Cáncer de mama temprano

1. Guías de la NCCN (National Comprehensive Cancer Network).

2. Guías de la ESMO (European Society for Medical Oncology). Estas son particularmente relevantes para este grupo de pacientes.

- B. Pestalozzi , M. Castiglione , and On behalf of the ESMO Guidelines Working Group. Primary breast cancer: ESMO Clinical Recommendations for diagnosis, treatment and follow-up. Annals of Oncology Advance Access published on May 1, 2008, DOI 10.1093/annonc/mdn071. Ann Oncol 19: ii7-ii10

3. Consenso de St. Gallen 2007: Cada 2 años se reunen los expertos más importantes de la mastología mundial en este pueblito de Suiza para establecer el consenso de tratamiento de cáncer de mama temprano. Las recomendaciones de San Galo influyen en el manejo de los oncólogos en Europa y en Colombia. Yo no las sigo estrictamente.

- A. Goldhirsch , W. C. Wood , R. D. Gelber , A. S. Coates , B. Thürlimann , H. -J. Senn , and Panel Members. Progress and promise: highlights of the international expert consensus on the primary therapy of early breast cancer 2007 Ann Oncol 18: 1133-1144.

4. Meta-análisis de quimioterapia para carcinoma de mama temprano (Oxford overview)

- Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. The Lancet 2005; 365:1687-1717

5. Adjuvant online: Es un calculador para establecer los riesgos de recidiva tumoral, con las diferentes estrategias de tratamiento en mujeres con carcinoma de mama temprano de 35 a 69 años de edad.

Inhibidores de aromatasa adyuvantes

A. Upfront
1. Anastrozol - ATAC 100 -

- Arimidex, Tamoxifen, Alone or in Combination (ATAC) Trialists' Group, Forbes JF, Cuzick J, Buzdar A, Howell A, Tobias JS, Baum M. Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 100-month analysis of the ATAC trial. Lancet Oncol. 2008 Jan;9(1):45-53

2. Letrozol - BIG 1.98

- The Breast International Group (BIG) 1-98 Collaborative Group, A Comparison of Letrozole and Tamoxifen in Postmenopausal Women with Early Breast Cancer. N Engl J Med 2005 353: 2747-2757

B. Switch
1. Exemestano - IES

-Coombes RC, Hall E, Gibson LJ, et al, the Intergroup Exemestane Study, A Randomized Trial of Exemestane after Two to Three Years of Tamoxifen Therapy in Postmenopausal Women with Primary Breast Cancer. N Engl J Med 2004 350: 1081-1092

2. Anastrozol - ARNO-95

- Kaufmann M, Jonat W, Hilfrich J, et al. Improved Overall Survival in Postmenopausal Women With Early Breast Cancer After Anastrozole Initiated After Treatment With Tamoxifen Compared With Continued Tamoxifen: The ARNO 95 Study. J Clin Oncol 2007 25: 2664-2670

C. Adyuvancia extendida
1. Letrozol - MA17

- Goss PE, Ingle JN, Martino S, et al. A Randomized Trial of Letrozole in Postmenopausal Women after Five Years of Tamoxifen Therapy for Early-Stage Breast Cancer. N Engl J Med 2003 349: 1793-1802

HER2 Positivo
1. Trastuzumab - HERA -

- Piccart-Gebhart MJ, Procter M, Leyland-Jones B, et al, the Herceptin Adjuvant (HERA) Trial Study Team, Trastuzumab after Adjuvant Chemotherapy in HER2-Positive Breast Cancer. N Engl J Med 2005 353: 1659-1672.

2. Trastuzumab neoadyuvante - MD Anderson

- Buzdar AU, Valero V, Ibrahim N, et al. Neoadjuvant Therapy with Paclitaxel followed by 5-Fluorouracil, Epirubicin, and Cyclophosphamide Chemotherapy and Concurrent Trastuzumab in Human Epidermal Growth Factor Receptor 2-Positive Operable Breast Cancer: An Update of the Initial Randomized Study Population and Data of Additional Patients Treated with the Same Regimen. Clin Cancer Res 2007 13: 228-233

Quimioterapia

1. Dosis densas - ATC

- Citron ML, Berry DA., Cirrincione C, et al. Randomized Trial of Dose-Dense Versus Conventionally Scheduled and Sequential Versus Concurrent Combination Chemotherapy as Postoperative Adjuvant Treatment of Node-Positive Primary Breast Cancer: First Report of Intergroup Trial C9741/Cancer and Leukemia Group B Trial 9741. J Clin Oncol 2003 21: 1431-1439.

2. Docetaxel + Ciclofosfamida - TC

- Jones SE, Savin MA, Holmes FA, et al. Phase III Trial Comparing Doxorubicin Plus Cyclophosphamide With Docetaxel Plus Cyclophosphamide As Adjuvant Therapy for Operable Breast Cancer. J Clin Oncol 2006 24: 5381-5387

3. Antraciclinas seguida por paclitaxel - CALGB 9344

- Henderson IC, Berry DA, Demetri GD, et al. Improved Outcomes From Adding Sequential Paclitaxel but Not From Escalating Doxorubicin Dose in an Adjuvant Chemotherapy Regimen for Patients With Node-Positive Primary Breast Cancer. J Clin Oncol 2003 21: 976-983

4. CEF vs CMF - NEAT.

Poole CJ, Earl HM, Hiller L, et al., the NEAT Investigators and the SCTBG, Epirubicin and Cyclophosphamide, Methotrexate, and Fluorouracil as Adjuvant Therapy for Early Breast Cancer. N Engl J Med 2006 355: 1851-1862