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Abstract
Breast cancer represents one of the most common cancers among women residing in the United States and
World wide. (Jemal et al., 2005).
Available surgical methods include modified radical mastectomy and lumpectomy with axillary node surgery.
Results from prospective randomized trials have demonstrated that breast conserving treatment with lumpectomy or segmentectomy and radiotherapy
produce rates of disease free survival and over all survival equivalent to those of mastectomy. (Benda et
al., 2004) Prognostic factors may select patients most likely to recur without adjuvant therapy and therefore potentially benefit from therapy. In addition, predictive factors may identify the appropriate therapy for an
individual patient. (Cianfrocca & Goldstein, 2004) Concerns on the toxicity associated with the use of
adjuvant chemotherapy are reasonable. Most acute side effects (i.e., nausea, vomiting, alopecia, neutropenia)
resolve on completion of treatment. Longer-term side effects with hormonal therapy (small increase in risk of
second malignancies, thromboembolism), chemotherapy (i.e., cardiac disease), or a combination of tamoxifen and
chemotherapy need to be carefully considered on an individual patient basis. (Sledge GW et al., 2000)
On multivariate analysis, the tumor stage, the number of metastatic axillary lymph nodes and high
nuclear grade were thought to be the most important prognostic factors. (Kyoung et al., 2005) Younger patients <35 years old have a poor prognosis compared with older patients >50 years.
(Mirshahidi & Abraham, 2004)