Textbook of Breast Cancer: A Clinical Guide to Therapy, by Gianni Bonadonna, Luca Gianni, Gabriel N. Hortobagyi,

By Gianni Bonadonna, Luca Gianni, Gabriel N. Hortobagyi, Pinuccia Valagussa

With the present advances in chemotherapy and hormonal medicines for breast melanoma, in addition to in surgical innovations and approaches, a revised variation of this well known textbook has turn into more and more important. thoroughly overhauling the present fabric, the editors of this crucial paintings have supplied an entire replace of the world, focusing particularly upon the subjects the place there was such a lot development and controversy.

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My mentor, Dr Edwin Fisher, used to stress that the most difficult thing in research is collecting materials. That comment is even more true these days. 4 Ideal management of breast cancer patients using prognosticators and predictive markers. 28 TEXTBOOK OF BREAST CANCER For breast cancer, the problem lies in the logistics of procuring fresh frozen tissue in the community practice setting. Since patients are presented with the option of participating in clinical trials only after the diagnostic biopsy is made, it is often too late to procure fresh tissue even if the protocol dictates submission of such materials.

001). In leave-one-out cross-validation analysis, 10 of 11 sensitive tumors (90% specificity) and 11 of 13 resistant tumors (85% sensitivity) were correctly classified, with an accuracy of 88%. This 92-gene predictor had positive and negative predictive values of 92% and 83%, respectively. Pusztai et al,15 from the MD Anderson Cancer Center presented their analysis of 45 cases treated with preoperative paclitaxel (ϮHerceptin [trastuzumab]) plus FAC (cyclophosphamide– Adriamycin–5-fluorouracil) regimen at the 2003 ASCO plenary session.

Due to the nature of the genes included in the 21-gene assay, which are mainly proliferation genes and ER-related genes, it could be argued that the assay is an expensive replacement for ER and Ki-67 immunohistochemical assays. However, there are two main advantages of the gene-based assay over immunohistochemical assays: first, it is highly reproducible; secondly, it is quantitative, in contrast to immunohistochemistry-based assays that are at best semiquantitative. Due to the quantitative nature of the data, individualized risk estimates could be derived from the assay results that were expressed on a scale of 0 to 100, which is a significant improvement over classical prognosticators.

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