Women's health
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For the last 15 years, there has been a vigorous ongoing debate as to whether or not all conservatively treated patients with ductal carcinoma in situ (DCIS) require radiation therapy following excision or whether selected patients with DCIS can be treated by excision alone. At just about all breast cancer symposia where DCIS is discussed, experts are assigned to debate the pros and cons of radiation therapy after excision. The debate is often heated. This article outlines numerous reasons to consider excision alone in the treatment of selected DCIS patients.
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Evaluation of: Rasmussen BB, Regan MM, Lykkesfeldt AE et al.: Adjuvant letrozole versus tamoxifen according to centrally-assessed ERBB2 status for postmenopausal women with endocrine-responsive early breast cancer: supplementary results from the BIG 1-98 randomized trial. Lancet Oncol. 9, 23-28 (2008). This study analysed data after a median of 51 months follow-up from 4922 postmenopausal women with early hormone-sensitive breast cancer randomly assigned to 5 years of treatment with letrozole or tamoxifen. ⋯ By central assessment, 7% (257 of 3650) of tumors were classified as ErbB2-positive. Disease-free survival was significantly worse in patients with ErbB2-positive tumors (p < 0.0001). Letrozole improved disease-free survival compared with tamoxifen regardless of ErbB2 status.
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'Bioidentical hormones' is a term created by the lay media to refer to chemicals derived from plants that are modified to be structurally identical to endogenous human hormones. These compounds include estradiol, estrone, estriol, progesterone, testosterone and dehydroepiandrosterone when prescribed for menopausal women. ⋯ Proponents of this therapy also support the use of salivary hormone measurements to adjust doses of these hormones instead of adjustment based on improvement or lack of improvement in menopausal symptoms. In this review, the rationale behind the use of bioidentical hormones is discussed, along with the evidence supporting the use of compounded and FDA-approved bioidentical products.
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Ovarian cancer is a leading cause of gynecologic cancer death among women. Tumors diagnosed early (in stage I) have a cure rate approaching 90%. ⋯ New technology and research techniques have allowed the identification of over 100 possible tumor markers, many of which are still being evaluated for clinical relevance and several of which have entered clinical trials. Here, we review the methods of biomarker discovery, address the significance and functions of newly identified ovarian cancer tumor markers, and provide further insight into the future of ovarian cancer biomarkers.