RESUMO
A decision regarding adjuvant chemotherapy in early (operable) breast cancer in the past was made entirely on the basis of clinical and pathological features. However with the growing awareness of tumor biology and the possibility of the genomic analysis to determine the molecular subtypes of breast cancer it is getting real to identify patients whose tumors are resistant to chemotherapy or vice versa benefit from its addition. Despite the fact that genomic analysis allows some patients avoiding chemotherapy (especially patients with localized breast cancer), such studies do not indicate the most appropriate chemotherapy regimens. Therefore treatment decisions should be based on a combination of biological features of the tumor, its stage and signs that characterize the patient such as age and tolerance to the side effects of therapy.
Assuntos
Antineoplásicos/uso terapêutico , Biomarcadores Tumorais/metabolismo , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Quimioterapia Adjuvante , Fatores Etários , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Neoplasias da Mama/genética , Neoplasias da Mama/metabolismo , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/tratamento farmacológico , Carcinoma Ductal de Mama/metabolismo , Técnicas de Apoio para a Decisão , Feminino , Humanos , Mastectomia Segmentar , MicroRNAs/metabolismo , Estadiamento de Neoplasias , Receptor ErbB-2/metabolismo , Medição de Risco , Fatores de RiscoRESUMO
Neoadjuvant systemic therapy is frequently used option for the systemic treatment for breast cancer. Inclusion in the regimen of targeted drugs as trastuzumab (Herceptin) and pertuzumab significantly improves outcomes in HER2-positive breast cancer patients. A certain part of HER2-positive patients can be cured by using only targeted drugs without chemotherapy.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/análise , Neoplasias da Mama/tratamento farmacológico , Terapia de Alvo Molecular/métodos , Terapia Neoadjuvante/métodos , Receptor ErbB-2/análise , Adulto , Idoso , Anticorpos Monoclonais Humanizados/administração & dosagem , Neoplasias da Mama/química , Neoplasias da Mama/patologia , Quimioterapia Adjuvante , Feminino , Humanos , Neoplasias Inflamatórias Mamárias/tratamento farmacológico , Lapatinib , Pessoa de Meia-Idade , Quinazolinas/administração & dosagem , Trastuzumab , Resultado do TratamentoRESUMO
Breast cancer in men is 100 times less common than in women. The main risk factors include: the mutation of genes BRCA 1 and 2, Klinefelter's syndrome, alcohol, liver disease, obesity. Clinical examinations, mammography and ultrasound are informative and highly sensitive for early detection of these tumors, but are rarely implemented due to lack of awareness of general practitioners. Local treatment includes the Patey-Dyson mastectomy and radiation therapy. Adjuvant systemic therapy is determined by pTNM and typically involves tamoxifen.
