Can Endocrine Treatment for Hormone-Positive Premenopausal Women With Early Breast Cancer Replace Adjuvant Chemotherapy?

2003 ◽  
Vol 21 (12) ◽  
pp. 2444-2445
Author(s):  
Reza Malayeri
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Early Breast Cancer ◽  
Premenopausal Women ◽  
Endocrine Treatment

Gene Expression Assay in the Management of Early Breast Cancer

2020 ◽  
Vol 27 (17) ◽  
pp. 2826-2839 ◽  
Author(s):  
Roberta Caputo ◽  
Daniela Cianniello ◽  
Antonio Giordano ◽  
Michela Piezzo ◽  
Maria Riemma ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
Decision Making ◽  
Adjuvant Chemotherapy ◽  
Early Breast Cancer ◽  
Treatment Decision ◽  
Endocrine Treatment ◽  
Expression Ratio ◽  
Treatment Decision Making ◽  
Low Sensitivity

The addition of adjuvant chemotherapy to hormonal therapy is often considered questionable in patients with estrogen receptor-positive early breast cancer. Low risk of disease relapse after endocrine treatment alone and/or a low sensitivity to chemotherapy are reasons behind not all patients benefit from chemotherapy. Most of the patients could be exposed to unnecessary treatment- related adverse events and health care costs when treatment decision-making is based only on classical clinical histological features. Gene expression profile has been developed to refine physician’s decision-making process and to tailor personalized treatment to patients. In particular, these tests are designed to spare patients the side effects of unnecessary treatment, and ensure that adjuvant chemotherapy is correctly recommended to patients with early breast cancer. In this review, we will discuss the main diagnostic tests and their potential clinical applications (Oncotype DX, MammaPrint, PAM50/Prosigna, EndoPredict, MapQuant Dx, IHC4, and Theros-Breast Cancer Gene Expression Ratio Assay).

scholarly journals Recognizing menopause in women with amenorrhea induced by cytotoxic chemotherapy for endocrine-responsive early breast cancer

2012 ◽  
Vol 19 (2) ◽  
pp. R21-R33 ◽  
Author(s):  
Francesco Torino ◽  
Agnese Barnabei ◽  
Liana De Vecchis ◽  
Marialuisa Appetecchia ◽  
Lidia Strigari ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Ovarian Function ◽  
Premenopausal Women ◽  
Cytotoxic Agents ◽  
Endocrine Treatment ◽  
Ovarian Toxicity ◽  
Variable Extent ◽  
Negative Effect ◽  
Anticancer Treatment

Cytotoxic anticancer treatment may induce amenorrhea or menopause to a variable extent. These side effects may not only impair or impede fertility but also cause sexual dysfunction, bone loss, and menopausal symptoms, with a strikingly negative effect on quality of life in many women. Aromatase inhibitors (AIs) are a recommended adjuvant endocrine treatment option in postmenopausal patients affected by early breast cancer (EBC) but are contraindicated in premenopausal women and in those with residual ovarian function. Women over 40 years of age with chemotherapy-induced amenorrhea (CIA) and routine hormonal levels consistent with menopause may receive an AI as adjuvant endocrine treatment. For these women, the tools available to identify menopause do not appear to be completely reliable. This review focused on the pathophysiology of ovarian toxicity induced by cytotoxic agents and on potentially useful methods to diagnose chemotherapy-induced menopause in patients treated with adjuvant chemotherapy for endocrine-responsive EBC. Moreover, practical approaches are proposed to distinguish true menopausal women, who would benefit from AIs, from those with transient or persistent CIA.

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