How to select endocrine agents for patients with ER-positive/ Her-2 -positive breast cancer has been a difficult question. Increasing evidences shows a consistent results that an association between Her-2 overexpression and poor response of endocrine treatment, tamoxifen and the third generation aromatase inhibitors has the similar poor efficacy. The treatment strategy for such patients should prefer chemotherapy alone or in combination with trastuzumab, and endocrine therapy combining with trastuzumab may be the development strategy.

Taxol is one of the most active agent in metastatic breast cancer. Taxol is also an excellent choice for combination therapy by its unique mechanism of action and favorable toxicity profile. Numerous phase II clinical studies have combined taxol with other active agents such as the anthracyclines, gemcitabine, carboplatin and Herceptin. In the adjuvant chemotherapy for early stage breast cancer, two large international clinical trials demonstrated the role of taxol in early breast cancer. CALGB 9344 demonstrated the addition of four cycles of taxol after the completion of a standard course of CA improves the disease-free and overall survival of patients with early breast cancer. CALGB 9741 showed dose density chemotherapy of taxol improves clinical outcomes significantly, while sequential chemotherapy is as effective as concurrent chemotherapty.

Metastatic breast cancer (MBC) is a heterogeneous disease that has a variety of different clinical scenarios. There are few recognized therapeutic standards for MBC. Combining recent international guidelines and consensus recommendations with our clinical practice experience, the article will introduce and comment many sides about the treatment for MBC patients.

Cardiotoxicity associated with anthracyclines and trastuzumab is discussed from clinical manifestations, pathogenesis, risk factors, monitoring methods, prevention and treatment.

Anti-angiogenesis drug has become an important method and a hot research field for treating cancers.Drugs such as bevacizumab,sunitinib,sorafenib,lapatinib,achieved good clinical effect in treating breast cancers,but they also brought a lot of problems that need to be concerned.

Objective To detect the mutation frequency and mutation type of tumor suppressor PTEN in sporadic breast carcinoma tissues, and to investigate the association of PTEN gene mutation and sporadic breast cancer. Methods Polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) was used to amplify 9 exons of PTEN and to analyze the conformation polymorphism, then DNA sequencing methods was used to detect point mutation of PTEN gene nine exons of abnormal single strand conformation in breast carcinoma. Results One of 45 cases showed 24th condon A→C missense mutation in the exon2 of PTEN gene, and this mutation made Met to change to Ala in PTEN protein structure. Conclusion These data indicated the existence of PTEN mutation in sporadic breast cancer, but PTEN gene mutation rate is very low.

Objective To investigate the expression of tumor suppressor gene PTEN in breast carcinomas and its significance. Methods Immunohistochemical method was used to detect the expression of PTEN gene in 146 cases of breast carcinoma and 10 specimens of normal breast tissue closely adjacent to carcinoma. Results It was showed that PTEN gene was expressed in all 10 specimens of breast tissue closely adjacent to carcinoma. Expression of PTEN was localized in cytoplasm and nuclei of epithelial cells of lobular acini and epithelial cells of ducts. The rate of PTEN expression was 57.5% (84/146) in breast carcinoma. Expression of PTEN was related to tumor size, pathological stage, and the expression of ER and PR of breast cancer. The 2-year disease free survival of PTEN high expression breast cancer patients was superior to those with low expression (P

Objective To analysis the relationships between bone markers, bone-specific alkaline phosphatase (BAP) and cross-linked telopeptide of type Ⅰ collage (ICTP), and bone metastasis of breast cancer.Methods A total of 217 patients' serum were collected.The 217 cases were divided into two groups:109 cases with bone metastasis, 108 cases without bone metastasis. Serum BAP and ICTP was measured by ELISA. The relationships between factors of bone metastasis and serum levels of BAP, ICTP were analyzed.Results The levels of serum BAP and ICTP in bone metastases group were significantly higher than those in non-bone metastasis group[BAP:24.8 μg/L(7.60-213.70 μg/L) vs 21.2 μg/L(7.3～68.8 μg/L),ICTP:7.0μg/L(1.4～32.4 μg/L) vs 4.1 μg/L(0.0～15.8 μg/L) (P=0.003,P=0.000)].The level of serum BAP and ICTP in patients with multiple bone metastasis was significantly higher than that in patients with single bone metastasis[BAP:32.3 μg/L(9.A～213.7 μg/L) vs 18.1 μg/L(7.6～60.0 μg/L),ICTP:7.6 μg/L(1.4～32.4 μg/L) vs 4.9 μg/L(1.8～10.5 μg/L),(P=0.001,P=0.010)].The sensibility of BAP and ICTP was 45.0 ％ (49/109)and 46.8 ％ (51/109),respectively.The specificity of ICTP and BAP was 83.3 ％ (90/108)and 84.3 ％ (91/108),respectively.Joint detection of BAP and ICTP had improved sensibility in the diagnosis of bone metastasis in breast cancer patients. Conclusion Joint detection of serum bone biochemical markers ICTP and BAP have a little values for diagnosing bone metastasis in breast cancer patients.

Objective To analyze the clinic characteristics, lifetime and prognostic factors of young female breast cancer patients. MethodsClinical data of 155 patients under 35 years of age with breast cancer were retrospectively reviewed and followed up.ResultsThe positive rate of hormone receptors was 61.6 % (77/125) in all cases who had been detected receptor status. The median survival time in hormone receptors positive and negative group were 119.0 and 51.3 months (P＜0.01), and 5-year survival rates were 68 % and 33 %, respectively. For patients who had been treated with adjuvant tamoxifen (47.1%), the median survival time was 182 months which longer than without tamoxifen (P ＜0.05). The median disease-free survival time and median survival time were 24 and 91 months in all cases. The overall 3-, 5- and 10-year survival rates were 79 %, 60 % and 51%, respectively. Multifactor analysis with the COX model indicated that tumor size, axillary metastatic status, tamoxifen treatment and overexpression of Her-2 were independent prognostic factors. While clinic stage and hormone receptors status might be referenced prognostic factors. ConclusionYoung women breast cancer patient may have good prognosis if multimodality treatment is conducted. Tumor size, axillary metastatic status, adjuvant endocrine therapy and overexpression of Her-2 are independent prognostic factors.

Aromatase inhibitors (AIs) directly applies to postmenopausal breast cancer patients. Patients underwent bilateral ovariectomy or ≥60 years were acknowledged as postmenopausal.Alternatively, for <60 years breast cancer patients, sex hormone detection to evaluate menopause is recommended by National Comprehensive Cancer Network (NCCN) guideline, textbooks, and AIs clinical trials.However, series of clinical trial found that, a broad overlap region of follicle stimulating hormone and estradiol appeared between premenopausal and postmenopausal patients, which unable to determine the menopause even with sensitivity promotion of detection equipment or manners.We have abandon this detection in clinical treatment, and decision making was only according to the relapse risk and disease status. We recommend bilateral ovariectomy resection accompanied with AIs for breast cancer patients with high recurrence risk (e.g. T3-4 or LNM≥4) or patients with advanced metastatic disease.However, patients with low or moderate recurrence risk can be treated with tamoxifen.