A Radically Different Approach to Treating Early Breast Cancer

According to the June 18th report from the onlinechemotherapy) based on criteria specific to each
cancer journal, The Annals of Oncology, themodality. We expect the refined algorithm to
international panel of experts that assembled forchange clinical practice because it clarifies the
the 11th St. Gallen Health Conference in March,indications for each treatment modality available
proposed a potentially radically different approachtoday."
when it comes to deciding upon the bestThe panel's report emphasizes the importance of
treatment options for early breast cancer.identifying which type of breast cancer a patient
While the panel still agrees that no case of breasthas and which treatment, or combination of
cancer is exactly the same and each patienttreatments, are most likely to be successful.
should received personalized care, it has putThey recommend the increased use of genetic
forward a new, more standardized approachprofiling using microarrays as a means for
when it comes to assessing disease risks andimproved identification, especially for the forms
appropriate treatment strategies.that have been more difficult to analyze.
They go on to suggest that these vital clinicalAdditionally, the panel discussed the importance of
systems must address three distinct questions: "(i)conducting extensive clinical trials because they
what justifies the use of endocrine therapy, (ii)can "provide essential information on the safety
what justifies the use of anti-HER2 therapy, andand efficacy of treatments."
(iii) what justifies the use of chemotherapy." ThisYet, while their discussion highlights the importance
is a change from the traditional method ofof standardization from medical professionals, the
identifying a single-risk category and then apanel knows who will make the final call. Professor
subsequent and separate therapyAlan Coates of the University of Sydney
recommendation.expressed how the patients must be at the
Furthermore, the panel gave a new algorithm forcenter of all treatment decisions saying, "We
clinicians to use when they are attempting torecognize the importance of quality of life,
decide what will be the most effective treatmentsupportive care and patient preference in the
approach for their patient. As one of thetreatment decision-making process."
members, Professor Richard Gelber of HarvardMore specific treatment recommendations and
University said, "We have identified 'thresholds forfurther details can be seen in the original Annals of
indication' of each type of systemic treatmentOncology doi: 10.
modality (endocrine therapy, anti-HER2 therapy,