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S E M I N A R S I N

ONCOLOGY NURSING

ol 23, No 1 February 2007

INTRODUCTION

ARCINOMA of the breast is the most common cancer among women. In 2006, more than 212,000women in the United States were diagnosed with breast cancer and, as the second-highest cause ofcancer-related death, nearly 41,000 women in the U.S. died from breast cancer.1 The incidence of

reast cancer continues to rise, yet the mortality rate is decreasing. This dichotomy can primarily bexplained by increased screening, resulting in diagnosis at earlier stages when the disease is most likely to beured, and the development of many new treatment strategies. Women with recurrent breast cancer have hadmproved survival from 15 to 58 months (10% to 44%) over the past several decades, largely attributable to therowing number of drugs available for treating the disease.2 In the past 10 years, the focus of clinical breastesearch has brought us new and sometimes amazing surgical and treatment choices.

The full sequencing of the human genome has brought the concept of genetic medicine into everyday life.enomic medicine and proteomics have begun to shape breast cancer diagnosis and treatment and the caref women with genetic mutations known to increase the risk of breast cancer.Breast-conserving surgery has become the standard in many areas of the country but for women whose

iagnosis mandates or whose personal choice is mastectomy, new reconstructive techniques offer the promisef a more cosmetically acceptable outcome. Adjuvant radiation therapy is indicated following breast-onserving therapy and options other than 5 to 6 weeks of external-beam therapy are now available. Advancesuch as trastuzumab for patients whose breast cancer overexpresses Her2-neu; aromatase inhibitors forostmenopausal women with hormonally responsive breast cancer; alterations in dosing regimens to improveisease-free and overall survival; and application of principles such as anti-angiogenesis have improved theurvival of thousands of breast cancer patients and improved the quality of life of countless breast canceramilies.

The most promising tool on the horizon may be DNA microarrays, capable of identification of particularharacteristics of an individual breast cancer against which a highly individualized treatment plan can bemplemented. As long suspected, bench research is finding that breast cancer is decidedly heterogeneous andurrent thinking is moving in the direction of concentrating more on the molecular characteristics of aarticular tumor rather than traditional methods of prognosis that only took into account the tumor size andymph node status. Gene expression analysis has identified several breast cancer subtypes that appear to helpnswer several prognostic puzzles.The contributors to this update bring knowledge, experience, and clinical expertise. All faced a daunting

ask of sifting through 10 years of clinical and research advances to present a cohesive summarization of newssues in breast cancer diagnosis, treatment, and survival without losing sight of the advances that laid the pathlong which we travel on a daily basis. To those who have survived breast cancer and continue to show us theay to improve the quality of our care, and those whose lives have touched us and departed, to those who have

aught us, worked and walked alongside us, and shared their experiences, we dedicate this issue of Seminars

n Oncology Nursing.

REFERENCES

1. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2006. CA Cancer J Clin 2006;56:106-130.2. Giordano SH, Buzdar AU, Smith TL, et al. Is breast cancer survival improving?: Trends in survival for patients with recurrent

reast cancer diagnosed from 1974 through 2000. Cancer 2004;100:44-52.

Susan Moore, RN, MSN, ANP, AOCN®

Guest EditorOncology Nurse Practitioner

Consultant, CancerExpertiseSM

Chicago, IL

© 2007 Elsevier Inc. All rights reserved.

doi:10.1016/j.soncn.2006.11.001