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News Archive - Progress Newsletter Summer, 1999 Online

Easy-to-Understand Information on Breast Cancer Treatment Options Now Available

The National Comprehensive Cancer Network (NCCN) and the American Cancer Society (ACS) have teamed up to provide patients and the general public the most current information about treatment options for breast cancer patients. The ACS has translated the NCCN breast cancer treatment guidelines, originally developed for oncologists' use, into an understandable language and format for patients.

"The NCCN Oncology Practice Guidelines, which now cover more than 95 percent of all cancer patients, have become the treatment standard for oncology professionals," said William T. McGivney, Ph.D., chief executive officer of NCCN, a nationwide network of 17 cancer centers (including the University of Michigan Compre-hensive Cancer Center). "We are proud our collaboration with the ACS will now bring these guidelines to the patients who need them most."

How the Guidelines Work
After studying research results on breast cancer treatment, a panel of NCCN experts has agreed upon specific, up-to-date, recommendations for treating women with this disease. These recommendations were formulated using scientific evidence and currently accepted approaches to treatment. Every year the panel will update their recommendations, if advances in medical science warrant it.

The guidelines will help people better understand breast cancer and their doctor's advice. The treatment options for different stages of cancer are presented as flow charts. For each stage, the chart shows step-by-step how the patient and doctor can arrive at choices about treatment. Categories used in the flow charts are: cancer stage (stages indicate how far breast cancer has spread within the breast, to nearby tissues, and to other organs); work-up (the tests done to help determine the initial breast cancer diagnosis); treatment; prevention (what can be done to prevent a recurrence of the disease); and follow-up.

For example, for ductal carcinoma in situ (DCIS): stage 0 breast cancer DCIS is the stage. The work-up is mammography of both breasts and biopsy and pathological review of the biopsy sample. The treatment options vary depending on the findings of the pathological review, but could include either a mastectomy with or without reconstruction or a lumpectomy with or without radiation. Prevention of a second cancer is an option, with a regimen of the drug tamoxifen for five years. Follow-up includes medical history and physical exam twice a year for five years, then once a year, along with a yearly mammogram.

"Patients want detailed information about their treatment, so they can work with their doctor to formulate a treatment plan that best fits their needs, both medically and personally," said Ted Gansler, M.D., M.B.A., director of health content for the ACS.

Questions to Ask
ACS and NCCN officials urge patients to discuss the guidelines with their doctor because each patient's situation is unique and must be evaluated individually.

Questions you might want to ask your doctor about breast cancer include:

  • What is the stage of my disease?
  • How many tumors do I have and how large are they?
  • What is my tumor's grade (how abnormal do the cells appear) and its histology (type and arrangement of tumor cell), as seen under a microscope?
  • Has the cancer spread to any of my lymph nodes? If yes, how many?
  • Is my particular cancer estrogen receptor-positive or progesterone receptor-positive?
  • Does the fact that I have (or have not) reached menopause affect my treatment?

"For more than 85 years, the public has relied on the American Cancer Society for accurate, up-to-date information about cancer and its treatment," said Charles J. McDonald, M.D., president of the ACS. "This joint effort with the NCCN ensures that breast cancer patients will have the information they need to better understand the disease and act, in conjunction with their physician, to get treatment that is right for them."

Reprinted with permission from American Cancer Society, Inc.

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