induced , Pulmonary Fibrosis/diagnosis , Pulmonary Fibrosis/diagnostic imaging , Pulmonary Fibrosis/pathology , Recombinant Proteins , Tomography, X-Ray Computed , Tuberculosis, Pulmonary
