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Hu
Liang-zhong
PROGRESS
I}I
BREAST
CANCER
The 19th Annual
San
Antonic
Breast Cancer
Sym-
posium was held
on
December
1O-1
3, 1995 in the
United
States
of
America.
Over
4OO
participants
from
23
countries
including USA,
UK,
France,
Germany, ltaly,
Switzerland
and
Japan attended
the
meet-
ing
and presented 388
articles.
Based
on these
presentations,
this
article
will outline
some
of
the
new developments as
the
results
of
scientitic research
in
breast cancer.
Many promising
new
therapies
and drugs
for
breast
cancer
are
under development.
However,
the
importance
of
combination therapy continues
to
be
emphasized
by
most of
the
investigators.
For
instance,
the
3-year local recurrent
rate
for the patients with
early-stage
breast cancer
was
estimated
Oo/o
atler
conservative surgery
(CS) combined
with
radiation
therapy,
compared
to
that
of
6o/o
atter
CS only. Combination
therapy,
such
as
dose-inten-
sive chemotherapy plus
G-CSF
(Granulocyte-Colony
Stimulat-
ing
Factor)
administration
and
bone marrow
(stem-cell)
transplanation,
is also
pro-
sed
for
patientswith advanced
tumors. Again, the combination
therapy using other high
dose
chemotherapeutic
agents
of
Taxol, Novantrone
and
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Thiotepa
followed
by
autologous
stem cell
rescue
is
effective
to the
patients
ol
anthracycline refractory
meta-
static
breast cancer.
An
increasing understand-
ing of the
molecular
events
involved
in
breast cancer
has
been accompanied
by
identification
of
newer
markers
of
cancer
risk
and/or
its
prog-
nosis.
BRCA2
has
been
con-
sidered
an
sensitive breast
can-
cer gene, which may
reflect
unfavorable
biological
behavior
of
the
cancer,
such as poor
sur-
vival rate of
the
patients.
An
over
expression
of
both
mutant
P53
and C-erbB-2
can
be related
with
a significant decrease
of
disease-free survival
and
over
all
survival rate
of the
patient.
Other
markers
with
prognostic
signifi-
cance
are
UPA
(urokinase-type
plasminogen activator),
PAI
(UPA
lnhibitor)-1 and
PLI-V
etc.
PLI-V is
a marker indicating
the
presence
of lymphonodular
metastasis and
is useful
for
determining whether
nodal
dissection
is
needed
or
not. This
is
particularly important
to
patients
with
a
ER
(estrogen
recsptor) positive breast
cancer
which is
smaller
than 20
mm
in
size
when
it
was
diagnosed.
ln
addition, a high amplification
rate
@7.AV.)
of
MDR-1
gene
(multi-
drug
resistant
gene-'l)
is
posi-
tively correlated
with
insensitivity
of
chemotherapy.
ln a
study
of
985 cases
of
breast cancer
with
lymphonodular metastasis,
an
apoptosis positive
rate
of
46Vo
was found,
indicating
a
poor
prognosis
for
these
patients
be-
cause
S-year survival
rate
for
apoptosis positive patients
is
557o
compared to that of
7Oo/o
tor
those
with
negative
apoptosis.
Finally,
a
number
of
plant
foods and
herbs including green
tea
elctract
has
been found
a
chemopreventive
effect
on
breast
cancer in
animals.
However,
Ginshen
can induce low
level
ol
Cathepsin
in
ER positive
breast
cancer
cells, but not
in
ER
nega-
tive
cells.
Thus,
it is
suggested
that Ginshen
should
not be
used
in patients
with
ER
positive
breast
cancer.
