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Update in Oncology
- Lynn M. Schuchter, MD; and
- Daniel G. Haller, MD
- From University of Pennsylvania, Philadelphia, Pennsylvania.
- Oncology
- Breast neoplasms
- Cervix neoplasms
- Multiple myeloma
- Colorectal neoplasms
- Prostatic neoplasms
2000-2001 Series: Update Sessions from ACP-ASIM's 2000 Annual Session
Margaret Ring Gillock, Editor; David Cramer, MD, Co-Editor; and Paul T. Kefalides, MD, Co-Editor
Many important papers in the field of oncology were published in 1999, but we limited our selection for this Update to studies of fairly common types of cancer. We concentrated on studies of breast cancer, cervical cancer, multiple myeloma, colorectal cancer, and prostate cancer.
Breast Cancer
The three articles on breast cancer presented here were among the most important articles on the topic published in 1999. The first discussed the role of prophylactic mastectomy in women who are at increased risk for breast cancer, the next examined the use of tamoxifen to prevent breast cancer, and the third evaluated the effectiveness and safety of a monoclonal antibody treatment (trastuzumab) for women with metastatic breast cancer.
Prophylactic Mastectomy Is Effective in Reducing the Incidence of Breast Cancer
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Hartmann LC, Schaid DJ, Woods JE, et al. Efficacy of bilateral prophylactic mastectomy in women with a family history of breast cancer. N Engl J Med. 1999; 340:77-84.
Women at high risk for breast cancer have several options for treatment, including chemoprevention, surveillance, and prophylactic mastectomy. Data on the outcomes for the latter two treatments are incomplete. To provide guidance regarding prophylactic mastectomy, Hartmann and colleagues conducted a retrospective study of 639 women with a well-defined family history of breast cancer who underwent bilateral prophylactic mastectomy. The untreated sisters of the women served as controls, and the Gail model was used to project the number of breast cancer cases expected in the treatment and control groups.
Prophylactic mastectomy was associated with a reduction of at least 90% in the incidence of breast cancer and the risk for death from the disease. Although 37.4 cases of breast cancer were expected in the moderate-risk group, only 4 occurred in the women treated with mastectomy.
This study …
