NEJM â Collection Updates for Breast Cancer

PERSPECTIVE: Screening Mammography and the âRâ Word

Thu, 24Â DecÂ 2009 00:00:00 -05:00

The new recommendations from the U.S. Preventive Services Task Force on screening for breast cancer1 were front-page news for several consecutive days, and they sent the Obama administration scrambling to...

PERSPECTIVE: On Mammography â More Agreement Than Disagreement

Thu, 24Â DecÂ 2009 00:00:00 -05:00

Breast cancer is the most common cancer in women in the United States, with more than 190,000 women receiving a diagnosis of invasive disease annually1 and more than 40,000 dying...

ORIGINAL ARTICLE: Letrozole Therapy Alone or in Sequence with Tamoxifen in Women with Breast Cancer

The BIG 1-98 Collaborative Group — Thu, 20Â AugÂ 2009 00:00:00 -05:00

Background: The aromatase inhibitor letrozole, as compared with tamoxifen, improves disease-free survival among postmenopausal women with receptor-positive early breast cancer. It is unknown whether sequential treatment with tamoxifen and letrozole...

EDITORIAL: A Weighty Matter â Lifting after Breast Cancer

Wendy Demark-Wahnefried, Ph.D., R.D. — Thu, 13Â AugÂ 2009 00:00:00 -05:00

In 1996, the Canadian Medical Association Journal featured a cover story entitled âBreast-cancer survivors begin to challenge exercise taboos.â1 This story appeared during an era when lymphedema was reported in...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 25-2009 â A 36-Year-Old Woman with Hormone-ReceptorâPositive Breast Cancer

Thu, 13Â AugÂ 2009 00:00:00 -05:00

Dr. Barbara L. Smith (Surgical Oncology): A 36-year-old woman was seen in the multidisciplinary breast cancer clinic of this hospital for management of hormone-receptorâpositive breast cancer.

Approximately 3 months earlier she...

ORIGINAL ARTICLE: Weight Lifting in Women with Breast-CancerâRelated Lymphedema

Thu, 13Â AugÂ 2009 00:00:00 -05:00

Background: Weight lifting has generally been proscribed for women with breast-cancerârelated lymphedema, preventing them from obtaining the well-established health benefits of weight lifting, including increases in bone density.

Methods: We performed...

ORIGINAL ARTICLE: Micrometastases or Isolated Tumor Cells and the Outcome of Breast Cancer

Thu, 13Â AugÂ 2009 00:00:00 -05:00

Background: The association of isolated tumor cells and micrometastases in regional lymph nodes with the clinical outcome of breast cancer is unclear.

Methods: We identified all patients in the Netherlands who...

ORIGINAL ARTICLE: Adjuvant Chemotherapy in Older Women with Early-Stage Breast Cancer

Thu, 14Â MayÂ 2009 00:00:00 -05:00

Background: Older women with breast cancer are underrepresented in clinical trials, and data on the effects of adjuvant chemotherapy in such patients are scant. We tested for the noninferiority of...

REVIEW ARTICLE: Gene-Expression Signatures in Breast Cancer

Christos Sotiriou, M.D., D.Phil., and Lajos Pusztai, M.D., D.Phil. — Thu, 19Â FebÂ 2009 00:00:00 -05:00

Gene-expression profiling with the use of DNA microarrays allows measurement of thousands of messenger RNA (mRNA) transcripts in a single experiment. Results of such studies have confirmed that breast cancer...

ORIGINAL ARTICLE: Endocrine Therapy plus Zoledronic Acid in Premenopausal Breast Cancer

Thu, 12Â FebÂ 2009 00:00:00 -05:00

Background: Ovarian suppression plus tamoxifen is a standard adjuvant treatment in premenopausal women with endocrine-responsive breast cancer. Aromatase inhibitors are superior to tamoxifen in postmenopausal patients, and preclinical data suggest...

ORIGINAL ARTICLE: Breast Cancer after Use of Estrogen plus Progestin in Postmenopausal Women

Thu, 05Â FebÂ 2009 00:00:00 -05:00

Background: Following the release of the 2002 report of the Women's Health Initiative (WHI) trial of estrogen plus progestin, the use of menopausal hormone therapy in the United States decreased...

CLINICAL THERAPEUTICS: Radiation Therapy for Early-Stage Breast Cancer after Breast-Conserving Surgery

Thomas A. Buchholz, M.D. — Thu, 01Â JanÂ 2009 00:00:00 -05:00

A 45-year-old woman with a family history of postmenopausal breast cancer (in a maternal aunt) discovers a mass in the upper outer quadrant of her left breast. A mammogram reveals...

IMAGES IN CLINICAL MEDICINE: Bone Destruction and Regeneration in a Patient with Breast Cancer

Ashok Malani, M.D. and Rony M. Abou-Jawde, M.D. — Thu, 11Â DecÂ 2008 00:00:00 -05:00

A 58-year-old woman presented with a cavitating left breast lesion and increasing pain in the left arm. For over a year she had noticed an enlarging breast mass but did...

ORIGINAL ARTICLE: Single Reading with Computer-Aided Detection for Screening Mammography

Thu, 16Â OctÂ 2008 00:00:00 -05:00

Background: The sensitivity of screening mammography for the detection of small breast cancers is higher when the mammogram is read by two readers rather than by a single reader. We...

BOOK REVIEW:

Thu, 09Â OctÂ 2008 00:00:00 -05:00

There is a complex emotional, social, and cultural overlay to the experience and treatment of breast disease that makes breast cancer unique. Although physician and historian Robert Aronowitz drew from...

CLINICAL THERAPEUTICS: Breast Reconstruction after Surgery for Breast Cancer

Peter G. Cordeiro, M.D. — Thu, 09Â OctÂ 2008 00:00:00 -05:00

A 45-year-old woman undergoes core needle biopsy of a breast mass 4 cm in diameter and fine-needle aspiration of a palpable axillary lymph node, the results of both of which...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 30-2008 â A 47-Year-Old Woman with a Mass in the Breast and a Solitary Lesion in the Spine

Thu, 25Â SepÂ 2008 00:00:00 -05:00

Dr. Barbara L. Smith (Surgical Oncology): A 47-year-old premenopausal woman came to this hospital for treatment of breast cancer.

The patient had been well until 8 months earlier, when she felt...

IMAGES IN CLINICAL MEDICINE: The StewartâTreves Syndrome

Laura B. Pincus, M.D. and Lindy P. Fox, M.D. — Thu, 28Â AugÂ 2008 00:00:00 -05:00

A 67-year-old woman with a history of cancer of the right breast, treated with a modified radical mastectomy, radiation, and chemotherapy in 1990, presented with a 6-month history of an...

SPECIAL ARTICLE: Polygenes, Risk Prediction, and Targeted Prevention of Breast Cancer

Thu, 26Â JunÂ 2008 00:00:00 -05:00

Background: New developments in the search for susceptibility alleles in complex disorders provide support for the possibility of a polygenic approach to the prevention and treatment of common diseases.

Methods: We...

ORIGINAL ARTICLE: Weekly Paclitaxel in the Adjuvant Treatment of Breast Cancer

Thu, 17Â AprÂ 2008 00:00:00 -05:00

Background: We compared the efficacy of two different taxanes, docetaxel and paclitaxel, given either weekly or every 3 weeks, in the adjuvant treatment of breast cancer.

Methods: We enrolled 4950 women...

IMAGES IN CLINICAL MEDICINE: Blue Hives

Martin J. O'Sullivan, F.R.C.S.I. and Monica Morrow, M.D. — Thu, 07Â FebÂ 2008 00:00:00 -05:00

A 77-year-old woman underwent surgical resection of a 1.5-cm papillary carcinoma of the right breast. Isosulfan blue dye (8 ml) was used intraoperatively to define the associated lymphatic drainage. Three...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 4-2008 â A 33-Year-Old Pregnant Woman with Swelling of the Left Breast and Shortness of Breath

Lawrence N. Shulman, M.D., Rachel A. Hitt, M.D., and Judith A. Ferry, M.D. — Thu, 31Â JanÂ 2008 00:00:00 -05:00

A 33-year-old pregnant woman was admitted to the hospital at 30.7 weeks' gestation because of swelling of the left breast, shortness of breath, and tachycardia.

The patient had received prenatal care...

EDITORIAL: Cost Sharing for Health Care â Whose Skin? Which Game?

Peter B. Bach, M.D., M.A.P.P. — Thu, 24Â JanÂ 2008 00:00:00 -05:00

In this issue of the Journal, Trivedi and colleagues1 examine the effect of cost sharing on the use of screening mammography among women enrolled in Medicare managed-care plans from 2001...

SPECIAL ARTICLE: Effect of Cost Sharing on Screening Mammography in Medicare Health Plans

Thu, 24Â JanÂ 2008 00:00:00 -05:00

Background: Policies that increase patients' share of health care expenses decrease the use of discretionary health services but also may reduce the use of important preventive care such as mammography.

Methods:...

PERSPECTIVE: âWesternizingâ Women's Risks? Breast Cancer in Lower-Income Countries

Thu, 17Â JanÂ 2008 00:00:00 -05:00

Recent media reports have highlighted the increasing incidence of breast cancer in low- and middle-income countries. Although the disease continues to be most prominent in affluent countries, the risks of...

ORIGINAL ARTICLE: Paclitaxel plus Bevacizumab versus Paclitaxel Alone for Metastatic Breast Cancer

Thu, 27Â DecÂ 2007 00:00:00 -05:00

Background: In an open-label, randomized, phase 3 trial, we compared the efficacy and safety of paclitaxel with that of paclitaxel plus bevacizumab, a monoclonal antibody against vascular endothelial growth factor,...

ORIGINAL ARTICLE: Breast-Cancer Stromal Cells with Mutations and Nodal Metastases

Thu, 20Â DecÂ 2007 00:00:00 -05:00

Background: The importance of cross-talk between a cancer and its microenvironment has been increasingly recognized. We hypothesized that mutational inactivation of the tumor-suppressor gene TP53 and genomic alterations in stromal...

PERSPECTIVE: Stromal Effects in Breast Cancer

Thu, 20Â DecÂ 2007 00:00:00 -05:00

Investigations into the interaction between epithelial cancer cells and adjacent stroma have revealed paracrine interactions that enhance the tumorigenic characteristics of the cancer cell.1 Tumor-associated stroma have been reported to...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 32-2007 â A 62-Year-Old Woman with a Second Breast Cancer

Thu, 18Â OctÂ 2007 00:00:00 -05:00

Dr. David A. Barbie (Medical Oncology): A 62-year-old woman came to this hospital for management of breast cancer.

Six years earlier, a routine mammogram had revealed calcifications in the left breast....

EDITORIAL: Breast-Cancer Therapy â Looking Back to the Future

Anne Moore, M.D. — Thu, 11Â OctÂ 2007 00:00:00 -05:00

Adjuvant therapy for breast cancer â treatment after surgical removal of the tumor â is a major therapeutic advance that has had a considerable effect on prolonging disease-free and overall...

ORIGINAL ARTICLE: HER2 and Response to Paclitaxel in Node-Positive Breast Cancer

Thu, 11Â OctÂ 2007 00:00:00 -05:00

Background: The status of human epidermal growth factor receptor type 2 (HER2) in breast-cancer cells predicts clinical outcomes in women who receive adjuvant anthracycline-based chemotherapy. We hypothesized that HER2 positivity...

IMAGES IN CLINICAL MEDICINE: Cellulitis after Treatment for Breast Cancer

Gheorghe Peltecu, M.D., Ph.D. — Thu, 02Â AugÂ 2007 00:00:00 -05:00

A 54-year-old woman presented with a sudden onset of fever (temperature, 39.3Â°C) and erythema on the right breast and right arm (Panel A) and on the right side of the...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 22-2007 â A Woman with a Family History of Gastric and Breast Cancer

Thu, 19Â JulÂ 2007 00:00:00 -05:00

A 38-year-old woman was seen in the Gastrointestinal Cancer Genetics Clinic of this hospital because of a family history of breast and gastric cancer.

Approximately 15 months earlier, mild chronic gastrointestinal...

EDITORIAL: Genes, Cancer Risks, and Clinical Outcomes

Patricia Hartge, Sc.D. — Thu, 12Â JulÂ 2007 00:00:00 -05:00

Learning whether a patient who has just been given a diagnosis of breast cancer also bears one of the cancer-causing mutations in the BRCA1 or BRCA2 genes may add little...

CLINICAL PRACTICE: Management of an Inherited Predisposition to Breast Cancer

Mark Robson, M.D., and Kenneth Offit, M.D., M.P.H. — Thu, 12Â JulÂ 2007 00:00:00 -05:00

A healthy 33-year-old woman comes to establish care. She reports no breast symptoms, her age at menarche was 14, and she has no children. She notes a family history of...

ORIGINAL ARTICLE: Clinical Outcomes of Breast Cancer in Carriers of and Mutations

Thu, 12Â JulÂ 2007 00:00:00 -05:00

Background: Some features of breast cancer in women with a BRCA1 mutation suggest that hereditary breast cancer has a poor outcome. We conducted a national population-based study of Israeli women...

REVIEW ARTICLE: Trastuzumab â Mechanism of Action and Use in Clinical Practice

Clifford A. Hudis, M.D. — Thu, 05Â JulÂ 2007 00:00:00 -05:00

Overexpression of human epidermal growth factor receptor type 2 (HER2, also referred to as HER2/neu or ErbB-2), a 185-kD receptor first described more than two decades ago,1 occurs in 20...

CLINICAL PRACTICE: Follow-up of Patients with Early Breast Cancer

Daniel F. Hayes, M.D. — Thu, 14Â JunÂ 2007 00:00:00 -05:00

An otherwise healthy 53-year-old woman is seen for routine care after completing treatment several months earlier for stage II estrogen-receptorâpositive, HER2-positive breast cancer. The treatment consisted of lumpectomy, irradiation, adjuvant...

REVIEW ARTICLE: Local Therapy and Survival in Breast Cancer

Thu, 07Â JunÂ 2007 00:00:00 -05:00

The effect of local therapy on the survival of patients with breast cancer has been debated for decades. Three viewpoints have been proposed on the basis of various hypotheses concerning...

SPECIAL REPORT: The Decrease in Breast-Cancer Incidence in 2003 in the United States

Thu, 19Â AprÂ 2007 00:00:00 -05:00

An initial analysis of data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) registries shows that the age-adjusted incidence rate of breast cancer in women in the...

EDITORIAL: Breast Imaging and Computer-Aided Detection

Ferris M. Hall, M.D. — Thu, 05Â AprÂ 2007 00:00:00 -05:00

Breast imaging is the newest, and according to most criteria the weakest, of all radiology subspecialties. Screening mammography in particular often loses money and is subsidized by other sections of...

ORIGINAL ARTICLE: Influence of Computer-Aided Detection on Performance of Screening Mammography

Thu, 05Â AprÂ 2007 00:00:00 -05:00

Background: Computer-aided detection identifies suspicious findings on mammograms to assist radiologists. Since the Food and Drug Administration approved the technology in 1998, it has been disseminated into practice, but its...

IMAGES IN CLINICAL MEDICINE: Rapid Progression of Basal-Type Breast Cancer

Victoria L. Seewaldt, M.D. and Victoria Scott, M.S. — Thu, 29Â MarÂ 2007 00:00:00 -05:00

A 33-year-old woman with a known BRCA1 mutation (2080delA) was referred for 3.0-tesla magnetic resonance imaging (3T MRI). The patient's mother had had breast cancer at the ages of 31...

EDITORIAL: The Evolving Role of MRI in the Detection and Evaluation of Breast Cancer

Robert A. Smith, Ph.D. — Thu, 29Â MarÂ 2007 00:00:00 -05:00

The age-adjusted rate of death from breast cancer in the United States was 24% lower in 2003 than it was in 1989,1 a decline that has been attributed principally to...

ORIGINAL ARTICLE: MRI Evaluation of the Contralateral Breast in Women with Recently Diagnosed Breast Cancer

Thu, 29Â MarÂ 2007 00:00:00 -05:00

Background: Even after careful clinical and mammographic evaluation, cancer is found in the contralateral breast in up to 10% of women who have received treatment for unilateral breast cancer. We...

EDITORIAL: The Mammogram That Cried Wolfe

Karla Kerlikowske, M.D. — Thu, 18Â JanÂ 2007 00:00:00 -05:00

That mammographic density is an important risk factor for breast cancer was first recognized by Wolfe in the 1970s. His pioneering observation has since been confirmed in more than 42...

EDITORIAL: Sorting Out Breast-Cancer Gene Signatures

Joan MassaguÃ©, Ph.D. — Thu, 18Â JanÂ 2007 00:00:00 -05:00

The advent of technology for the analysis of human tissue samples for the activity of the entire genome initiated a quest for the molecular profiling of tumors. The aim of...

ORIGINAL ARTICLE: Mammographic Density and the Risk and Detection of Breast Cancer

Thu, 18Â JanÂ 2007 00:00:00 -05:00

Background: Extensive mammographic density is associated with an increased risk of breast cancer and makes the detection of cancer by mammography difficult, but the influence of density on risk according...

ORIGINAL ARTICLE: The Prognostic Role of a Gene Signature from Tumorigenic Breast-Cancer Cells

Thu, 18Â JanÂ 2007 00:00:00 -05:00

Background: Breast cancers contain a minority population of cancer cells characterized by CD44 expression but low or undetectable levels of CD24 (CD44+CD24â/low) that have higher tumorigenic capacity than other subtypes...

EDITORIAL: Targeted Therapy for Metastatic Breast Cancer

Hyman B. Muss, M.D. — Thu, 28Â DecÂ 2006 00:00:00 -05:00

Metastatic breast cancer is incurable, so most oncologists favor sequential chemotherapy with one agent at a time over concurrent therapy with multiple agents.1 The use of single agents on a...

ORIGINAL ARTICLE: Lapatinib plus Capecitabine for HER2-Positive Advanced Breast Cancer

Thu, 28Â DecÂ 2006 00:00:00 -05:00

Background: 06122828.xml Lapatinib, a tyrosine kinase inhibitor of human epidermal growth factor receptor type 2 (HER2, also referred to as HER2/neu) and epidermal growth factor receptor (EGFR), is active in...

EDITORIAL: Adjuvant Chemotherapy for Breast Cancer â 30 Years Later

Mark N. Levine, M.D., and Timothy Whelan, B.M., B.Ch. — Thu, 02Â NovÂ 2006 00:00:00 -05:00

In 1976, Bonadonna and his colleagues published the results of their landmark trial of adjuvant chemotherapy for breast cancer.1 They showed that 12 months of postoperative chemotherapy consisting of cyclophosphamide,...

ORIGINAL ARTICLE: Epirubicin and Cyclophosphamide, Methotrexate, and Fluorouracil as Adjuvant Therapy for Early Breast Cancer

Thu, 02Â NovÂ 2006 00:00:00 -05:00

Background: The National Epirubicin Adjuvant Trial (NEAT) and the BR9601 trial examined the efficacy of anthracyclines in the adjuvant treatment of early breast cancer.

Methods: In NEAT, we compared four cycles...

EDITORIAL: Molecular Signatures Predict Outcomes of Breast Cancer

Joyce A. O'Shaughnessy, M.D. — Thu, 10Â AugÂ 2006 00:00:00 -05:00

Breast cancer is classified and managed largely on the basis of anatomy â in contrast with lymphoma, which has been classified and treated according to grade for more than 20...

ORIGINAL ARTICLE: Concordance among Gene-ExpressionâBased Predictors for Breast Cancer

Thu, 10Â AugÂ 2006 00:00:00 -05:00

Background: Gene-expressionâprofiling studies of primary breast tumors performed by different laboratories have resulted in the identification of a number of distinct prognostic profiles, or gene sets, with little overlap in...

EDITORIAL: RiskâBenefit Profiles of Raloxifene for Women

Marcia L. Stefanick, Ph.D. — Thu, 13Â JulÂ 2006 00:00:00 -05:00

During the past decade, considerable scientific, clinical, and public interest in the benefits and risks of postmenopausal estrogen therapy has focused attention on selective estrogen-receptor modulators (SERMs). These act as...

ORIGINAL ARTICLE: Effects of Raloxifene on Cardiovascular Events and Breast Cancer in Postmenopausal Women

Thu, 13Â JulÂ 2006 00:00:00 -05:00

Background: The effect of raloxifene, a selective estrogen-receptor modulator, on coronary heart disease (CHD) and breast cancer is not established.

Methods: We randomly assigned 10,101 postmenopausal women (mean age, 67.5 years)...

EDITORIAL: Anthracyclines and the Tailoring of Treatment for Early Breast Cancer

Martine J. Piccart-Gebhart, M.D., Ph.D. — Thu, 18Â MayÂ 2006 00:00:00 -05:00

Adjuvant chemotherapy and hormonal treatment have substantially reduced the risks of relapse and death that threaten a woman for many years after the diagnosis of breast cancer.1 Progress in breast-cancer...

ORIGINAL ARTICLE: and Responsiveness of Breast Cancer to Adjuvant Chemotherapy

Thu, 18Â MayÂ 2006 00:00:00 -05:00

Background: Amplification of the human epidermal growth factor receptor type 2 (HER2, also called HER2/neu) gene and overexpression of its product in breast-cancer cells may be associated with responsiveness to...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 6-2006 â A 71-Year-Old Woman with Urinary Incontinence and a Mass in the Bladder

Thu, 23Â FebÂ 2006 00:00:00 -05:00

Dr. Donald S. Kaufman: A 71-year-old woman was referred to this hospital for a second opinion on the management of a malignant tumor of the urinary bladder. Urinary incontinence had...

ORIGINAL ARTICLE: Adjuvant Docetaxel or Vinorelbine with or without Trastuzumab for Breast Cancer

Thu, 23Â FebÂ 2006 00:00:00 -05:00

Background: We compared docetaxel with vinorelbine for the adjuvant treatment of early breast cancer. Women with tumors that overexpressed HER2/neu were also assigned to receive concomitant treatment with trastuzumab or...

PERSPECTIVE: Herceptin and the Heart â A Molecular Modifier of Cardiac Failure

Thu, 23Â FebÂ 2006 00:00:00 -05:00

Translation, translation, translation. Around the halls of academic medicine, translation is the mantra of the moment. In the literary world, translation is the process of interpreting an extant body of...

REVIEW ARTICLE: Estrogen Carcinogenesis in Breast Cancer

James D. Yager, Ph.D., and Nancy E. Davidson, M.D. — Thu, 19Â JanÂ 2006 00:00:00 -05:00

In this article, we review recent findings related to estrogen exposure and the risk of breast cancer, the mechanisms that may be involved, and the clinical implications of these findings....

EDITORIAL: Aromatase Inhibitors â A Triumph of Translational Oncology

Sandra M. Swain, M.D. — Thu, 29Â DecÂ 2005 00:00:00 -05:00

Great strides have been made in the diagnosis and treatment of early-stage breast cancer, thanks to advances in molecular medicine, interdisciplinary treatment, and rapid electronic communication. Hormonal therapy, the first...

ORIGINAL ARTICLE: A Comparison of Letrozole and Tamoxifen in Postmenopausal Women with Early Breast Cancer

The Breast International Group (BIG) 1-98 Collaborative Group — Thu, 29Â DecÂ 2005 00:00:00 -05:00

Background: The aromatase inhibitor letrozole is a more effective treatment for metastatic breast cancer and more effective in the neoadjuvant setting than tamoxifen. We compared letrozole with tamoxifen as adjuvant...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 35-2005 â A 56-Year-Old Woman with Breast Cancer and Isolated Tumor Cells in a Sentinel Lymph Node

Thu, 17Â NovÂ 2005 00:00:00 -05:00

Dr. Barbara L. Smith (Surgical Oncology): A 56-year-old woman was referred to the multidisciplinary breast clinic, part of the cancer center of this hospital, for management of invasive breast cancer...

EDITORIAL: Film or Digital Mammographic Screening?

D. David Dershaw, M.D. — Thu, 27Â OctÂ 2005 00:00:00 -05:00

The report by Pisano et al.1 of the results of the Digital Mammographic Imaging Screening Trial (DMIST) in this issue of the Journal adds important information that physicians will use...

IMAGES IN CLINICAL MEDICINE: Breast Cancer of an Accessory Nipple

Leah S. Gendler, M.D. and Kathie-Ann Joseph, M.D., M.P.H. — Thu, 27Â OctÂ 2005 00:00:00 -05:00

A 42-year-old woman presented to the breast clinic with a mass posterior to an accessory nipple (arrow) that had been progressively enlarging over the past year. On physical examination, the...

ORIGINAL ARTICLE: Effect of Screening and Adjuvant Therapy on Mortality from Breast Cancer

Thu, 27Â OctÂ 2005 00:00:00 -05:00

Background: We used modeling techniques to assess the relative and absolute contributions of screening mammography and adjuvant treatment to the reduction in breast-cancer mortality in the United States from 1975...

ORIGINAL ARTICLE: Diagnostic Performance of Digital versus Film Mammography for Breast-Cancer Screening

Thu, 27Â OctÂ 2005 00:00:00 -05:00

Background: Film mammography has limited sensitivity for the detection of breast cancer in women with radiographically dense breasts. We assessed whether the use of digital mammography would avoid some of...

EDITORIAL: Trastuzumab in the Treatment of Breast Cancer

Gabriel N. Hortobagyi, M.D. — Thu, 20Â OctÂ 2005 00:00:00 -05:00

Two articles in this issue of the Journal report on the considerable therapeutic benefit of trastuzumab, a monoclonal antibody, in primary breast cancer, as measured by reductions in the rates...

IMAGES IN CLINICAL MEDICINE: Cerebral Metastases in Breast Cancer

Hannah Rouse, M.B., B.S. and Sarah-Jane Dawson, M.B., B.S. — Thu, 20Â OctÂ 2005 00:00:00 -05:00

A 52-year-old woman received a diagnosis of stage II hormone-receptorânegative, HER2-positive breast carcinoma (2 of 13 nodes positive). She underwent a left segmental mastectomy, axillary dissection, adjuvant chemotherapy (doxorubicin and...

ORIGINAL ARTICLE: Trastuzumab plus Adjuvant Chemotherapy for Operable HER2-Positive Breast Cancer

Thu, 20Â OctÂ 2005 00:00:00 -05:00

Background: We present the combined results of two trials that compared adjuvant chemotherapy with or without concurrent trastuzumab in women with surgically removed HER2-positive breast cancer.

Methods: The National Surgical Adjuvant...

ORIGINAL ARTICLE: Trastuzumab after Adjuvant Chemotherapy in HER2-Positive Breast Cancer

Thu, 20Â OctÂ 2005 00:00:00 -05:00

Background: Trastuzumab, a recombinant monoclonal antibody against HER2, has clinical activity in advanced breast cancer that overexpresses HER2. We investigated its efficacy and safety after excision of early-stage breast cancer...

PERSPECTIVE: The Distinctive Nature of HER2-Positive Breast Cancers

Harold J. Burstein, M.D., Ph.D. — Thu, 20Â OctÂ 2005 00:00:00 -05:00

Breast cancer is not a single disease but a group of several important tumor subtypes, each with a different natural history and each requiring a different treatment. Overexpression of HER2...

ORIGINAL ARTICLE: A Pooled Analysis of Bone Marrow Micrometastasis in Breast Cancer

Thu, 25Â AugÂ 2005 00:00:00 -05:00

Background: We assessed the prognostic significance of the presence of micrometastasis in the bone marrow at the time of diagnosis of breast cancer by means of a pooled analysis.

Methods: We...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 24-2005 â A 58-Year-Old Woman with Early-Stage Estrogen-ReceptorâPositive Breast Cancer

Paula D. Ryan, M.D., Ph.D., Daniel B. Kopans, M.D., and Dennis C. Sgroi, M.D. — Thu, 11Â AugÂ 2005 00:00:00 -05:00

A 58-year-old woman was seen in the multidisciplinary breast-cancer clinic of this hospital for management of early-stage breast cancer.

One month earlier, a routine screening mammogram at another facility revealed an...

IMAGES IN CLINICAL MEDICINE: Paget's Disease of the Breast

Lindy Peta Fox, M.D. and Marc E. Grossman, M.D. — Thu, 21Â JulÂ 2005 00:00:00 -05:00

A 70-year-old woman presented with an erythematous, scaly plaque with a hyperpigmented border that had replaced the areola and completely effaced the nipple of the left breast. No breast mass...

EDITORIAL: Benign Breast Disease â The Risks of Communicating Risk

Joann G. Elmore, M.D., M.P.H., and Gerd Gigerenzer, Ph.D. — Thu, 21Â JulÂ 2005 00:00:00 -05:00

The term âriskâ appears in the title of more than 10,000 medical articles published in 2004 (2 percent of the total) â nine times as many as appeared in 1975....

IMAGES IN CLINICAL MEDICINE: Adenocarcinoma of the Breast in a Man

Andrew Birnie, M.R.C.P. and Sandeep Varma, M.R.C.P. — Thu, 21Â JulÂ 2005 00:00:00 -05:00

An 83-year-old man presented with a one-month history of an enlarging lump on his right nipple. It was asymptomatic. Physical examination revealed an 11-mm erythematous, well-circumscribed nodule attached to the...

REVIEW ARTICLE: Benign Breast Disorders

Richard J. Santen, M.D., and Robert Mansel, M.D., Ph.D. — Thu, 21Â JulÂ 2005 00:00:00 -05:00

Hormones and growth factors act on stromal and epithelial cells to regulate the development, maturation, and differentiation of mammary-gland cells.12 Broadly summarized, estrogen mediates the development and elongation of ductal...

ORIGINAL ARTICLE: Benign Breast Disease and the Risk of Breast Cancer

Thu, 21Â JulÂ 2005 00:00:00 -05:00

Background: Benign breast disease is an important risk factor for breast cancer. We studied a large group of women with benign breast disease to obtain reliable estimates of this risk.

Methods:...

EDITORIAL: TAC â A New Standard in Adjuvant Therapy for Breast Cancer?

Edith A. Perez, M.D. — Thu, 02Â JunÂ 2005 00:00:00 -05:00

Chemotherapy, an integral component of adjuvant treatment for women with resected node-positive breast cancer, improves disease-free and overall survival in many patients. Older regimens include such combinations as cyclophosphamide, methotrexate,...

ORIGINAL ARTICLE: Adjuvant Docetaxel for Node-Positive Breast Cancer

Thu, 02Â JunÂ 2005 00:00:00 -05:00

Background: We compared docetaxel plus doxorubicin and cyclophosphamide (TAC) with fluorouracil plus doxorubicin and cyclophosphamide (FAC) as adjuvant chemotherapy for operable node-positive breast cancer.

Methods: We randomly assigned 1491 women with...

IMAGES IN CLINICAL MEDICINE: Calcified Filariasis of the Breasts

Hatem Alkadhi, M.D. and Elisabeth Garzoli, M.D. — Thu, 13Â JanÂ 2005 00:00:00 -05:00

A 23-year-old woman who had emigrated from Cameroon two years previously was admitted because of bilateral breast lumps. Her history was unremarkable. On physical examination, several nonpainful, mobile, firm lumps...

EDITORIAL: Individualized Care for Patients with Cancer â A Work in Progress

Robert C. Bast, Jr., M.D., and Gabriel N. Hortobagyi, M.D. — Thu, 30Â DecÂ 2004 00:00:00 -05:00

During the past two decades, molecular biologists have been dissecting the heterogeneity of human cancer â a diversity that oncologists have long appreciated, especially because patients who have similar stages...

IMAGES IN CLINICAL MEDICINE: Lytic Lesions in Breast Cancer

Daniela Katz, M.D. and Dvora Aharoni, M.D. — Thu, 30Â DecÂ 2004 00:00:00 -05:00

A previously healthy 54-year-old woman presented with a two-week history of pelvic pain. On physical examination, she had limited movement, without tenderness in the bones. An initial radiographic survey of...

ORIGINAL ARTICLE: A Multigene Assay to Predict Recurrence of Tamoxifen-Treated, Node-Negative Breast Cancer

Thu, 30Â DecÂ 2004 00:00:00 -05:00

Background: The likelihood of distant recurrence in patients with breast cancer who have no involved lymph nodes and estrogen-receptorâpositive tumors is poorly defined by clinical and histopathological measures.

Methods: We tested...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Breast Cancer â Loss of PTEN Predicts Resistance to Treatment

Pier Paolo Pandolfi, M.D., Ph.D. — Thu, 25Â NovÂ 2004 00:00:00 -05:00

PTEN, the lipid phosphatase and tensin homologue, is a key tumor suppressor. Mutations resulting in the loss of PTEN or the loss of its function are common and functionally relevant...

ORIGINAL ARTICLE: Growth Patterns and the Risk of Breast Cancer in Women

Thu, 14Â OctÂ 2004 00:00:00 -05:00

Background: Adult height and body-mass index influence the risk of breast cancer in women. Whether these associations reflect growth patterns of the fetus or growth during childhood and adolescence is...

ORIGINAL ARTICLE: Lumpectomy plus Tamoxifen with or without Irradiation in Women 70 Years of Age or Older with Early Breast Cancer

Thu, 02Â SepÂ 2004 00:00:00 -05:00

Background: In women 70 years of age or older who have early breast cancer, it is unclear whether lumpectomy plus tamoxifen is as effective as lumpectomy followed by tamoxifen plus...

ORIGINAL ARTICLE: Tamoxifen with or without Breast Irradiation in Women 50 Years of Age or Older with Early Breast Cancer

Thu, 02Â SepÂ 2004 00:00:00 -05:00

Background: We determined the effect of breast irradiation plus tamoxifen on disease-free survival and local relapse in women 50 years of age or older who had T1 or T2 node-negative...

EDITORIAL: Breast Radiotherapy after Lumpectomy â No Longer Always Necessary

Ian E. Smith, M.D., and Gillian M. Ross, Ph.D. — Thu, 02Â SepÂ 2004 00:00:00 -05:00

Breast-conserving surgery followed by radiotherapy is the standard of care for women with small breast cancers who wish to avoid mastectomy. This approach achieves good local control, does not disturb...

EDITORIAL: Circulating Tumor Cells in Metastatic Breast Cancer â Toward Individualized Treatment?

Stephan Braun, M.D., and Christian Marth, M.D. — Thu, 19Â AugÂ 2004 00:00:00 -05:00

When Steven Paget published his theory of âseed and soilâ in 1889,1 the idea of hematogenous tumor-cell dissemination was born. More than a century later, with the use of molecular...

ORIGINAL ARTICLE: Circulating Tumor Cells, Disease Progression, and Survival in Metastatic Breast Cancer

Thu, 19Â AugÂ 2004 00:00:00 -05:00

Background: We tested the hypothesis that the level of circulating tumor cells can predict survival in metastatic breast cancer.

Methods: In a prospective, multicenter study, we tested 177 patients with measurable...

EDITORIAL: Breast Cancer Screening with MRI â What Are the Data for Patients at High Risk?

Laura Liberman, M.D. — Thu, 29Â JulÂ 2004 00:00:00 -05:00

More than 275,000 women in the United States will receive a diagnosis of breast cancer this year, and 40,110 women will die of the disease.1 Randomized trials have shown that...

ORIGINAL ARTICLE: Efficacy of MRI and Mammography for Breast-Cancer Screening in Women with a Familial or Genetic Predisposition

Thu, 29Â JulÂ 2004 00:00:00 -05:00

Background: The value of regular surveillance for breast cancer in women with a genetic or familial predisposition to breast cancer is currently unproven. We compared the efficacy of magnetic resonance...

REVIEW ARTICLE: Ductal Carcinoma in Situ of the Breast

Thu, 01Â AprÂ 2004 00:00:00 -05:00

Ductal carcinoma in situ of the breast (also called intraductal carcinoma) consists of the clonal proliferation of cells that appear malignant and that accumulate within the lumens of the mammary...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: A Novel BRCA2-Binding Protein and Breast and Ovarian Tumorigenesis

Mary-Claire King, Ph.D. — Thu, 18Â MarÂ 2004 00:00:00 -05:00

A fundamental question of cancer genetics is how genes responsible for inherited cancer contribute to the far more frequent cases of cancer that are purely somatic in origin. Somatic mutations...

EDITORIAL: New Stars in the Sky of Treatment for Early Breast Cancer

Martine J. Piccart-Gebhart, M.D., Ph.D. — Thu, 11Â MarÂ 2004 00:00:00 -05:00

Since Sir George Beatson observed in 1896 that breast tumors in premenopausal women sometimes regressed after oophorectomy,1 numerous investigations have established that estrogen stimulates the growth of breast-cancer cells. Three...

ORIGINAL ARTICLE: A Randomized Trial of Exemestane after Two to Three Years of Tamoxifen Therapy in Postmenopausal Women with Primary Breast Cancer

Thu, 11Â MarÂ 2004 00:00:00 -05:00

Background: Tamoxifen, taken for five years, is the standard adjuvant treatment for postmenopausal women with primary, estrogen-receptorâpositive breast cancer. Despite this treatment, however, some patients have a relapse.

Methods: We conducted...

EDITORIAL: Beyond Tamoxifen â Extending Endocrine Treatment for Early-Stage Breast Cancer

Harold J. Burstein, M.D., Ph.D. — Thu, 06Â NovÂ 2003 00:00:00 -05:00

Five years of tamoxifen therapy is the standard adjuvant endocrine therapy for early-stage, hormone-receptorâpositive breast cancer.123 Randomized trials have demonstrated the superiority of five years of treatment over shorter durations...

EDITORIAL: Letrozole after Tamoxifen for Breast Cancer â What Is the Price of Success?

John Bryant, Ph.D., and Norman Wolmark, M.D. — Thu, 06Â NovÂ 2003 00:00:00 -05:00

In this issue of the Journal, Goss et al.1 report results from a trial that will have a considerable effect on the treatment of early-stage breast cancer. The study was...

ORIGINAL ARTICLE: A Randomized Trial of Letrozole in Postmenopausal Women after Five Years of Tamoxifen Therapy for Early-Stage Breast Cancer

Thu, 06Â NovÂ 2003 00:00:00 -05:00

Background: In hormone-dependent breast cancer, five years of postoperative tamoxifen therapy â but not tamoxifen therapy of longer duration â prolongs disease-free and overall survival. The aromatase inhibitor letrozole, by...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 28-2003 â A 51-Year-Old Premenopausal Woman with Newly Diagnosed Breast Cancer and a Strong Family History of Breast Cancer

Thu, 11Â SepÂ 2003 00:00:00 -05:00

A 51-year-old, premenopausal woman came to this hospital with a newly diagnosed breast carcinoma and a strong family history of breast cancer.

Three months earlier, on physical examination at another institution,...

EDITORIAL: The Design of Trials Comparing Sentinel-Node Surgery and Axillary Resection

David Krag, M.D., and Takamaru Ashikaga, Ph.D. — Thu, 07Â AugÂ 2003 00:00:00 -05:00

The technique of the sentinel-node biopsy has reoriented our understanding of the dynamics between a solid tumor and its associated lymphatic collection system.1234 Moreover, the sentinel-node biopsy is an excellent...

ORIGINAL ARTICLE: A Randomized Comparison of Sentinel-Node Biopsy with Routine Axillary Dissection in Breast Cancer

Thu, 07Â AugÂ 2003 00:00:00 -05:00

Background: Although numerous studies have shown that the status of the sentinel node is an accurate predictor of the status of the axillary nodes in breast cancer, the efficacy and...

EDITORIAL: Stem-Cell Transplantation for High-Risk Breast Cancer

Gerald J. Elfenbein, M.D. — Thu, 03Â JulÂ 2003 00:00:00 -05:00

The controversy over the question of whether to use high-dose chemotherapy and autologous hematopoietic stem-cell transplantation in women with high-risk breast cancer has persisted for more than a decade.1 It...

ORIGINAL ARTICLE: High-Dose Chemotherapy with Hematopoietic Stem-Cell Rescue for High-Risk Breast Cancer

Thu, 03Â JulÂ 2003 00:00:00 -05:00

Background: The use of high-dose adjuvant chemotherapy for high-risk primary breast cancer is controversial. We studied its efficacy in patients with 4 to 9 or 10 or more tumor-positive axillary...

ORIGINAL ARTICLE: Conventional Adjuvant Chemotherapy with or without High-Dose Chemotherapy and Autologous Stem-Cell Transplantation in High-Risk Breast Cancer

Thu, 03Â JulÂ 2003 00:00:00 -05:00

Background: The prognosis for women with primary breast cancer and 10 or more involved axillary lymph nodes is poor. High-dose chemotherapy with autologous hematopoietic stem-cell transplantation has been reported to...

REVIEW ARTICLE: Aromatase Inhibitors in Breast Cancer

Ian E. Smith, M.D., and Mitch Dowsett, Ph.D. — Thu, 12Â JunÂ 2003 00:00:00 -05:00

The third-generation aromatase inhibitors provide novel approaches to the endocrine treatment of breast cancer. These drugs are effectively challenging tamoxifen, the previous gold standard of care,12345678910111213 for use in postmenopausal...

EDITORIAL: Genes, Hormones, and Pathways to Breast Cancer

Patricia Hartge, Sc.D. — Thu, 05Â JunÂ 2003 00:00:00 -05:00

Much current epidemiologic research aims to find the factors that trigger the development of breast cancer in women who are genetically predisposed to it. In this issue of the Journal,...

REVIEW ARTICLE: Breast and Ovarian Cancer

Richard Wooster, Ph.D., and Barbara L. Weber, M.D. — Thu, 05Â JunÂ 2003 00:00:00 -05:00

Despite years of intensive study and substantial progress in understanding susceptibility to breast and ovarian cancer, these diseases remain important causes of death in women. However, several recent critical advances...

ORIGINAL ARTICLE: Puberty and Genetic Susceptibility to Breast Cancer in a CaseâControl Study in Twins

Ann S. Hamilton, Ph.D., and Thomas M. Mack, M.D., M.P.H. — Thu, 05Â JunÂ 2003 00:00:00 -05:00

Background: Breast cancer is thought to result from excessive cumulative exposure to ovarian hormones. Different predictors of hereditary and sporadic breast cancer suggest different pathogenic mechanisms. Affected twin pairs may...

CLINICAL PRACTICE: Mammographic Screening for Breast Cancer

Suzanne W. Fletcher, M.D., and Joann G. Elmore, M.D., M.P.H. — Thu, 24Â AprÂ 2003 00:00:00 -05:00

A 44-year-old woman who is a new patient has no known current health problems and no family history of breast or ovarian cancer. Eighteen months ago, she had a normal...

IMAGES IN CLINICAL MEDICINE: Effect of Intrapleural Streptokinase on a Loculated Malignant Pleural Effusion

N.A. Maskell, M.R.C.P. and F.V. Gleeson, F.R.C.R., F.R.C.P. — Thu, 03Â AprÂ 2003 00:00:00 -05:00

A 62-year-old woman with metastatic breast carcinoma presented with shortness of breath due to a left-sided malignant pleural effusion. A catheter placed in the pleural cavity failed to drain more...

REVIEW ARTICLE: Selective Estrogen-Receptor Modulators â Mechanisms of Action and Application to Clinical Practice

B. Lawrence Riggs, M.D., and Lynn C. Hartmann, M.D. — Thu, 13Â FebÂ 2003 00:00:00 -05:00

The selective estrogen-receptor modulators (SERMs) represent a major therapeutic advance for clinical practice. Unlike estrogens, which are uniformly agonists, and antiestrogens, which are uniformly antagonists, the SERMs exert selective agonist...

EDITORIAL: Molecular Signatures of Breast Cancer â Predicting the Future

Thu, 19Â DecÂ 2002 00:00:00 -05:00

Breast cancer affects about 10 percent of women in Western countries and is still a major cause of illness and death. Most patients with lymph-nodeânegative disease (i.e., with no evidence...

ORIGINAL ARTICLE: A Gene-Expression Signature as a Predictor of Survival in Breast Cancer

Thu, 19Â DecÂ 2002 00:00:00 -05:00

Background: A more accurate means of prognostication in breast cancer will improve the selection of patients for adjuvant systemic therapy.

Methods: Using microarray analysis to evaluate our previously established 70-gene prognosis...

PERSPECTIVE: Predictive Molecular Pathology

Thu, 19Â DecÂ 2002 00:00:00 -05:00

The search for markers that can predict the outcome in an individual patient with cancer or the response of an individual tumor to specific therapies is a major focus of...

ORIGINAL ARTICLE: Cyclin E and Survival in Patients with Breast Cancer

Thu, 14Â NovÂ 2002 00:00:00 -05:00

Background: Cyclin E, a regulator of the cell cycle, affects the behavior of breast-cancer cells. We investigated whether levels of cyclin E in the tumor correlated with survival among patients...

PERSPECTIVE: Cyclin E and Prognosis in Patients with Breast Cancer

Thu, 14Â NovÂ 2002 00:00:00 -05:00

An early and essential event in the evolution of cancer is loss of the normal control mechanisms responsible for the orderly progression of cells through the cell cycle, with consequent...

EDITORIAL: Rational Local Therapy for Breast Cancer

Thu, 17Â OctÂ 2002 00:00:00 -05:00

In a 1976 lecture to the Society of Surgical Oncology, the late Jerome Urban lamented the loss of a rational approach to the treatment of breast cancer, which he thought...

ORIGINAL ARTICLE: Twenty-Year Follow-up of a Randomized Trial Comparing Total Mastectomy, Lumpectomy, and Lumpectomy plus Irradiation for the Treatment of Invasive Breast Cancer

Thu, 17Â OctÂ 2002 00:00:00 -05:00

Background: In 1976, we initiated a randomized trial to determine whether lumpectomy with or without radiation therapy was as effective as total mastectomy for the treatment of invasive breast cancer.

Methods:...

ORIGINAL ARTICLE: Twenty-Year Follow-up of a Randomized Study Comparing Breast-Conserving Surgery with Radical Mastectomy for Early Breast Cancer

Thu, 17Â OctÂ 2002 00:00:00 -05:00

Background: We conducted 20 years of follow-up of women enrolled in a randomized trial to compare the efficacy of radical (Halsted) mastectomy with that of breast-conserving surgery.

Methods: From 1973 to...

ORIGINAL ARTICLE: Heritability of Mammographic Density, a Risk Factor for Breast Cancer

Thu, 19Â SepÂ 2002 00:00:00 -05:00

Background: Women with extensive dense breast tissue visible on a mammogram have a risk of breast cancer that is 1.8 to 6.0 times that of women of the same age...

PERSPECTIVE: Breast Density and the Risk of Breast Cancer

Thu, 19Â SepÂ 2002 00:00:00 -05:00

There is great variation among women in the density of breast parenchyma as seen on mammograms. Mammographic density also varies inversely with age. Thus, younger women tend to have denser...

ORIGINAL ARTICLE: Twenty-Five-Year Follow-up of a Randomized Trial Comparing Radical Mastectomy, Total Mastectomy, and Total Mastectomy Followed by Irradiation

Thu, 22Â AugÂ 2002 00:00:00 -05:00

Background: In women with breast cancer, the role of radical mastectomy, as compared with less extensive surgery, has been a matter of debate. We report 25-year findings of a randomized...

ORIGINAL ARTICLE: Oral Contraceptives and the Risk of Breast Cancer

Thu, 27Â JunÂ 2002 00:00:00 -05:00

Background: It is uncertain whether the use of an oral contraceptive increases the risk of breast cancer later in life, when the incidence of breast cancer is increased. We conducted...

EDITORIAL: Prophylactic Oophorectomy to Reduce the Risk of Ovarian and Breast Cancer in Carriers of Mutations

Thu, 23Â MayÂ 2002 00:00:00 -05:00

The BRCA1 and BRCA2 genes encode proteins that participate in the cellular response to DNA damage; inactivating mutations in these genes heighten susceptibility to breast and ovarian cancers. The mechanism...

ORIGINAL ARTICLE: Prophylactic Oophorectomy in Carriers of or Mutations

Thu, 23Â MayÂ 2002 00:00:00 -05:00

Background: Data concerning the efficacy of bilateral prophylactic oophorectomy for reducing the risk of gynecologic cancer in women with BRCA1 or BRCA2 mutations are limited. We investigated whether this procedure...

ORIGINAL ARTICLE: Risk-Reducing Salpingo-oophorectomy in Women with a or Mutation

Thu, 23Â MayÂ 2002 00:00:00 -05:00

Background: Risk-reducing salpingo-oophorectomy is often considered by carriers of BRCA mutations who have completed childbearing. However, there are limited data supporting the efficacy of this approach. We prospectively compared the...

EDITORIAL: Mind Matters â Group Therapy and Survival in Breast Cancer

Thu, 13Â DecÂ 2001 00:00:00 -05:00

How much does mind matter in the outcome of cancer? The extent to which treatment of the emotional aspects of cancer affects disease progression is ultimately an empirical question. There...

ORIGINAL ARTICLE: The Effect of Group Psychosocial Support on Survival in Metastatic Breast Cancer

Thu, 13Â DecÂ 2001 00:00:00 -05:00

Background: Supportiveâexpressive group therapy has been reported to prolong survival among women with metastatic breast cancer. However, in recent studies, various psychosocial interventions have not prolonged survival.

Methods: In a multicenter...

ORIGINAL ARTICLE: Recurrence Rates after Treatment of Breast Cancer with Standard Radiotherapy with or without Additional Radiation

Thu, 08Â NovÂ 2001 00:00:00 -05:00

Background: Radiotherapy prevents local recurrence of breast cancer after breast-conserving surgery. We evaluated the effect of a supplementary dose of radiation to the tumor bed on the rates of local...

EDITORIAL: Prophylactic Mastectomy for Women with and Mutations â Facts and Controversy

Thu, 19Â JulÂ 2001 00:00:00 -05:00

Genetic testing for susceptibility to breast cancer has been controversial since its inception. Among other issues, it has provoked questions about the efficacy and acceptability of prophylactic mastectomy for women...

ORIGINAL ARTICLE: Breast Cancer after Prophylactic Bilateral Mastectomy in Women with a or Mutation

Thu, 19Â JulÂ 2001 00:00:00 -05:00

Background: Women with a BRCA1 or BRCA2 mutation have a high risk of breast cancer and may choose to undergo prophylactic bilateral total mastectomy. We investigated the efficacy of this...

REVIEW ARTICLE: Side Effects of Adjuvant Treatment of Breast Cancer

Charles L. Shapiro, M.D., and Abram Recht, M.D. — Thu, 28Â JunÂ 2001 00:00:00 -05:00

Women with primary invasive breast cancer receive both local and systemic treatment. Surgery and radiation therapy are local treatments given to reduce the risk of recurrent cancer in the breast,...

EDITORIAL: From the Molecule to the Clinic â Inhibiting HER2 to Treat Breast Cancer

Thu, 15Â MarÂ 2001 00:00:00 -05:00

Much of the fundamental cancer research of the past two decades has focused on identifying the molecular and genetic changes that cause malignant transformation. These abnormalities can be attractive targets...

ORIGINAL ARTICLE: Use of Chemotherapy plus a Monoclonal Antibody against HER2 for Metastatic Breast Cancer That Overexpresses HER2

Thu, 15Â MarÂ 2001 00:00:00 -05:00

Background: The HER2 gene, which encodes the growth factor receptor HER2, is amplified and HER2 is overexpressed in 25 to 30 percent of breast cancers, increasing the aggressiveness of the...

ORIGINAL ARTICLE: Gene-Expression Profiles in Hereditary Breast Cancer

Thu, 22Â FebÂ 2001 00:00:00 -05:00

Background: Many cases of hereditary breast cancer are due to mutations in either the BRCA1 or the BRCA2 gene. The histopathological changes in these cancers are often characteristic of the...

REVIEW ARTICLE: Estrogen and the Risk of Breast Cancer

Mark Clemons, M.B., B.S., M.D., and Paul Goss, M.D., Ph.D. — Thu, 25Â JanÂ 2001 00:00:00 -05:00

The connection between breast cancer and estrogen has been recognized for more than 100 years, since George Beatson demonstrated that bilateral oophorectomy resulted in the remission of breast cancer in...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Roads Leading to Breast Cancer

Thu, 23Â NovÂ 2000 00:00:00 -05:00

Cancer results from the accumulation of mutations in genes that regulate cellular proliferation. These mutations can occur early in the process of malignant transformation or later, during progression to an...

REVIEW ARTICLE: Primary Care for Survivors of Breast Cancer

Harold J. Burstein, M.D., Ph.D., and Eric P. Winer, M.D. — Thu, 12Â OctÂ 2000 00:00:00 -05:00

There are more than 2 million women in the United States alone who are living with a history of breast cancer.12 Screening programs have increased the number of women in...

REVIEW ARTICLE: Reducing the Risk of Breast Cancer

Rowan T. Chlebowski, M.D., Ph.D. — Thu, 20Â JulÂ 2000 00:00:00 -05:00

Recent research results suggest that the risk of breast cancer can be reduced. In this review I will focus on chemoprevention, emphasizing evidence from randomized clinical trials, and in addition...

EDITORIAL: High-Dose Chemotherapy plus Autologous Bone Marrow Transplantation for Metastatic Breast Cancer

Thu, 13Â AprÂ 2000 00:00:00 -05:00

In this issue of the Journal, Stadtmauer et al. present the results of a clinical trial in which conventional-dose chemotherapy was compared with high-dose chemotherapy plus autologous bone marrow transplantation...

IMAGES IN CLINICAL MEDICINE: Meningeal Carcinomatosis in Breast Cancer

Deborah L. Ornstein, M.D. and Kirt Frederickson, M.D. — Thu, 13Â AprÂ 2000 00:00:00 -05:00

Figure 1. A 49-year-old woman with progressive metastatic breast cancer despite aggressive chemotherapy was hospitalized with slurred speech, clumsiness of the right hand, and increasing lethargy. Examination revealed that the...

ORIGINAL ARTICLE: Conventional-Dose Chemotherapy Compared with High-Dose Chemotherapy plus Autologous Hematopoietic Stem-Cell Transplantation for Metastatic Breast Cancer

Thu, 13Â AprÂ 2000 00:00:00 -05:00

Background: We conducted a randomized trial in which we compared high-dose chemotherapy plus hematopoietic stem-cell rescue with a prolonged course of monthly conventional-dose chemotherapy in women with metastatic breast cancer.

Methods:...

EDITORIAL: Approaches to Breast-Cancer Staging

Thu, 24Â FebÂ 2000 00:00:00 -05:00

Each year more than 180,000 women in the United States receive a diagnosis of breast cancer, and over 40,000 of them ultimately die of their disease. Larger primary tumors and...

REVIEW ARTICLE: Assessing the Risk of Breast Cancer

Katrina Armstrong, M.D., Andrea Eisen, M.D., and Barbara Weber, M.D. — Thu, 24Â FebÂ 2000 00:00:00 -05:00

Each year in the United States, breast cancer is diagnosed in more than 170,000 women.1 Despite this substantial burden of disease, however, assessment of breast-cancer risk has received very little...

ORIGINAL ARTICLE: Cytokeratin-Positive Cells in the Bone Marrow and Survival of Patients with Stage I, II, or III Breast Cancer

Thu, 24Â FebÂ 2000 00:00:00 -05:00

Background: Cytokeratins are specific markers of epithelial cancer cells in bone marrow. We assessed the influence of cytokeratin-positive micrometastases in the bone marrow on the prognosis of women with breast...

EDITORIAL: Use of Alternative Medicine â A Marker for Distress?

Thu, 03Â JunÂ 1999 00:00:00 -05:00

In this issue of the Journal, Burstein and colleagues give us surprising new information about women who begin to use alternative medicine after receiving a diagnosis of breast cancer.1 The...

SPECIAL ARTICLE: Use of Alternative Medicine by Women with Early-Stage Breast Cancer

Thu, 03Â JunÂ 1999 00:00:00 -05:00

Background: We analyzed the use of alternative medicine by women who had received standard therapy for early-stage breast cancer diagnosed between September 1993 and September 1995.

Methods: A cohort of 480...

EDITORIAL: Ductal Carcinoma in Situ â The Focus for Prevention, Screening, and Breast Conservation in Breast Cancer

Thu, 13Â MayÂ 1999 00:00:00 -05:00

We entered this century with a confusion of terms for benign conditions of the breast that are possibly associated with cancer, summarized by J.C. Warren in 1905.1 We exit this...

ORIGINAL ARTICLE: The Influence of Margin Width on Local Control of Ductal Carcinoma in Situ of the Breast

Thu, 13Â MayÂ 1999 00:00:00 -05:00

Background: Ductal carcinoma in situ is a noninvasive carcinoma that is unlikely to recur if completely excised. Margin width, the distance between the boundary of the lesion and the edge...

ORIGINAL ARTICLE: Radial Scars in Benign Breast-Biopsy Specimens and the Risk of Breast Cancer

Thu, 11Â FebÂ 1999 00:00:00 -05:00

Background: Radial scars are benign breast lesions of uncertain clinical significance. In particular, it is not known whether these lesions alter the risk of breast cancer in women with benign...

EDITORIAL: The Quality of Life after Breast Cancer â Solving the Problem of Lymphedema

Thu, 04Â FebÂ 1999 00:00:00 -05:00

In the past 30 years we have witnessed an assault on the view that breast cancer can be treated as a regional disease solely by aggressive surgical techniques. First to...

IMAGES IN CLINICAL MEDICINE: Mammographically Occult Breast Cancer

Bruce L. Daniel, M.D. — Thu, 04Â FebÂ 1999 00:00:00 -05:00

Figure 1. A right axillary mass was palpated by a 62-year-old woman while she was exercising. Surgical biopsy revealed adenocarcinoma, suggestive of metastatic breast cancer. The results of physical examination...

ORIGINAL ARTICLE: Lack of Effect of Coumarin in Women with Lymphedema after Treatment for Breast Cancer

Thu, 04Â FebÂ 1999 00:00:00 -05:00

Background: Lymphedema of the arms can be a serious consequence of local and regional therapy in women with breast cancer. Coumarin has been reported to be effective for the treatment...

ORIGINAL ARTICLE: Efficacy of Bilateral Prophylactic Mastectomy in Women with a Family History of Breast Cancer

Thu, 14Â JanÂ 1999 00:00:00 -05:00

Background: Options for women at high risk for breast cancer include surveillance, chemoprevention, and prophylactic mastectomy. The data on the outcomes for surveillance and prophylactic mastectomy are incomplete.

Methods: We conducted...

SOUNDING BOARD: Putting the Risk of Breast Cancer in Perspective

Thu, 14Â JanÂ 1999 00:00:00 -05:00

Educating the public about the risk of breast cancer promises to contribute to the prevention or early detection of the disease. Data on the risk of breast cancer are widely...

EDITORIAL: Prophylactic Mastectomy â The Price of Fear

Thu, 14Â JanÂ 1999 00:00:00 -05:00

Recent progress in understanding the genetic basis of susceptibility to breast cancer has simultaneously allowed the identification of women at increased risk and spawned controversy over their care. Like such...

REVIEW ARTICLE: Tamoxifen in the Treatment of Breast Cancer

C. Kent Osborne, M.D. — Thu, 26Â NovÂ 1998 00:00:00 -05:00

Breast cancer is the most common cancer in women in the Western world. Because breast cancer is estrogen-dependent, reducing estrogen secretion by oophorectomy, hypophysectomy, or adrenalectomy can cause the cancer...

SOUNDING BOARD: Sentinel-Lymph-Node Biopsy for Breast Cancer â Not Yet the Standard of Care

Thu, 01Â OctÂ 1998 00:00:00 -05:00

A sentinel lymph node is the first lymph node to receive lymphatic drainage from a tumor. It can be detected by injection of a blue dye or radioactive colloid around...

REVIEW ARTICLE: Treatment of Breast Cancer

Gabriel N. Hortobagyi, M.D. — Thu, 01Â OctÂ 1998 00:00:00 -05:00

Breast cancer is a major public health problem worldwide. Management of breast cancer was last reviewed in the Journal in 1992.1 The accumulation of new biologic information, the results of...

ORIGINAL ARTICLE: The Sentinel Node in Breast Cancer â A Multicenter Validation Study

Thu, 01Â OctÂ 1998 00:00:00 -05:00

Background: Pilot studies indicate that probe-guided resection of radioactive sentinel nodes (the first nodes that receive drainage from tumors) can identify regional metastases in patients with breast cancer. To confirm...

ORIGINAL ARTICLE: Reduction in New Metastases in Breast Cancer with Adjuvant Clodronate Treatment

Thu, 06Â AugÂ 1998 00:00:00 -05:00

Background: Bisphosphonates are effective against the increased bone resorption caused by certain diseases because they inhibit the activity of osteoclasts. In patients who have breast cancer and metastatic bone disease,...

EDITORIAL: Benefit and Harm Associated with Screening for Breast Cancer

Thu, 16Â AprÂ 1998 00:00:00 -05:00

Despite many high-quality randomized trials, the balance of harm and benefit attributable to breast-cancer screening is not known for women 40 to 49 years of age. In this issue of...

ORIGINAL ARTICLE: Ten-Year Risk of False Positive Screening Mammograms and Clinical Breast Examinations

Thu, 16Â AprÂ 1998 00:00:00 -05:00

Background: The cumulative risk of a false positive result of a breast-cancer screening test is unknown.

Methods: We performed a 10-year retrospective cohort study of breast-cancer screening and diagnostic evaluations among...

EDITORIAL: Tissue-Specific Estrogens â The Promise for the Future

Thu, 04Â DecÂ 1997 00:00:00 -05:00

As life expectancy continues to increase, women will soon be postmenopausal for one third of their lives. The human and economic costs of this increased longevity in an estrogen-deficient state...

ORIGINAL ARTICLE: Effects of Raloxifene on Bone Mineral Density, Serum Cholesterol Concentrations, and Uterine Endometrium in Postmenopausal Women

Thu, 04Â DecÂ 1997 00:00:00 -05:00

Background: Long-term estrogen therapy can reduce the risk of osteoporotic fracture and cardiovascular disease in postmenopausal women. At present, however, these beneficial effects are not separable from undesirable stimulation of...

EDITORIAL: Xenoestrogens and Breast Cancer

Thu, 30Â OctÂ 1997 00:00:00 -05:00

Chemophobia, the unreasonable fear of chemicals, is a common public reaction to scientific or media reports suggesting that exposure to various environmental contaminants may pose a threat to health. The...

ORIGINAL ARTICLE: Plasma Organochlorine Levels and the Risk of Breast Cancer

Thu, 30Â OctÂ 1997 00:00:00 -05:00

Background: Exposure to âenvironmental estrogensâ such as organochlorines in pesticides and industrial chemicals has been proposed as a cause of increasing rates of breast cancer. Several studies have reported higher...

EDITORIAL: Stopping Metastases at Their Source

Thu, 02Â OctÂ 1997 00:00:00 -05:00

In this issue of the Journal, two papers address the role of radiation therapy in patients with breast cancer treated with adjuvant chemotherapy. These prospective, randomized trials from Denmark1 and...

ORIGINAL ARTICLE: Adjuvant Radiotherapy and Chemotherapy in Node-Positive Premenopausal Women with Breast Cancer

Thu, 02Â OctÂ 1997 00:00:00 -05:00

Background: Radiotherapy after mastectomy to treat early breast cancer has been known since the 1940s to reduce rates of local relapse. However, the routine use of postoperative radiotherapy began to...

ORIGINAL ARTICLE: Postoperative Radiotherapy in High-Risk Premenopausal Women with Breast Cancer Who Receive Adjuvant Chemotherapy

Thu, 02Â OctÂ 1997 00:00:00 -05:00

Background: Irradiation after mastectomy can reduce locoregional recurrences in women with breast cancer, but whether it prolongs survival remains controversial. We conducted a randomized trial of radiotherapy after mastectomy in...

IMAGES IN CLINICAL MEDICINE: Nail Changes after Chemotherapy

P.H.T.J. Slee, M.D., Ph.D. — Thu, 17Â JulÂ 1997 00:00:00 -05:00

Figure 1. A 50-year-old woman with metastatic breast cancer received seven courses of docetaxel at three-week intervals. After this treatment, the number and sizes of her lung metastases (the only...

EDITORIAL: Postmenopausal Hormone-Replacement Therapy â Time for a Reappraisal?

Thu, 19Â JunÂ 1997 00:00:00 -05:00

In this issue of the Journal, Grodstein and colleagues1 present important data from a large study of the risks and benefits associated with postmenopausal hormone-replacement therapy. Like previous investigators, they...

ORIGINAL ARTICLE: Postmenopausal Hormone Therapy and Mortality

Thu, 19Â JunÂ 1997 00:00:00 -05:00

Background: Postmenopausal hormone therapy has both benefits and hazards, including decreased risks of osteoporosis and cardiovascular disease and an increased risk of breast cancer.

Methods: We examined the relation between the...

SPECIAL REPORT: Decision Analysis â Effects of Prophylactic Mastectomy and Oophorectomy on Life Expectancy among Women with or Mutations

Thu, 15Â MayÂ 1997 00:00:00 -05:00

Background: Women with BRCA1 or BRCA2 mutations have an increased risk of breast cancer and ovarian cancer. Prophylactic mastectomy and oophorectomy are often considered as ways of reducing these risks,...

EDITORIAL: Genes â Bookmaking, Fortunetelling, and Medical Care

Thu, 15Â MayÂ 1997 00:00:00 -05:00

The world cheered the discovery of the BRCA1 cancer-susceptibility gene in 19941 and was chilled by its implications. A woman with a strong family history of breast or ovarian cancer,...

ORIGINAL ARTICLE: Differential Contributions of and to Early-Onset Breast Cancer

Thu, 15Â MayÂ 1997 00:00:00 -05:00

Background: Germ-line mutations in the BRCA1 and BRCA2 genes predispose women to breast cancer. BRCA1 mutations are found in approximately 12 percent of women with breast cancer of early onset,...

ORIGINAL ARTICLE: Mutations in Women Attending Clinics That Evaluate the Risk of Breast Cancer

Thu, 15Â MayÂ 1997 00:00:00 -05:00

Background: To define the incidence of BRCA1 mutations among patients seen in clinics that evaluate the risk of breast cancer, we analyzed DNA samples from women seen in this setting...

EDITORIAL: Exercise and Breast Cancer â Time to Get Moving?

Thu, 01Â MayÂ 1997 00:00:00 -05:00

Most cases of breast cancer are related to lifestyle or environment, but exactly which factors affect the risk of breast cancer is difficult to define. The preponderance of breast cancer...

ORIGINAL ARTICLE: Physical Activity and the Risk of Breast Cancer

Thu, 01Â MayÂ 1997 00:00:00 -05:00

Background: Because physical activity may affect hormonal concentrations and energy balance, we decided to investigate whether everyday exercise is related to the risk of breast cancer.

Methods: During 1974 to 1978...

EDITORIAL: Contentious Screening Decisions â Does the Choice Matter?

Thu, 24Â AprÂ 1997 00:00:00 -05:00

Artists often understand us better than we understand ourselves. A cartoon in the March 26 edition of the Philadelphia Daily News shows a physician who, after exhaustively reviewing the literature,...

SOUNDING BOARD: Whither Scientific Deliberation in Health Policy Recommendations? â Alice in the Wonderland of Breast-Cancer Screening

Thu, 17Â AprÂ 1997 00:00:00 -05:00

At 9 a.m. on January 23, 1997, after two days of speeches and presentations at a consensus-development conference sponsored by the National Institutes of Health (NIH), the conference panel presented...

EDITORIAL: Breast Implantation â The Quest for Safety and Quality

Thu, 06Â MarÂ 1997 00:00:00 -05:00

Breast implantation is performed primarily for three indications: breast augmentation, reconstruction after mastectomy for cancer, and reconstruction after prophylactic mastectomy. Outcome is judged by the safety of the surgery and...

ORIGINAL ARTICLE: Complications Leading to Surgery after Breast Implantation

Thu, 06Â MarÂ 1997 00:00:00 -05:00

Background: Local complications that require additional surgical procedures are an important problem for women with breast implants.

Methods: We studied 749 women who lived in Olmsted County, Minnesota, and received a...

ORIGINAL ARTICLE: Bone Mass and the Risk of Breast Cancer among Postmenopausal Women

Thu, 27Â FebÂ 1997 00:00:00 -05:00

Background: Recent studies have shown a direct relation between serum estrogen levels assessed at a single point in time and the risk of breast cancer, but no evidence links estrogen...

ORIGINAL ARTICLE: Induced Abortion and the Risk of Breast Cancer

Thu, 09Â JanÂ 1997 00:00:00 -05:00

Background: It has been hypothesized that an interrupted pregnancy might increase a woman's risk of breast cancer because breast cells could proliferate without the later protective effect of differentiation.

Methods: We...

EDITORIAL: Abortion, Breast Cancer, and Epidemiology

Thu, 09Â JanÂ 1997 00:00:00 -05:00

In this issue of the Journal,1 Melbye et al. present substantial epidemiologic evidence that induced abortions do not affect a woman's risk of having breast cancer. In a linkage study,...

EDITORIAL: Bisphosphonates in the Treatment of Bone Diseases

Thu, 12Â DecÂ 1996 00:00:00 -05:00

Bisphosphonates are drugs that inhibit bone turnover by decreasing the resorption of bone. They do this both directly, by inhibiting the recruitment and function of osteoclasts (the bone-resorbing cells), and...

ORIGINAL ARTICLE: Efficacy of Pamidronate in Reducing Skeletal Complications in Patients with Breast Cancer and Lytic Bone Metastases

Thu, 12Â DecÂ 1996 00:00:00 -05:00

Background: Bisphosphonates such as pamidronate disodium inhibit osteoclast-induced bone resorption associated with cancer that has metastasized to bone.

Methods: Women with stage IV breast cancer who were receiving cytotoxic chemotherapy and...

EDITORIAL: Genetics in Clinical Cancer Care â The Future is Now

Thu, 07Â NovÂ 1996 00:00:00 -05:00

The identification of BRCA1 as the first gene for susceptibility to breast and ovarian cancer was an important step toward a better understanding of the biology of these cancers.1 This...

SPECIAL ARTICLE: The Effect of Legislative Requirements on the Use of Breast-Conserving Surgery

Thu, 03Â OctÂ 1996 00:00:00 -05:00

Background: We studied the effect of state legislation requiring the disclosure of options for the treatment of breast cancer on the use of breast-conserving surgery in clinical practice.

Methods: The National...

EDITORIAL: The Changing Approach to the Treatment of Early Breast Cancer

Thu, 23Â MayÂ 1996 00:00:00 -05:00

For decades, the order of the therapeutic steps in early-stage, invasive breast cancer was largely unchallenged, proceeding according to the widely accepted priorities of Halsted with their emphasis on local...

ORIGINAL ARTICLE: The Sequencing of Chemotherapy and Radiation Therapy after Conservative Surgery for Early-Stage Breast Cancer

Thu, 23Â MayÂ 1996 00:00:00 -05:00

Background: Patients with early-stage breast cancer who are at substantial risk for systemic metastases are increasingly treated with breast-conserving therapy and adjuvant chemotherapy. However, the optimal sequencing of chemotherapy and...

EDITORIAL: Second Cancers after Hodgkin's Disease in Childhood

Thu, 21Â MarÂ 1996 00:00:00 -05:00

The treatment of Hodgkin's disease is a model of successful therapy for childhood cancer, with cure rates of over 90 percent expected from chemotherapy regimens and low-dose radiation (15 to...

ORIGINAL ARTICLE: Breast Cancer and Other Second Neoplasms after Childhood Hodgkin's Disease

Thu, 21Â MarÂ 1996 00:00:00 -05:00

Background: Patients who survive Hodgkin's disease are at increased risk for second neoplasms. As survival times increase, solid tumors are emerging as a serious long-term complication.

Methods: The Late Effects Study...

ORIGINAL ARTICLE: Cohort Studies of Fat Intake and the Risk of Breast Cancer â A Pooled Analysis

Thu, 08Â FebÂ 1996 00:00:00 -05:00

Background: Experiments in animals, international correlation comparisons, and caseâcontrol studies support an association between dietary fat intake and the incidence of breast cancer. Most cohort studies do not corroborate the...

EDITORIAL: â Lots of Mutations, Lots of Dilemmas

Thu, 18Â JanÂ 1996 00:00:00 -05:00

Breast cancer is the most common cancer among women in the Western world, with a cumulative lifetime risk of 1 in 8.1 The two strongest risk factors are age and...

ORIGINAL ARTICLE: Germ-Line Mutations in Jewish and Non-Jewish Women with Early-Onset Breast Cancer

Thu, 18Â JanÂ 1996 00:00:00 -05:00

Background: Mutations in a germ-line allele of the BRCA1 gene contribute to the familial breast cancer syndrome. However, the prevalence of these mutations is unknown in women with breast cancer...

ORIGINAL ARTICLE: Mutations in a Population-Based Sample of Young Women with Breast Cancer

Thu, 18Â JanÂ 1996 00:00:00 -05:00

Background: Inherited mutations in the BRCA1 gene are associated with a high risk of breast and ovarian cancer in some families. However, little is known about the contribution of BRCA1...

NEJM â Collection Updates for Breast Cancer

PERSPECTIVE: Screening Mammography and the âRâ Word

PERSPECTIVE: On Mammography â More Agreement Than Disagreement

ORIGINAL ARTICLE: Letrozole Therapy Alone or in Sequence with Tamoxifen in Women with Breast Cancer

EDITORIAL: A Weighty Matter â Lifting after Breast Cancer

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 25-2009 â A 36-Year-Old Woman with Hormone-ReceptorâPositive Breast Cancer

ORIGINAL ARTICLE: Weight Lifting in Women with Breast-CancerâRelated Lymphedema

ORIGINAL ARTICLE: Micrometastases or Isolated Tumor Cells and the Outcome of Breast Cancer

ORIGINAL ARTICLE: Adjuvant Chemotherapy in Older Women with Early-Stage Breast Cancer

REVIEW ARTICLE: Gene-Expression Signatures in Breast Cancer

ORIGINAL ARTICLE: Endocrine Therapy plus Zoledronic Acid in Premenopausal Breast Cancer

ORIGINAL ARTICLE: Breast Cancer after Use of Estrogen plus Progestin in Postmenopausal Women

CLINICAL THERAPEUTICS: Radiation Therapy for Early-Stage Breast Cancer after Breast-Conserving Surgery

IMAGES IN CLINICAL MEDICINE: Bone Destruction and Regeneration in a Patient with Breast Cancer

ORIGINAL ARTICLE: Single Reading with Computer-Aided Detection for Screening Mammography

BOOK REVIEW:

CLINICAL THERAPEUTICS: Breast Reconstruction after Surgery for Breast Cancer

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 30-2008 â A 47-Year-Old Woman with a Mass in the Breast and a Solitary Lesion in the Spine

IMAGES IN CLINICAL MEDICINE: The StewartâTreves Syndrome

SPECIAL ARTICLE: Polygenes, Risk Prediction, and Targeted Prevention of Breast Cancer

ORIGINAL ARTICLE: Weekly Paclitaxel in the Adjuvant Treatment of Breast Cancer

IMAGES IN CLINICAL MEDICINE: Blue Hives

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 4-2008 â A 33-Year-Old Pregnant Woman with Swelling of the Left Breast and Shortness of Breath

EDITORIAL: Cost Sharing for Health Care â Whose Skin? Which Game?

SPECIAL ARTICLE: Effect of Cost Sharing on Screening Mammography in Medicare Health Plans

PERSPECTIVE: âWesternizingâ Women's Risks? Breast Cancer in Lower-Income Countries

ORIGINAL ARTICLE: Paclitaxel plus Bevacizumab versus Paclitaxel Alone for Metastatic Breast Cancer

ORIGINAL ARTICLE: Breast-Cancer Stromal Cells with Mutations and Nodal Metastases

PERSPECTIVE: Stromal Effects in Breast Cancer

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 32-2007 â A 62-Year-Old Woman with a Second Breast Cancer

EDITORIAL: Breast-Cancer Therapy â Looking Back to the Future

ORIGINAL ARTICLE: HER2 and Response to Paclitaxel in Node-Positive Breast Cancer

IMAGES IN CLINICAL MEDICINE: Cellulitis after Treatment for Breast Cancer

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 22-2007 â A Woman with a Family History of Gastric and Breast Cancer

EDITORIAL: Genes, Cancer Risks, and Clinical Outcomes

CLINICAL PRACTICE: Management of an Inherited Predisposition to Breast Cancer

ORIGINAL ARTICLE: Clinical Outcomes of Breast Cancer in Carriers of and Mutations

REVIEW ARTICLE: Trastuzumab â Mechanism of Action and Use in Clinical Practice

CLINICAL PRACTICE: Follow-up of Patients with Early Breast Cancer

REVIEW ARTICLE: Local Therapy and Survival in Breast Cancer

SPECIAL REPORT: The Decrease in Breast-Cancer Incidence in 2003 in the United States

EDITORIAL: Breast Imaging and Computer-Aided Detection

ORIGINAL ARTICLE: Influence of Computer-Aided Detection on Performance of Screening Mammography

IMAGES IN CLINICAL MEDICINE: Rapid Progression of Basal-Type Breast Cancer

EDITORIAL: The Evolving Role of MRI in the Detection and Evaluation of Breast Cancer

ORIGINAL ARTICLE: MRI Evaluation of the Contralateral Breast in Women with Recently Diagnosed Breast Cancer

EDITORIAL: The Mammogram That Cried Wolfe

EDITORIAL: Sorting Out Breast-Cancer Gene Signatures

ORIGINAL ARTICLE: Mammographic Density and the Risk and Detection of Breast Cancer

ORIGINAL ARTICLE: The Prognostic Role of a Gene Signature from Tumorigenic Breast-Cancer Cells

EDITORIAL: Targeted Therapy for Metastatic Breast Cancer

ORIGINAL ARTICLE: Lapatinib plus Capecitabine for HER2-Positive Advanced Breast Cancer

EDITORIAL: Adjuvant Chemotherapy for Breast Cancer â 30 Years Later

ORIGINAL ARTICLE: Epirubicin and Cyclophosphamide, Methotrexate, and Fluorouracil as Adjuvant Therapy for Early Breast Cancer

EDITORIAL: Molecular Signatures Predict Outcomes of Breast Cancer

ORIGINAL ARTICLE: Concordance among Gene-ExpressionâBased Predictors for Breast Cancer

EDITORIAL: RiskâBenefit Profiles of Raloxifene for Women

ORIGINAL ARTICLE: Effects of Raloxifene on Cardiovascular Events and Breast Cancer in Postmenopausal Women

EDITORIAL: Anthracyclines and the Tailoring of Treatment for Early Breast Cancer

ORIGINAL ARTICLE: and Responsiveness of Breast Cancer to Adjuvant Chemotherapy

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 6-2006 â A 71-Year-Old Woman with Urinary Incontinence and a Mass in the Bladder

ORIGINAL ARTICLE: Adjuvant Docetaxel or Vinorelbine with or without Trastuzumab for Breast Cancer

PERSPECTIVE: Herceptin and the Heart â A Molecular Modifier of Cardiac Failure

REVIEW ARTICLE: Estrogen Carcinogenesis in Breast Cancer

EDITORIAL: Aromatase Inhibitors â A Triumph of Translational Oncology

ORIGINAL ARTICLE: A Comparison of Letrozole and Tamoxifen in Postmenopausal Women with Early Breast Cancer

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 35-2005 â A 56-Year-Old Woman with Breast Cancer and Isolated Tumor Cells in a Sentinel Lymph Node

EDITORIAL: Film or Digital Mammographic Screening?

IMAGES IN CLINICAL MEDICINE: Breast Cancer of an Accessory Nipple

ORIGINAL ARTICLE: Effect of Screening and Adjuvant Therapy on Mortality from Breast Cancer

ORIGINAL ARTICLE: Diagnostic Performance of Digital versus Film Mammography for Breast-Cancer Screening

EDITORIAL: Trastuzumab in the Treatment of Breast Cancer

IMAGES IN CLINICAL MEDICINE: Cerebral Metastases in Breast Cancer

ORIGINAL ARTICLE: Trastuzumab plus Adjuvant Chemotherapy for Operable HER2-Positive Breast Cancer

ORIGINAL ARTICLE: Trastuzumab after Adjuvant Chemotherapy in HER2-Positive Breast Cancer

PERSPECTIVE: The Distinctive Nature of HER2-Positive Breast Cancers

ORIGINAL ARTICLE: A Pooled Analysis of Bone Marrow Micrometastasis in Breast Cancer

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 24-2005 â A 58-Year-Old Woman with Early-Stage Estrogen-ReceptorâPositive Breast Cancer

IMAGES IN CLINICAL MEDICINE: Paget's Disease of the Breast

EDITORIAL: Benign Breast Disease â The Risks of Communicating Risk

NEJM â Collection Updates for Breast Cancer

PERSPECTIVE: Screening Mammography and the âRâ Word

PERSPECTIVE: On Mammography â More Agreement Than Disagreement

EDITORIAL: A Weighty Matter â Lifting after Breast Cancer

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 25-2009 â A 36-Year-Old Woman with Hormone-ReceptorâPositive Breast Cancer

ORIGINAL ARTICLE: Weight Lifting in Women with Breast-CancerâRelated Lymphedema

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 30-2008 â A 47-Year-Old Woman with a Mass in the Breast and a Solitary Lesion in the Spine

IMAGES IN CLINICAL MEDICINE: The StewartâTreves Syndrome

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 4-2008 â A 33-Year-Old Pregnant Woman with Swelling of the Left Breast and Shortness of Breath

EDITORIAL: Cost Sharing for Health Care â Whose Skin? Which Game?

PERSPECTIVE: âWesternizingâ Women's Risks? Breast Cancer in Lower-Income Countries

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 32-2007 â A 62-Year-Old Woman with a Second Breast Cancer

EDITORIAL: Breast-Cancer Therapy â Looking Back to the Future

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 22-2007 â A Woman with a Family History of Gastric and Breast Cancer

REVIEW ARTICLE: Trastuzumab â Mechanism of Action and Use in Clinical Practice

EDITORIAL: Adjuvant Chemotherapy for Breast Cancer â 30 Years Later

ORIGINAL ARTICLE: Concordance among Gene-ExpressionâBased Predictors for Breast Cancer

EDITORIAL: RiskâBenefit Profiles of Raloxifene for Women

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 6-2006 â A 71-Year-Old Woman with Urinary Incontinence and a Mass in the Bladder

PERSPECTIVE: Herceptin and the Heart â A Molecular Modifier of Cardiac Failure

EDITORIAL: Aromatase Inhibitors â A Triumph of Translational Oncology

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 35-2005 â A 56-Year-Old Woman with Breast Cancer and Isolated Tumor Cells in a Sentinel Lymph Node

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 24-2005 â A 58-Year-Old Woman with Early-Stage Estrogen-ReceptorâPositive Breast Cancer

EDITORIAL: Benign Breast Disease â The Risks of Communicating Risk

EDITORIAL: TAC â A New Standard in Adjuvant Therapy for Breast Cancer?

EDITORIAL: Individualized Care for Patients with Cancer â A Work in Progress

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Breast Cancer â Loss of PTEN Predicts Resistance to Treatment

EDITORIAL: Breast Radiotherapy after Lumpectomy â No Longer Always Necessary

EDITORIAL: Circulating Tumor Cells in Metastatic Breast Cancer â Toward Individualized Treatment?

EDITORIAL: Breast Cancer Screening with MRI â What Are the Data for Patients at High Risk?

EDITORIAL: Beyond Tamoxifen â Extending Endocrine Treatment for Early-Stage Breast Cancer

EDITORIAL: Letrozole after Tamoxifen for Breast Cancer â What Is the Price of Success?

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 28-2003 â A 51-Year-Old Premenopausal Woman with Newly Diagnosed Breast Cancer and a Strong Family History of Breast Cancer

ORIGINAL ARTICLE: Puberty and Genetic Susceptibility to Breast Cancer in a CaseâControl Study in Twins

REVIEW ARTICLE: Selective Estrogen-Receptor Modulators â Mechanisms of Action and Application to Clinical Practice

EDITORIAL: Molecular Signatures of Breast Cancer â Predicting the Future

EDITORIAL: Mind Matters â Group Therapy and Survival in Breast Cancer

EDITORIAL: Prophylactic Mastectomy for Women with and Mutations â Facts and Controversy

EDITORIAL: From the Molecule to the Clinic â Inhibiting HER2 to Treat Breast Cancer