Panel Revises Breast Cancer Treatment Guidelines

Dec. 13, 2005 — -- Recently released guidelines for breast cancer treatment contain a major revision that paves the way for more individualized treatment, physicians say.

Compiled by the National Comprehensive Cancer Network, an alliance of 19 cancer centers across the country, the guidelines recommend that oncologists should first determine if a breast cancer patient has any of several conditions that mean his or her cancer is affected by high levels of estrogen, rather than the traditional assessment of lymph node involvement and tumor size.

For example, the first step in determining treatment should include testing a patient's "hormone receptor status," to see if cancer cells are sensitive to estrogen or progesterone. If so, drugs that block estrogen, such as tamoxifen, may be highly effective at slowing the cancer.

The American Cancer Society estimates that there were about 217,400 new breast cancer cases in 2004, most among women.

While the new guidelines somewhat reduce the need for chemotherapy, it does not mean that patients won't ever need that form of treatment, said Philadelphia oncologist Marisa Weiss, founder of www.breastcancer.org.

This is especially true for younger women with more aggressive forms of cancer or patients who do not have hormone-receptive types of cancer, Weiss noted.

Although the guidelines make the instructions "official," many doctors already have been following that protocol, said Dr. Larry Norton, the deputy physician-in-chief for Breast Cancer Programs at Memorial Sloan-Kettering Cancer Center in New York.

"The whole approach toward the disease is being modified by the knowledge of the biology," Norton said. "It's a very rapidly evolving field."

The NCCN panel also added three new drugs to the list of treatments for metastatic disease: Taxol, Avastin and Abraxane.

While the new steps and medications make cancer treatment more complex, they also help tailor treatment for women, Weiss said.

Dr. Monica Morrow, chair of surgery at Fox Chase Cancer Center in Philadelphia, agreed.

"This is an important step in really individualizing therapy for breast cancer patients," she said.