Download Understanding early breast cancer

Understanding
early breast cancer
Early breast cancer (eBC) refers to cancer
that is confined to the breast i.e. it has
not ‘metastasised’ or spread to other
parts of the body1
EARLY STAGE
BREAST CANCER
ADVANCED STAGE
BREAST CANCER
The aim of treating eBC is to
prevent the disease from
returning or reaching an
advanced and incurable stage
Approximately 1.67 million
new cases of breast cancer are
diagnosed annually worldwide.
The majority of these cases
are identified in the early stages
of the disease.2,3,4
Removal of the tumour through surgery is a mainstay
of treatment but other treatment options may include:
RADIOTHERAPY
CHEMOTHERAPY
HORMONAL
THERAPY
TARGETED
THERAPIES
Patients with eBC can be given
therapies before and/or after surgery
to reduce the size of the tumour and
to prevent the cancer from returning
NEOADJUVANT
Treatment given
before surgery may
be referred to as
‘neoadjuvant’
therapy. This
treatment aims to
reduce the size of
the tumour
SURGERY
ADJUVANT
Treatment after
surgery is referred
to as ‘adjuvant’
therapy. This
treatment aims to
kill any remaining
cancer cells and
prevent the cancer
from returning
When breast cancer is diagnosed and treated
in the early setting it is potentially curable5-10
Even with current treatment options,
almost a third of patients first
diagnosed with eBC will go on to
develop advanced disease, at which
point it becomes incurable11
Bringing new treatments to patients with eBC can
take a long time
‘Disease-free survival (DFS)’ is a common endpoint used
to assess whether a cancer medicine works in eBC. However,
it can take years to demonstrate DFS. This means it can take
a long time to approve a medicine and get it to patients
Novel endpoints like pCR may
help bring more effective
medicines to patients faster
pCR stands for
pathological complete
response and means that
the patient responded so well
to neoadjuvant treatment that
there is no tumour tissue that
can be detected at the time of
surgery in the affected breast
+/- local lymph nodes
pCR can be assessed within
months rather than years,
providing an early indication
of how well a medicine works
It has been suggested that achieving pCR in the neoadjuvant setting,
followed by a one year course of adjuvant treatment, may be associated
with longer-term improvements in patient outcomes12
References:
1. Breast cancer.org [online]. Available from: http://www.breastcancer.org/symptoms/diagnosis/staging.jsp [Accessed May 2015].
2. World Health Organization [online].
Available from: http://publications.cancerresearchuk.org/downloads/product/CS_REPORT_WORLD.pdf [Accessed May 2015].
3. Howlader N, et al. [online]. Available from: http://seer.cancer.gov/csr/1975_2011/ [Accessed May 2015].
4. Cardoso F, et al. Ann Oncol 2012;23 Suppl 7:vii11-9.
5. Gianni L, et al. Lancet Oncol 2011;12:236-244.
6. Perez E, et al. J Clin Oncol 2011;29,25:3366-73.
7. Piccart-Gebhart M, et al. N. Engl. J. Med 2005;353:1659-72.
8. Romond E, et al. N. Engl. J. Med 2005;353,16:1673-84.
9. Slamon D, et al. N. Engl. J. Med 2011;365,14:1273-1283.
10. Smith I, et al. Lancet 2007;369:29–36.
11. Early Breast Cancer Trialists' Collaborative Group. Lancet 2005;365(9472):1687-717.
12. Gianni L, et al. Lancet Oncol 2014;15,6:640-7.
NP/ONCO/1505/0011