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Volume 10 Supplement 3

Symposium Mammographicum 2008

  • Oral presentation
  • Published:

Minimising oncological treatment of early breast cancer

Recommendations for adjuvant systemic therapies are based on estimates of life expectancy (prognostic markers) and of benefit to therapy (predictive markers). The oestrogen receptor is a classic predictive marker guiding use of anti-oestrogen therapy, and expression profiling appears to select patients more or less likely to benefit. Expression profiling is also under evaluation as a prognostic marker to identify patients who do not need cytotoxic chemotherapy (MINDACT trial). Biological therapy with trastuzu-mab is prescribed on the basis of a predictive test for over-expression of the target growth factor receptor protein, HER2. The ER-PR-HER2-subgroup identifies patients who may benefit selectively from platinum compounds. In radiotherapy, there is also a trend towards delivering fewer, larger fractions of breast radiotherapy to a lower total dose than the historical standard 50 Gy in 25 fractions. Partial breast radiotherapy is under test as a safe and effective alternative to whole-breast radiotherapy for women with low-risk disease, a measure that is also likely to reduce iatrogenic morbidity in long-term survivors. Finally, the identification of subgroups in which radiotherapy can be safely withheld remains a research priority, with age as the single most powerful factor predicting risk of local relapse.

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Yarnold, J. Minimising oncological treatment of early breast cancer. Breast Cancer Res 10 (Suppl 3), P6 (2008).

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