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1.  Side Effects of Standard Adjuvant and Neoadjuvant Chemotherapy Regimens According to Age Groups in Primary Breast Cancer 
Breast Care  2013;8(1):60-66.
Elderly breast cancer patients are underrepresented in clinical trials and this leads to a lack of knowledge regarding the tolerance and side effects of modern chemotherapy regimens, especially in dose-dense (dd) or dose-intensified combination.
Patients and Methods
In this analysis, data from 4 German, randomized (neo-)adjuvant trials, including anthracycline-based chemotherapy, were evaluated for toxicity, compliance and feasibility. Patients were grouped according to age.
Of the 4,775 patients, 73.6% were < 60 years, 15.8% were 60–64 years and 10.6% were > 64 years. The patients’ compliance decreased with increasing age, the rate of therapy discontinuations was 10.3%; 16.0% were > 64 years old (p < 0.001). The rate of dose reductions also increased with increasing age in the docetaxel/doxorubicin/cyclophosphamide (TAC) (p overall = 0.02) and 5-fluorouracil/epirubicin-cyclophosphamide (FE120C) (p overall < 0.001) treatment groups. Neutropenia grade 3 + 4 in patients of > 64 years was 77% in FE120C- compared to 55% in TAC-treated patients (with primary granulocyte colony-stimulating factors (G-CSFs)). The incidence of febrile neutropenia (FN) was lowest in the regimens without additional taxanes. FN in patients aged > 64 years was lower in the FE120C- than in TAC-and dd-doxorubicin/docetaxel-treated groups.
The range and intensity of toxicity increased with age. Neutropenia did not increase significantly in the dd groups; the highest rate was seen in FE120C-treated patients. FE120C without G-CSFs is not an option in patients older than 64 years.
PMCID: PMC3971817  PMID: 24715845
Elderly; Chemotherapy; Side effect; Tolerability; Breast cancer
2.  Breast Cancer Proteomics – Differences in Protein Expression between Estrogen Receptor-Positive and -Negative Tumors Identified by Tandem Mass Tag Technology 
Breast Care  2010;5(1):7-10.
Proteomic analysis has become an effective tool in breast cancer research. In this study, we applied the new gel-free tandem mass tag (TMT) reference method for the first time in breast cancer.
Materials and Methods
Proteomic analysis was used to compare 10 estrogen receptor (ER)-positive and 10 ER-negative samples. The results of the proteomic approach were validated by Western blot, immunohistochemistry and gene expression analysis.
17 proteins with significant differences in expression were identified. 13 proteins were overexpressed in ER-negative tumors and 4 were overexpressed in ER-positive samples. All these proteins were characterized by relatively high cellular abundance.
Our results demonstrate that the gel-free TMT approach allows the quantification of differences in protein expression levels. Further improvement of the sensitivity by subfractionation of the tissue should allow also the identification of low-abundance proteins and might lead to the use of this method in breast cancer research.
PMCID: PMC3357159  PMID: 22619634
Proteomics; Tandem mass tags; Breast cancer; Estrogen receptor
3.  Zurich Consensus: German Expert Opinion on the St. Gallen Votes on 15 March 2009 (11th International Conference at St. Gallen: Primary Therapy of Early Breast Cancer) 
Breast Care  2009;4(2):109-116.
A German working group of 23 breast cancer experts discussed the results from the vote at this year's St. Gallen Consensus Conference on Primary Therapy for Early Breast Cancer (March 11–14, 2009) and came up with some concrete recommendations for day-to-day therapeutic decisions in Germany. Due the fact that the concept of the St. Gallen Consensus Conference merely allows for a minimal consensus, the objective of the working group was to provide practice-related recommendations for day-to-day clinical decisions in Germany. One area of emphasis at St. Gallen was tumor biology as a starting point for reaching individual therapeutic decisions. Intensive discussion was necessary with respect to the clinical relevance of predictive and prognostic factors. A new addition to the area of systemic therapy was a first-ever discussion of the adjuvant administration of bisphosponates and the fact that therapy with trastuzumab in HER2 overexpressing breast cancer has been defined as the standard for neoadjuvant therapy. The value of taxanes as a component of (neo)adjuvant chemotherapy as well as the value of aromatase inhibitors for the endocrine adjuvant treatment of postmenopausal patients were affirmed.
PMCID: PMC2931071  PMID: 21049070
4.  Guidelines – Inflation or Help in Clinical Routine? 
Breast Care  2008;3(2):80-81.
PMCID: PMC2931079  PMID: 21373208
5.  Adjuvant Consensus: A Breast Cancer Patient Web Tool 
Breast Care  2008;3(2):114-117.
The new web tool Adjuvant Consensus gives the user access to the most recent information on how world leading experts suggest to treat a specific breast cancer with systemic therapy. By entering tumor characteristics, age, and menopausal status, the user can find out what experts and national guidelines suggest for this specific tumor. The basis for the suggested treatment options and guidelines are coming from 2 world leading resources: They reflect the reached expert consensus on the implications of evidence for patient treatment selection at the world leading consensus conference on adjuvant therapy held regularly in St. Gallen, and the ‘Clinical Practice Guidelines in Oncology’ for breast cancer published in the US by the National Cancer Center Network in January 2007. The calculated treatment options include the suggested systemic treatment — chemotherapy, hormonal therapy, and antibody therapy, alone or in combination — and the duration and sequence of therapy. Furthermore, the user can find information on the mode of action and important side effects of the different drugs.
PMCID: PMC2931085  PMID: 21373214
Breast cancer; Internet; Counseling

Results 1-5 (5)