Controversies in the Therapy of Early Stage Breast Cancer

Learning Objectives After completing this course, the reader will be able to: Select appropriate adjuvant therapies for patients with early stage breast cancer.Describe the evolving role of taxanes in the adjuvant therapy of early stage breast cancer.Discuss the evolving role of aromatase inhibitors in the adjuvant therapy of early stage breast cancer.Discuss the controversies that remain in the treatment of early stage breast cancer.Interpret the recent data supporting the use of trastuzumab in the adjuvant setting for patients with HER-2–positive, early stage breast cancer. Access and take the CME test online and receive 1 AMA PRA category 1 credit at CME.TheOncologist.com Breast cancer is the most common malignancy among U.S. women, with more than 200,000 new cases diagnosed annually. In the U.S., mortality from breast cancer has declined in recent years as a result of more widespread screening, leading to earlier detection, as well as advances in the adjuvant treatment of early-stage disease. It is widely accepted that the appropriate use of adjuvant chemotherapy and endocrine therapy improves the disease-free and overall survival of patients with early-stage breast cancer. It is, therefore, standard clinical practice to administer adjuvant systemic therapy to patients with node-positive and high-risk, node-negative breast cancer. There remain, however, many controversies in the primary systemic therapy of breast cancer, which are discussed in this review.