Systemic Treatment Approaches in Breast Cancer

Breast cancer is the most conmlon malignant tumor among women, with an estimated 135,000 new cases and 58,000 recorded deaths per year in the Europeau Community in 1990. With respect to the Netherlands, the most recent data of The Netherlands Cancer Registry show an incidence of nearly 10.000 new cases of primary breast cancer and about 3500 breast cancer deaths per year. In women breast cancer comprises one-third (33,2%) of all types of cancer. Ultimately about one out of 10 women wiII get breast cancer during her life and one out of every 22 women wiII sooner or later die as a consequence of metastatic disease. Among the solid tumors breast cancer is one of the few types of cancers sensitive to different systemic treatment reginJens both with respect to endocrine- and chemotherapy. Both treatment modalities are nowadays standard practice in the treatment of breast cancer, either to achieve cure, or prolongation of (relapse-free) survival in the adjuvant setting, or to palliate metastatic disease. The efficacy of the different forms of systemic treatment is dependent on patients- and tumor characteristics

Clinical experience with venlafaxine in the treatment of hot flushes in women with a history of breast cancer

OBJECTIVE: To obtain practical experience with venlafaxine for hot flushes in breast cancer patients and incorporate this in a treatment protocol. METHOD: Twenty-two women with a history of breast cancer (mean age 49.2 years, range 35-65) were referred for consideration of treatment with venlafaxine for hot flushes. Patients received extensive information on treatment with venlafaxine and were advised to self-monitor the frequency of their hot flushes. RESULTS: Eight women did not start venlafaxine because they had no postmenopausal complaints, were lost to follow-up, had too low a frequency of hot flushes, or refused treatment. Eventually 14 women started venlafaxine. Two of them did not tolerate venlafaxine, four reported some effect but stopped because of side effects, two women had no effect whatsoever. Six women observed a clear ( > 50%) reduction in their hot flush frequency that was maintained at a median follow-up of 13 months. CONCLUSION: The group of patients referred for treatment was more heterogeneous and more patients dropped out because of side effects than expected. Extensive patient education, patient selection and evaluation of the treatment effect (by self-monitoring of hot flush frequency) are mandatory to avoid useless (continuation of) treatment and to prepare patients for side effects. Under these conditions, a substantial minority of patients benefit from venlafaxine

Кон'юнктурний аналіз розвитку ринку рекреаційних послуг АР Крим

Метою дослідження є кон’юнктурний аналіз розвитку ринку рекреаційних послуг АР Крим та порівняльна оцінка функціонування конкурентоспроможних рекреаційних районів

Weekly low-dose mitoxantrone plus doxorubicin as second-line chemotherapy for advanced breast cancer

Weekly low dose mitoxantrone (3 mg/m2) plus doxorubicin (8 mg/m2) was administered as second-line chemotherapy to 33 patients with advanced breast cancer. Four out of 28 evaluable patients (14%) obtained a partial response with a median duration of 34 weeks (range 18-67+ weeks), while 8 patients (29%) showed stable disease with a median duration of 28 weeks (range 11+-60 weeks). Gastrointestinal toxicity and alopecia were mild. Grade II and III leukopenia occurred in 63% of the courses without serious infectious disease. Four patients experienced an asymptomatic drop of 16-20% in the left ventricular ejection fraction (LVEF) after relatively low cumulative doses of each drug, and one patient with a history of pericarditis carcinomatosa and mediastinal irradiation developed a heart failure. In conclusion, this second-line combination treatment had moderate activity in breast cancer and caused only few subjective side effects, especially with respect to gastrointestinal symptoms