Cilt 12 / No:1 - 2 / Ocak - Şubat 1999

Meme Kanseri Özel Sayısı

PREFACE
Taner Demirer

MEME KANSERLERİNİN HİSTOPATOLOJİK ÖZELLİKLERİ
Serpil Dizbay Sak

MEME KANSERLERİNİN ERKEN TANISINDA RADYOLOJİK YÖNTEMLERİN ÖNEMİ
Selma Tükel

BENİGN MEME HASTALIKLARINA YAKLAŞIM, TANI VE TEDAVİ
Özgür Özyılkan

ERKEN EVRE MEME KANSERİNDE KEMOTERAPİ
Nil Molinas Mandel

EVRE II MEME KANSERİNDE KONVANSİYONEL TEDAVİ VE TAKİP PRENSİPLERİ
Ali Aydın Yavuz, Fazıl Aydın, Melek Nur Yavuz

EVRE III VE İNFLAMATUVAR MEME KANSERLERİNİN KONVANSİYONEL TEDAVİSİ
E. Gökhan Kandemir, Necdet Üskent

PREMENOPOZAL METASTATİK MEME KANSERİNDE KONVANSİYONEL TEDAVİLER VE TAKİP PRENSİPLERİ
Nazan Günel

POSTMENOPOZAL METASTATİK (EVRE IV) MEME KANSERLERİNİN KONVANSİYONEL TEDAVİSİ VE TAKİP PRENSİPLERİ
Nilüfer Güler

MEME KANSERLERİDE YÜKSEK DOZ KEMOTERAPİ VE OTOLOG KÖK HÜCRE NAKLİ
Fikret Arpacı



PREFACE
Taner Demirer

Breast cancer is one of the most common malignancies mainly affecting the female gender between 40-70 years old. Breast cancer is the second only to lung cancer regarding death rate and most common of the solid tumors among women in the USA. The incidence of breast cancer is approximately 15/100.000 in our country. Therefore, women have to be well informed about breast cancer in which an early diagnosis is very important for a successful outcome. Last decade, there have been very important progress regarding supportive care and conventional chemotherapy of breast cancer and this has improved survival rates of these patients remarkably. We wanted to inform and update our general practitioners and clinicians about the recent advances and approach in the treatment of patients with breast cancer in this special issue of “Journal of Klinik Gelişim”.
I have tried to give a special attention over the histopathology of breast cancer in this issue. Grade, histopathologic types and terminology are frequently causing confusions among practising physicians. Therefore, a chapter about histo and clinicopathology has been written by Dr. Serpil Dizbay Sak in this issue. Many women are frequently seeking a medical attention for benign breast diseases in every hospital. Therefore, differential diagnosis and approach to benign breast diseases are very important. This chapter has been written by Dr. Özgür Özyılkan. As you know, we have somehow consensus for the treatment of different stages of breast cancer. Approach and treatment may differ from stage to stage and some individuals may be treated with different modalities based on the patient and disease characteristics. Therefore, in this special issue, stage I, II and III (and inflammatory) breast cancers have been reviewed by Drs Nil Molinas Mandel, Fazıl Aydın, and Necdet İskent, respectively.
To date, there is no cürative treatment for stage IV (metastatic) breast cancer. It will still be a challenging disease in the 21st century. Clinical approaches for evaluation and treatment of pre-menopausal and post-menopausal metastatic breast cancer are somehow different.Therefore, in this issue, pre and post menopausal metastatic breast cancers have been written by Drs. Nazan Günel and Nilüfer Güler as a separate chapters. I think, review of pre-menopausal and post-menopausal metastatic breast cancer as independent chapters will minimize confusions among practising physicians and provide a better understanding of this stage of disease.
As you know, there has been fair amount of progression in regard to treatment of high-risk (stage II, III) primary breast cancer and early stage metastatic breast cancer with high-dose chemotherapy (HDC) and autologous peripheral blood stem cell transplantation (APBSCT). Over last 10 years, several single arm studies investigating the efficacy of HDC and APBSCT in this setting have been completed and several ongoing randomized studies, hopefully, will be completed soon. Based on the single arm non-randomized studies which were conducted in the USA, disease- free survival (DFS), at 5 years, of high risk stage II breast cancer patients who had a HDC and APBSCT was approximately 70-75%. This would be at best 40-45% with conventional chemotherapy. Again, DFS at 5 years in patients with stage III and inflammatory breast cancer who had a HDC and APBSCT was 60-65%. This would be at best 30-35% with conventional chemotherapy. One can also provide a better overall survival for early stage metastatic breast cancer patients by using a HDC + APBSCT. Stage IV metastatic breast cancer patients who had a complete remission with initial chemotherapies and followed by had a HDC + APBSCT may enjoy a 25-35% DFS at 5 years. Based on these data, HDC + APBSCT is a promising modality and most likely will be used frequently for some subset of patients (high risk stage II, III and inflammatory breast cancers, ER-PR receptor negative, and high S phase) after completion of randomized studies. Therefore, HDC and APBSCT is a hot topic for last several years and this chapter has been written by Dr. Fikret Arpacı. Dr. Arpacı will focus on the indications and overall outcome of HDC + APBSCT in patients with breast cancer.
I hope this special issue of “Journal of Klinik Gelişim” for breast cancer will meet the requirements and answer some questions of our practising physicians and will be a nice as well as handy resource.