Actividad física y cáncer de mama: un tratamiento dirigido / Physical activity and breast cancer

In Chile breast cancer (BC) is the first cause of death in women. While the most important risk factor for its development is estrogenic stimulation, environmental factors and lifestyles also contribute to its pathogenesis. Epidemiological studies show a direct relationship between physical activity (PA), incidence and recurrence of BC. Supervised PA practice is recommended in most cancer patients to improve their quality of life, to reduce adverse effects from treatment and eventually to improve the prognosis of the disease. We review the epidemiological evidence linking PA and BC and the biological basis of this relationship. We also review the relevant interventional studies and we explore some practical indications of PA in patients with BC, as a model for other tumors of epidemiological importance.

Terapia endocrina neoadyuvante en cáncer de mama, una alternativa de tratamiento e investigación / Neoadyuvant endocrine therapy in breast cancer

Neoadjuvant chemotherapy is an accepted strategyforpatients with locally advanced breast cáncer. This approach increases the possibilities ofconservative treatment and improves the resectability rates ofinitially unresectable tumors. In addition, preoperative systemic therapy allows the evaluation of prognostic and predictive factors, dynamically and in vivo. Since over 80% ofthese tumors express estrogen receptors (ER), endocrine therapy seems a logical treatment to employ in the neoadjuvant setting. The advent ofnew drugs that regúlate the ERfunction, along with the results of severa! clinical studies with the use of neoadjuvant endocrine therapy, support the feasibility and safety of utilizing this strategy before surgery. We herein analyze the available clinical evidence about the use of neoadjuvant therapy aiming to regúlate the activity ofthe ER. We also discuss the valué of predictive factors that could help the oncologist to select those patients most likely to benefit from this approach and the role of endocrine therapy as a research instrument.