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Future treatment strategies for metastatic breast cancer: curable or incurable?

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  • From improved survival to potential cure in patients with metastatic breast cancer
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Abstract

Current Japanese and American guidelines for the surveillance of patients diagnosed with early stage breast cancer recommend regular follow-up including mammography, history, and physical examination; however, additional routine laboratory and imaging studies are not recommended because there is no evidence of improved clinical outcomes associated with the early detection of distant metastasis. Metastatic breast cancer (MBC) remains a largely incurable disease. The goals of treatment for MBC are to maintain quality of life and prolong survival. However, despite the emergence of new concepts including oligometastases, cancer stem cells, and the development of individualized therapies, clinical management and treatment guidelines remain largely unchanged. The future prospects for personalized management strategies for patients with MBC are described in this review.

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References

  1. Early Breast Cancer Trialists’ Collaborative Group. Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15 years survival: an overview of the randomized trials. Lancet. 2005;365:1687–717.

    Article  Google Scholar 

  2. Kennecke H, Yerushalmi R, Woods R, Cheang MCU, Voduc D, Speers CH, et al. Metastatic behavior of breast cancer subtypes. J Clin Oncol. 2010;28:3271–7.

    Article  PubMed  Google Scholar 

  3. Norton L, Massague J. Is cancer a disease of self-seeding? Nat Med. 2006;12:875–8.

    Article  PubMed  CAS  Google Scholar 

  4. Paget S. The distribution of secondary growths in cancer of the breast. Cancer Metastasis Rev. 1989;8:98–101.

    PubMed  CAS  Google Scholar 

  5. Liu S, Wicha MS. Targeting breast cancer stem cells. J Clin Oncol. 2010;28:4006–12.

    Article  PubMed  CAS  Google Scholar 

  6. Mansi JL, Gogas H, Bliss JM, Gazet J-C, Berger U, Coombes RC. Outcome of primary-breast-cancer patients with micrometastases: a long-term follow-up study. Lancet. 1999;354:197–202.

    Article  PubMed  CAS  Google Scholar 

  7. Braun S, Vogel FD, Naume B, Janni W, Osborne MP, Coombes RC, et al. A pooled analysis of bone marrow micrometastasis in breast cancer. N Engl J Med. 2005;353:793–802.

    Article  PubMed  CAS  Google Scholar 

  8. Gerber B, Krause A, Muller H, Richter D, Makovitzky J, Herrnring C, et al. Simultaneous immunohistochemical detection of tumor cells in lymph nodes and bone marrow aspirates in breast cancer and its correlation with other prognostic factors. J Clin Oncol. 2001;19:960–71.

    PubMed  CAS  Google Scholar 

  9. Bidard F-C, Vincent-Salomon A, Gomme S, Nos C, Rycke Y, Thiery JP, et al. Disseminated tumor cells of breast cancer patients: a strong prognostic factor for distant and local relapse. Clin Cancer Res. 2008;14:3306–11.

    Article  PubMed  CAS  Google Scholar 

  10. Diel IJ, Kaufmann M, Costa S, Holle R, Minckwitz G, Solomayer EF, et al. Micrometastatic breast cancer cells in bone marrow at primary surgery: prognostic value in comparison with nodal status. J Natl Cancer Inst. 1996;88:1652–64.

    Article  PubMed  CAS  Google Scholar 

  11. Wiedswang G, Borgen E, Karesen R, Kvalheim G, Neslamnd JM, Qvist H, et al. Detection of isolated tumor cells in bone marrow is an independent prognostic factor in breast cancer. J Clin Oncol. 2003;21:3469–78.

    Article  PubMed  CAS  Google Scholar 

  12. Xenidis N, Perraki M, Kafousi M, Apostolaki S, Bolonaki I, Stathopoulou A, et al. Predictive and prognostic value of peripheral blood cytokeratin-19 mRNA-positive cells detected by real-time polymerase chain reaction in node-negative breast cancer patients. J Clin Oncol. 2006;24:3756–62.

    Article  PubMed  CAS  Google Scholar 

  13. Wiedswang G, Borgen E, Schirmer C, Karesen R, Kvalheim G, Nesland JM, et al. Comparison of the clinical significance of occult tumor cells in blood and bone marrow in breast cancer. Int J Cancer. 2006;118:2013–9.

    Article  PubMed  CAS  Google Scholar 

  14. Kennecke HF, McArthur H, Olivotto IA, Speers C, Bajdik C, Chia SK, et al. Risk of early recurrence among postmenopausal women with estrogen receptor-positive early breast cancer treated with adjuvant tamoxifen. Cancer. 2008;112:1437–44.

    Article  PubMed  CAS  Google Scholar 

  15. Saphner T, Tormey DC, Gray R. Annual hazard rates of recurrence for breast cancer after primary therapy. J Clin Oncol. 1996;14:2738–46.

    PubMed  CAS  Google Scholar 

  16. Kennecke HF, Olivotto IA, Speers C, Norris B, Chia SK, Bryce C, et al. Late risk of relapse and mortality among postmenopausal women with estrogen responsive early breast cancer after 5 years of tamoxifen. Ann Oncol. 2007;18:45–51.

    Article  PubMed  CAS  Google Scholar 

  17. Pantel K, Alix-Panabieres C, Riethdorf S. Cancer micrometastases. Nat Rev Clin Oncol. 2009;6:339–51.

    Article  PubMed  CAS  Google Scholar 

  18. The Japanese clinical guideline for breast cancer based on scientific evidences 1: medical treatment. 2010;57–59 (in Japanese).

  19. Rahman ZU, Frye DK, Smith TL, Asmar L, Theriault RL, Buzdar AU, et al. Results and long term follow-up for 1581 patients with metastatic breast carcinoma treated with standard dose doxorubicin-containing chemotherapy. Cancer. 1999;85:104–11.

    Article  PubMed  CAS  Google Scholar 

  20. Toi M, Nakamura S, Kuroi K, Iwata H, Ohno S, Masuda N, et al. Phase II study of preoperative sequential FEC and docetaxel predicts of pathological response and disease free survival. Breast Cancer Res Treat. 2008;110:531–9.

    Article  PubMed  CAS  Google Scholar 

  21. Pagani O, Senkus E, Wood W, Colleoni M, Cufer T, Kyriakides S, et al. International guidelines for management of metastatic breast cancer: can metastatic breast cancer be cured? J Natl Cancer Inst. 2010;102:456–63.

    Article  PubMed  Google Scholar 

  22. Hanrahan EO, Broglio KR, Buzdar AU, Theriaults RL, Valero V, Cristofanilli M, et al. Combined-modality treatment for isolated recurrences of breast carcinoma. Update on 30 years of experience at the University of Texas M.D. Anderson Cancer Center and assessment of prognostic factors. Cancer. 2005;104:1158–71.

    Article  PubMed  CAS  Google Scholar 

  23. Khatcheressian JL, Wolff AC, Smith TJ, Grunfeld E, Muss HB, Vogel VG, et al. American society of clinical oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting. J Clin Oncol. 2006;24:5091–7.

    Article  PubMed  Google Scholar 

  24. The GIVIO Investigators. Impact of follow-up testing on survival and health-related quality of life in breast cancer patients. A multicenter randomized controlled trial. JAMA. 1994;271:1587–92.

    Article  Google Scholar 

  25. Rosselli Del Turco M, Palli D, Cariddi A, Ciatto S, Pacini P, Distante V. Intensive diagnostic follow-up after treatment of primary breast cancer. A randomized trial. National Research Council project on breast cancer follow-up. JAMA. 1994;271:1593–7.

    Article  PubMed  CAS  Google Scholar 

  26. Palli D, Russo A, Saieva C, Ciatto S, Rosselli Del Turco M, Distante V, et al. Intensive vs clinical follow-up after treatment of primary breast cancer: 10-year update of randomized trial. National Research Council project on breast cancer follow-up. JAMA 1999;281:1586.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Hiroji Iwata.

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Iwata, H. Future treatment strategies for metastatic breast cancer: curable or incurable?. Breast Cancer 19, 200–205 (2012). https://doi.org/10.1007/s12282-011-0267-4

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  • DOI: https://doi.org/10.1007/s12282-011-0267-4

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