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Breast Cancer Update - A CME Audio Series and Activity

STATEMENT OF NEED/TARGET AUDIENCE

Breast cancer is one of the most rapidly evolving fields in medical oncology. Published results from a plethora of ongoing clinical trials lead to the continuous emergence of new therapeutic agents and changes in the indications for existing treatments. In order to offer optimal patient care — including the option of clinical trial participation — the practicing medical oncologist must be well informed of these advances. To bridge the gap between research and patient care, this special edition of Breast Cancer Update utilizes case-based discussions held between community oncologists and research leaders at two live CME meetings to demonstrate the integration of clinical research data into clinical practice.

GLOBAL LEARNING OBJECTIVES

  • Critically evaluate the clinical implications of emerging clinical trial data, patterns of care data and patients’ perspectives on breast cancer treatment decisions.
  • Counsel women with low-risk invasive disease about the absolute risks and benefits of adjuvant systemic chemotherapy, and describe the potential utility of a predictive assay to help guide these discussions.
  • Counsel postmenopausal patients with ER-positive breast cancer about the risks and benefits of adjuvant aromatase inhibitors and about switching or sequencing aromatase inhibitors after tamoxifen.
  • Counsel premenopausal women about the risks and benefits of adjuvant ovarian ablation in combination with tamoxifen or aromatase inhibition.
  • Distinguish the risk-to-benefit profiles of chemotherapeutic agents and combinations to determine a management algorithm for metastatic breast cancer.
  • Develop and explain a management strategy for therapy for patients with ER-positive, metastatic disease including sequencing of hormonal therapies.
  • Describe and implement an algorithm for treatment of HER2-positive breast cancer.

PURPOSE OF THIS ISSUE OF BREAST CANCER UPDATE

The purpose of this special edition of Breast Cancer Update is to support these global objectives by offering the perspectives of the faculty on the integration of emerging clinical research data into the management of breast cancer.

ACCREDITATION STATEMENT

Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CREDIT DESIGNATION STATEMENT

Research To Practice designates this educational activity for a maximum of 3.25 category 1 credits toward the AMA Physician’s Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.

HOW TO USE THIS MONOGRAPH

This CME activity contains both audio and print components. To receive credit, the participant should listen to the CDs or tapes, review the monograph and complete the post-test and evaluation form located in the back of this monograph or on our website. This monograph contains edited comments, clinical trial schemas, graphics and references that supplement the audio program. www.BreastCancerUpdate.com includes an easy-to-use, interactive version of this monograph with links to relevant full-text articles, abstracts, trial information and other web resources indicated here in blue underlined text.

 
 
 
     
 
 


 
Editor’s Note:
Common questions about breast cancer from oncologists in community practice


Case 1: An active 79-year-old woman with a 7.5-centimeter, Grade II, ER/PR-positive, HER2-negative breast cancer with lymphovascular invasion and three positive nodes (from the practice of Dr Martha A Tracy)

- Select publications

Case 2: A 41-year-old premenopausal woman with an ER/PR-positive, HER2-positive infiltrating ductal carcinoma and six positive lymph nodes (from the practice of Dr Herbert I Rappaport)
- Select publications

Case 3: A 68-year-old woman with disease progression 10 years after presenting with hormone receptor-positive diffuse metastatic disease to the bone (from the practice of Dr Ghaleb A Saab)
- Select publications

Case 4: A 91-year-old woman with dementia who was diagnosed with Stage II, ER-positive, lymph node-negative breast cancer 15 years ago and now has diffuse bone metastases (from the practice of Dr Juliann M Smith)
- Select publications

Case 5: A 41-year-old surgically postmenopausal woman with a 3.5-centimeter, ER/PR-positive, HER2-positive tumor and two positive lymph nodes (from the practice of Dr Herbert I Rappaport)
- Select publications

Case 6: A 45-year-old premenopausal woman with a 0.7-cm, ER/PR-positive, HER2-positive tumor with 25 percent high-grade DCIS and an Oncotype DX™ recurrence score of 16 (from the practice of Dr Steven W Papish)
- Select publications

Case 7: A woman who presented in 1989 with an infiltrating lobular carcinoma and 21 positive nodes and was treated with adjuvant chemotherapy and tamoxifen and then develops metastatic disease and is treated over the next 11 years with a variety of chemotherapeutic and hormonal agents (from the practice of Dr Pamela Drullinsky)
- Select publications

Case 8: A 35-year-old woman with a 3.5-cm, ER/PR-positive, HER2-positive infiltrating ductal carcinoma and two positive sentinel lymph nodes treated on the nontrastuzumab- containing arm of the Intergroup N9831 trial (from the practice of Dr Pamela Drullinsky)
- Select publications

 
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