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Treatment of Nonmetastatic Breast Cancer

Educational Objective
To understand current practices and emerging trends in breast oncology
1 Credit CME

The treatment of breast cancer has evolved largely based on refinements in understanding of the biology of the disease and the variable risk for mortality among separate disease subtypes.1 Further, due to widespread use of screening mammography, there is a reduction in average breast tumor size at diagnosis. Breast cancer primarily affects women but also affects a smaller number of men. Because many clinicians provide medical care to patients with breast cancer, familiarity with contemporary treatments is important. In this JAMA Insights article, current practices and emerging trends in breast oncology are highlighted, including aspects of precision oncology and the recent deescalation of certain treatments to minimize long-term toxicities.

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Article Information

Corresponding Author: Patricia A. Ganz, MD, Jonsson Comprehensive Cancer Center, 650 Charles Young Dr S, Room A2-125 CHS, Los Angeles, CA 90095-6900 (pganz@mednet.ucla.edu).

Published Online: April 12, 2019. doi:10.1001/jama.2019.3927

Conflict of Interest Disclosures: Dr Ruddy reported sale of stock from Merck and from Pfizer outside the submitted work. No other disclosures were reported.

References
1.
Waks  AG, Winer  EP.  Breast cancer treatment: a review.  JAMA. 2019;321(3):288-300.PubMedGoogle ScholarCrossref
2.
Bland  KI, Copeland  EM, Klimberg  VS, Gradishar  WJ, eds.  The Breast: Comprehensive Management of Benign and Malignant Diseases. 5th ed. Philadelphia, PA: Elsevier; 2018.
3.
Burstein  HJ, Lacchetti  C, Anderson  H,  et al.  Adjuvant endocrine therapy for women with hormone receptor-positive breast cancer.  J Clin Oncol. 2019;37(5):423-438.PubMedGoogle ScholarCrossref
4.
Krop  I, Ismaila  N, Andre  F,  et al.  Use of biomarkers to guide decisions on adjuvant systemic therapy for women with early-stage invasive breast cancer.  J Clin Oncol. 2017;35(24):2838-2847.PubMedGoogle ScholarCrossref
5.
Gradishar  WJ, Anderson  BO, Balassanian  R,  et al.  Breast cancer, version 4.2017, NCCN Clinical Practice Guidelines in Oncology.  J Natl Compr Canc Netw. 2018;16(3):310-320.PubMedGoogle ScholarCrossref
6.
Runowicz  CD, Leach  CR, Henry  NL,  et al.  American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline.  J Clin Oncol. 2016;34(6):611-635.PubMedGoogle ScholarCrossref
7.
Jacobsen  PB, Nipp  RD, Ganz  PA.  Addressing the survivorship care needs of patients receiving extended cancer treatment.  Am Soc Clin Oncol Educ Book. 2017;37:674-683.PubMedGoogle ScholarCrossref
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