Volume 82, Issue 3 , Pages 361-369, June 2012
Adjuvant early breast cancer systemic therapies according to daily used technologies
► Various adjuvant breast cancer guidelines are available. ► These consensual statements can be optimized using locally available daily used technologies. ► The conjunction of the Adjuvant! Online tool with additional predictive and prognostic factors, such as the uPA/PAI-1 complex, can be used in the routine clinical decision process.
Abstract
Prognosis of early breast cancer patients is significantly improved with the use of adjuvant therapies. Various guidelines have been proposed to select patients who will derive the most benefit from such treatments. However, classifications have limited usefulness in subsets of patients such as those with node negative breast cancer.
The 2007 St. Paul de Vence Clinical Practice Recommendations proposed to consider adjuvant therapy in accordance with the 10-year relapse-free survival reduction estimated by Adjuvant! Online. However, many limitations remain regarding the use of Adjuvant! Online. Among them, adverse prognostic and/or predictive factors such as vascular invasion, mitotic activity, progesterone receptor negativity, and HER-2 expression are not incorporated in the routine clinical decision process. Our group has therefore issued guidelines based on the consideration of both Adjuvant! Online calculations and the prognostic and/or predictive effects of these markers. In addition, web-accessible comprehensive tables summarizing these recommendations are provided.
Keywords: Breast cancer, Adjuvant chemotherapy, Prognostic factors, Predictive factors
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PII: S1040-8428(11)00215-0
doi:10.1016/j.critrevonc.2011.09.002
© 2011 Elsevier Ireland Ltd. All rights reserved.
Volume 82, Issue 3 , Pages 361-369, June 2012
