Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program
description
Transcript of Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program
![Page 1: Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program](https://reader036.fdocuments.in/reader036/viewer/2022062722/568139e7550346895da19fd8/html5/thumbnails/1.jpg)
Jo Anne Zujewski, MDClinical Investigations Branch
Cancer Therapy Evaluation ProgramDivision of Cancer Diagnosis and Treatment
May 2011
The Global Burden of Breast Cancer
![Page 2: Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program](https://reader036.fdocuments.in/reader036/viewer/2022062722/568139e7550346895da19fd8/html5/thumbnails/2.jpg)
![Page 3: Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program](https://reader036.fdocuments.in/reader036/viewer/2022062722/568139e7550346895da19fd8/html5/thumbnails/3.jpg)
Breast Cancer: Most common cancer in developed and
developing world• 1.38 million cases in 2008
– Most frequent cancer in women (23% of all cancers)
• Incidence – 19.3/100,000 women in East Africa– 89.7/100,000 women in Western
Europe
GLOBOCON
![Page 4: Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program](https://reader036.fdocuments.in/reader036/viewer/2022062722/568139e7550346895da19fd8/html5/thumbnails/4.jpg)
Globocon Breast Cancer Incidence 2008
![Page 5: Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program](https://reader036.fdocuments.in/reader036/viewer/2022062722/568139e7550346895da19fd8/html5/thumbnails/5.jpg)
Breast Cancer Mortality
• 6-19 per 100,000 due to more favorable survival in (high-incidence) developed regions
• Most frequent cause of cancer death in women in both developing (269,000 deaths) and developed regions (189,000 deaths).
![Page 6: Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program](https://reader036.fdocuments.in/reader036/viewer/2022062722/568139e7550346895da19fd8/html5/thumbnails/6.jpg)
Globocon Breast Cancer Mortality 2008
![Page 7: Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program](https://reader036.fdocuments.in/reader036/viewer/2022062722/568139e7550346895da19fd8/html5/thumbnails/7.jpg)
![Page 8: Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program](https://reader036.fdocuments.in/reader036/viewer/2022062722/568139e7550346895da19fd8/html5/thumbnails/8.jpg)
Thun, M. J. et al. Carcinogenesis 2010 31:100-110; doi:10.1093/carcin/bgp263
Number and distribution of cancer cases by level of economic development and year (assuming no change in the annual incidence rate)
![Page 9: Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program](https://reader036.fdocuments.in/reader036/viewer/2022062722/568139e7550346895da19fd8/html5/thumbnails/9.jpg)
Breast Cancer Rates are Rising…
• ‘Westernization' of lifestyles• Urbanization• Dietary habits and physical inactivity• Changes in reproductive factors such as
lower rates of childbearing • Exposure to exogenous estrogen
![Page 10: Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program](https://reader036.fdocuments.in/reader036/viewer/2022062722/568139e7550346895da19fd8/html5/thumbnails/10.jpg)
Trends in Mortality
![Page 11: Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program](https://reader036.fdocuments.in/reader036/viewer/2022062722/568139e7550346895da19fd8/html5/thumbnails/11.jpg)
Berry D.A., et al. N Engl J Med. 353:1784-92, 2005
Decrease in breast cancer mortality
![Page 12: Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program](https://reader036.fdocuments.in/reader036/viewer/2022062722/568139e7550346895da19fd8/html5/thumbnails/12.jpg)
Cancers in Women: Uzbekistan
Uzbekistan
Incidence 19.2/100,000 (2174 cases)
Mortality 10.2/100,000 (1111 deaths)
![Page 13: Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program](https://reader036.fdocuments.in/reader036/viewer/2022062722/568139e7550346895da19fd8/html5/thumbnails/13.jpg)
How effective is therapy for breast cancer?
stage 5 year survival
0 93 %
I 88 %
IIA 81 %
IIB 74 %
IIIA 67 %
IIIB 41 %
IIIC 49 %
IV 15 %
years 5 year survival
1974-1976 75 %
1983-1985 78 %
1992-1997 86 %
1995-2003 89 %
National Cancer Data Basebreast cancer diagnosis 2001 and 2002.
SEER, 1973-2003, DCP, NCI, 2009
![Page 14: Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program](https://reader036.fdocuments.in/reader036/viewer/2022062722/568139e7550346895da19fd8/html5/thumbnails/14.jpg)
No surgery
mastectomy
chemoTx + antiER
chemoTx + antiER + targeted
Incremental Benefit
![Page 15: Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program](https://reader036.fdocuments.in/reader036/viewer/2022062722/568139e7550346895da19fd8/html5/thumbnails/15.jpg)
Breast cancer rates increasing- approaches
require: • Guidelines that are evidence-based,
economically feasible, and culturally appropriate
• Early detection - metastatic disease is not treated successfully in ANY country
• Improved cancer registries and data collection
• Clinical trials in developing countries
![Page 16: Jo Anne Zujewski, MD Clinical Investigations Branch Cancer Therapy Evaluation Program](https://reader036.fdocuments.in/reader036/viewer/2022062722/568139e7550346895da19fd8/html5/thumbnails/16.jpg)
In the name of life….