High-Risk Assessment of Early Breast Cancer III

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • According to the American Society of Clinical Oncology (ASCO) and European Society for Medical Oncology (ESMO), decisions about adding chemotherapy to adjuvant endocrine therapy are individualized on the basis of patient and disease factors, including results of genomic assays
  • Most cases of small ER-positive, PR-positive, HER2-negative, node-negative breast cancer have a good prognosis with endocrine therapy alone and do not require adjuvant chemotherapy
  • By contrast, tumors that are high-grade, with higher measures of proliferation and lower levels of ER/PR expression, tend to be less sensitive to endocrine treatment and are more likely to benefit from adjuvant chemotherapy
  • Although assessment of response to neoadjuvant endocrine therapy or chemotherapy is used in the setting of locally advanced breast cancer, particularly when the size and/or location of the tumor preclude breast-conserving surgery, patients with very small, early, HER2-negative, hormone-positive cancers are generally treated with surgery first, followed by radiation therapy and consideration of adjuvant therapy with an endocrine regimen, chemotherapy, or both
  • Ki67 is an indirect measure of cell proliferation
  • Although a high Ki67 score is often considered a marker for poorer prognosis in early breast cancer, it cannot predict the benefit of chemotherapy as a single measure
  • Recently, the International Ki67 in Breast Cancer Working Group concluded that Ki67 has limited value for treatment decisions due to questionable analytical limitations
#Arrangoiz #BreastSurgeon #CancerSurgeon #SurgicalOncologist #MountSinaiMedicalCenter #MSMC #Miami #Mexico #BreastCancer

Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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