Small tumors are good, or good tumors are small?

The above is an abbreviation of the title of a New England Journal of Medicine (N Engl J Med 2017; 376:2286-91), in this article, the authors discuss identification of a group of tumors that are composed of predominantly overdiagnosed tumors. In order to be clear, I have to start with few definitions.

Overdiagnosis refer to tumors dectected on screening that never would have led to clinical symptoms.

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HER2-Positive Metastatic Breast Cancer

HER2, or human epidermal growth factor 2, is a special protein (receptor) on the surface breast cancer cells, and it controls the growth of the cancer cells. The HER2 protein is present as a result of overexpression or amplification of the oncogene ERBB2. A tumor is considered HER2 positive by either the presence of HER2 protein presence and/or the overexpression of HER2 gene (the ERBB2). HER2 positive tumors are considered aggressive and have a tendency to recur, however, there are newer medications targeting HER2-positive cancer and led to significant improvement in outcome. 15% to 20% of all invasive breast cancer is reported to be HER2 positive. In this post, I will discuss the treatment of metastatic HER2 positive disease only, the nonmetastatic disease will be presented at a later date.

her2 testing must be done on biopsy material of metastatic site in all patients.

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Management of Breast Cancer in the Elderly

Elderly breast cancer is rising. Increasing age is considered a risk factor for developing breast cancer. With older age generally defined as age ≥65, it estimated that nearly half of all new breast cancer diagnosis occurring in such age group.

Multiple studies documented that elderly breast cancer patients are treated differently.

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Exercise and Breast Cancer

Exercise benefits in patients diagnosed with cancer are perhaps the least controversial subject in oncology yet it remains to be the most underutilized tool in the management of cancer patients. In this post, I will review recent publications showing the benefits of exercise in cancer patients in general and in breast cancer patients in particular. I will also attempt to provide practical recommendations for patients and clinicians to promote the idea of utilizing physical exercise.

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