The Right Treatment for the Right Patient – Personalised Treatment of Breast Cancer

The probability of healing breast cancer has been greatly improved in recent decades through the introduction and optimisation of multi-modal therapies and interdisciplinary treatments. Today, in addition to surgery or radiation, most patients receive a systemic treatment. To prevent excessive treatment, patients whose prognosis is so good that certain adjuvant therapies can be foregone or reduced must be identified. A lack of compliance with therapy, especially in the endocrine therapies stretching over years, is a further problem. As only treatments that are also carried out can improve chances of survival, efforts to improve compliance must be intensified. Studies show that lifestyle changes influence the efficiency of medication on the one hand, and on the other hand can also by themselves achieve a relevant improvement of the prognosis. Therefore, it is time not only to treat the tumour, but to also focus on the patient as a whole in therapeutic interventions.

[1]  Z. Hall Cancer , 1906, The Hospital.

[2]  J. Westman The right to treatment. , 1977, Journal of autism and childhood schizophrenia.

[3]  D. Wallwiener,et al.  Reduction in new metastases in breast cancer with adjuvant clodronate treatment. , 1998, The New England journal of medicine.

[4]  S. Dobie,et al.  Prophylactic mastectomy for prevention of breast cancer. , 1999, The Journal of family practice.

[5]  G. Kundt,et al.  Perioperative screening for metastatic disease is not indicated in patients with primary breast cancer and no clinical signs of tumor spread. , 2003, Breast cancer research and treatment.

[6]  L. Fallowfield,et al.  Tolerability of hormone therapies for breast cancer: How informative are documented symptom profiles in medical notes for ‘well-tolerated’ treatments? , 2001, Breast Cancer Research and Treatment.

[7]  Robert M Elashoff,et al.  Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women's Intervention Nutrition Study. , 2007, Journal of the National Cancer Institute.

[8]  M. Morrow,et al.  Effect of margin status on local recurrence after breast conservation and radiation therapy for ductal carcinoma in situ. , 2009, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[9]  R. Peto,et al.  Overview of the randomized trials of radiotherapy in ductal carcinoma in situ of the breast. , 2010, Journal of the National Cancer Institute. Monographs.

[10]  M. Beckmann,et al.  The German SUCCESS C Study – The First European Lifestyle Study on Breast Cancer , 2010, Breast Care.

[11]  Dawn L. Hershman,et al.  Early discontinuation and non-adherence to adjuvant hormonal therapy are associated with increased mortality in women with breast cancer , 2011, Breast Cancer Research and Treatment.

[12]  Early Breast Cancer Trialists' Collaborative Group Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials , 2011, The Lancet.

[13]  R Peto,et al.  Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10 801 women in 17 randomised trials , 2011, The Lancet.

[14]  T. Julian,et al.  Long-term outcomes of invasive ipsilateral breast tumor recurrences after lumpectomy in NSABP B-17 and B-24 randomized clinical trials for DCIS. , 2011, Journal of the National Cancer Institute.

[15]  L. Ngo,et al.  Causes of death and relative survival of older women after a breast cancer diagnosis. , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[16]  M. R. del Turco,et al.  Mastectomy trends for early-stage breast cancer: a report from the EUSOMA multi-institutional European database. , 2012, European journal of cancer.

[17]  Thomas J. Smith,et al.  American Society of Clinical Oncology identifies five key opportunities to improve care and reduce costs: the top five list for oncology. , 2012, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[18]  D. Cutter,et al.  Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100 000 women in 123 randomised trials , 2012, The Lancet.

[19]  M. Brennan,et al.  Evaluation of the evidence on staging imaging for detection of asymptomatic distant metastases in newly diagnosed breast cancer. , 2012, Breast.

[20]  R. Peto,et al.  Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials. , 2012, Lancet.

[21]  Barbara L. Smith,et al.  Lumpectomy plus tamoxifen with or without irradiation in women age 70 years or older with early breast cancer: long-term follow-up of CALGB 9343. , 2013, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[22]  M. Morrow,et al.  Effect of Margin Width on Local Recurrence in Triple-Negative Breast Cancer Patients Treated with Breast-Conserving Therapy , 2014, Annals of Surgical Oncology.

[23]  K. Kostev,et al.  Persistence in patients with breast cancer treated with tamoxifen or aromatase inhibitors: a retrospective database analysis , 2013, Breast Cancer Research and Treatment.

[24]  R. Chlebowski Nutrition and physical activity influence on breast cancer incidence and outcome. , 2013, Breast.

[25]  P. Goodwin Obesity and endocrine therapy: host factors and breast cancer outcome. , 2013, Breast.

[26]  R. Turner,et al.  Preoperative Magnetic Resonance Imaging in Breast Cancer: Meta-Analysis of Surgical Outcomes , 2013, Annals of surgery.

[27]  A. Scharl,et al.  Multimodale Therapie des nicht metastasierten Mammakarzinoms , 2014, Der Onkologe.

[28]  M. Rezai,et al.  Pathological complete response (pCR) rates after carboplatin-containing neoadjuvant chemotherapy in patients with germline BRCA (gBRCA) mutation and triple-negative breast cancer (TNBC): Results from GeparSixto. , 2014 .

[29]  S. Gomez,et al.  Use of and mortality after bilateral mastectomy compared with other surgical treatments for breast cancer in California, 1998-2011. , 2014, JAMA.

[30]  Seema A Khan,et al.  Society of Surgical Oncology–American Society for Radiation Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stages I and II Invasive Breast Cancer , 2014, Annals of Surgical Oncology.

[31]  J. Cuzick,et al.  Anastrozole for prevention of breast cancer in high-risk postmenopausal women (IBIS-II): an international, double-blind, randomised placebo-controlled trial , 2014, The Lancet.

[32]  David A. Williams,et al.  Patient‐reported symptoms and discontinuation of adjuvant aromatase inhibitor therapy , 2014, Cancer.

[33]  A. Giobbie-Hurder,et al.  Adjuvant exemestane with ovarian suppression in premenopausal breast cancer. , 2014, The New England journal of medicine.

[34]  L. Turnbull,et al.  An individual person data meta-analysis of preoperative magnetic resonance imaging and breast cancer recurrence. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[35]  A. Giobbie-Hurder,et al.  Adjuvant ovarian suppression in premenopausal breast cancer. , 2015, The New England journal of medicine.

[36]  B. Hutton,et al.  Are Physicians Choosing Wisely When Imaging for Distant Metastases in Women With Operable Breast Cancer? , 2015, Journal of oncology practice.

[37]  D. Cameron,et al.  Breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer (PRIME II): a randomised controlled trial. , 2015, The Lancet. Oncology.

[38]  M. Ellis,et al.  Adjuvant paclitaxel and trastuzumab for node-negative, HER2-positive breast cancer. , 2015, The New England journal of medicine.

[39]  Carsten Denkert,et al.  Tumor-infiltrating lymphocytes and response to neoadjuvant chemotherapy with or without carboplatin in human epidermal growth factor receptor 2-positive and triple-negative primary breast cancers. , 2015, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[40]  C. Gross,et al.  Randomized exercise trial of aromatase inhibitor-induced arthralgia in breast cancer survivors. , 2015, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.