From the Guidelines
Breast cancer is the most common malignancy in women in the United States, with an estimated 235,030 Americans diagnosed with invasive breast cancer and 40,430 deaths in 2014, according to the American Cancer Society 1. The incidence of breast cancer has been steadily increasing in the United States over the past few decades. However, breast cancer-related mortality seems to be declining, suggesting a benefit from the combination of early detection and more effective treatment. Some key points to consider in the management of breast cancer include:
- Early detection through regular screenings like mammograms significantly improves survival rates
- The combination of early detection and effective treatment has been shown to reduce breast cancer-related mortality 1
- Advances in treatment have dramatically improved survival rates for many cancer types It is essential to prioritize early detection and effective treatment to improve outcomes for patients with breast cancer. The estimated number of deaths from breast cancer in the United States highlights the need for continued efforts to improve early detection and treatment strategies. Key factors that contribute to the development of breast cancer include genetic mutations, which can cause cells to divide uncontrollably, forming tumors that can damage surrounding tissues. Regular screenings and a healthy lifestyle can help reduce the risk of developing breast cancer. The decline in breast cancer-related mortality suggests that current treatment strategies are effective, and continued research is necessary to further improve outcomes.
From the Research
Overview of Cancer Treatment
- Cancer is a global health problem responsible for one in six deaths worldwide 2
- Conventional treatment approaches include surgery, chemotherapy, and radiotherapy, while significant advances are being made in recent times, including stem cell therapy, targeted therapy, ablation therapy, nanoparticles, natural antioxidants, radionics, chemodynamic therapy, sonodynamic therapy, and ferroptosis-based therapy 2
Chemotherapy Regimens
- High dose, dose-intensive chemotherapy with doxorubicin and cyclophosphamide has an excellent initial therapeutic effect in advanced breast cancer, but does not prolong duration of remission or overall survival beyond that of standard treatment 3
- The combination of doxorubicin and cyclophosphamide (AC) is a standard adjuvant chemotherapy regimen, while docetaxel and cyclophosphamide (TC) has shown promise in metastatic breast cancer 4
- Neoadjuvant docetaxel followed by adjuvant doxorubicin and cyclophosphamide is an active regimen for patients with stage III breast cancer 5
- Docetaxel and doxorubicin compared with doxorubicin and cyclophosphamide as first-line chemotherapy for metastatic breast cancer has shown significant improvement in time to progression and overall response rate 6
Treatment Outcomes
- The median time to progression was 5 1/2 months and the median survival was 18 1/2 months in patients with advanced breast cancer treated with high dose, dose-intensive chemotherapy 3
- The 5-year disease-free survival rate was significantly superior for TC compared with AC (86% v 80%, respectively) 4
- The 5-year overall survival rate was 80% in patients with stage III breast cancer treated with neoadjuvant docetaxel followed by adjuvant doxorubicin and cyclophosphamide 5
- Overall survival was comparable in both arms of the study comparing docetaxel and doxorubicin with doxorubicin and cyclophosphamide as first-line chemotherapy for metastatic breast cancer 6
Toxicity and Side Effects
- Neutropenia occurred after 89% of courses and 65% of courses were accompanied by a significant (WHO grade III or IV) infection in patients treated with high dose, dose-intensive chemotherapy 3
- Moderate to severe epithelial toxicity (WHO grade 3 or 4) accompanied 43% of courses and was dose limiting 3
- Grade 3/4 neutropenia was frequent in both groups, although febrile neutropenia and infections were more frequent for patients taking docetaxel and doxorubicin compared with doxorubicin and cyclophosphamide 6