The statistics are comforting and well-known: When breast
cancer is detected and treated in its early stages, 86% or more of women
survive at least five years.
What about women who have advanced breast cancer? What about
women who are diagnosed with Stage III breast cancer, in which a number of
lymph nodes may be affected, or metastatic breast cancer (Stage IV) that has
spread to other parts of the body?
Surgery is recommended as the primary treatment of breast cancer in pregnant women. Since radiation in therapeutic doses may expose the fetus to potentially harmful scatter radiation, modified radical mastectomy is the treatment of choice. Conservative surgery with postpartum radiation therapy has been used for breast preservation. An analysis has been performed that helps to predict the risk of waiting to have radiation.[3,4]
If adjuvant chemotherapy is necessary, it should not be given during...
Without doubt, they face a tougher battle. Yet medical research
is making strides in their care. Indeed, women with Stage III breast cancers
currently have a 49% to 56% chance of surviving five years, while women
diagnosed with metastatic breast cancer -- once considered hopeless -- now have
a 16% chance of surviving five years. Moreover, new treatments being tested
offer great hope that these women may soon live longer and better lives.
To understand the gains in treating later-stage breast cancer
WebMD turned to three prominent oncologists: Claudine Isaacs, MD, co-director
of the breast cancer program at Georgetown University Medical Center; Edith
Perez, MD, professor of medicine at the Mayo Medical School in Jacksonville,
Florida; and, Jonathan Serody, MD, an associate professor of medicine and
researcher at the University of North Carolina's Lineberger Comprehensive
Here's their summary of drugs offering hope on the horizon:
The biggest news today for women with advanced breast cancer is
a drug called Herceptin. No other treatment in recent years has done as much to
prolong the lives of women with later-stage disease: In a study published in
the New England Journal of Medicine, Herceptin improved the average
survival time for women with Stage IV HER2-positive disease from 20 months to
25 months. That's the most significant improvement in survival for these women
that's been seen in a long time.
Herceptin is one of a new class of drugs called monoclonal
antibodies -- lab-engineered antibodies designed to mimic the body's own immune
system response. Herceptin targets the HER2 protein, which, when it's
overproduced in breast cells, leads to the proliferation of abnormal cells or
cancer. When the drug finds HER2 proteins on the surface of the tumor cell, it
binds to them and either kills the cancerous cells outright or stops their
Herceptin is only effective in the 20%-30% of women whose
cancers involve overproduction of the HER2 protein. Still, for these women,
"Herceptin has improved survival rates more than anything else," says
Claudine Isaacs, MD, associate professor of medicine and oncology at Georgetown
University Medical Center and co-director of the breast cancer program.
Herceptin is representative of a new approach to treating advanced breast
cancer, and more monoclonal antibodies are in development that will target
other causes of the disease. For instance, researchers are now looking at
several drugs that are designed to affect another protein involved in some
types of breast cancer called HER1, or more commonly, EGFR. While initial
results haven't been especially positive, researchers are still hopeful that
further study of EGFR-targeting drugs will be more successful.