References:

NP/ONCO/1505/0011

Breast cancer.org [online]. Available from: http://www.breastcancer.org/symptoms/diagnosis/staging.jsp [Accessed May 2015].World Health Organization [online].Available from: http://publications.cancerresearchuk.org/downloads/product/CS_REPORT_WORLD.pdf [Accessed May 2015].Howlader N, et al. [online]. Available from: http://seer.cancer.gov/csr/1975_2011/ [Accessed May 2015].Cardoso F, et al. Ann Oncol 2012;23 Suppl 7:vii11-9.Gianni L, et al. Lancet Oncol 2011;12:236-244.Perez E, et al. J Clin Oncol 2011;29,25:3366-73.Piccart-Gebhart M, et al. N. Engl. J. Med 2005;353:1659-72.Romond E, et al. N. Engl. J. Med 2005;353,16:1673-84.Slamon D, et al. N. Engl. J. Med 2011;365,14:1273-1283.Smith I, et al. Lancet 2007;369:29–36.Early Breast Cancer Trialists' Collaborative Group. Lancet 2005;365(9472):1687-717.Gianni L, et al. Lancet Oncol 2014;15,6:640-7.

1.2.

3.4.5.6.7.8.9.10.11.12.

Understandingearly breast cancer

The aim of treating eBC is to prevent the disease from returning or reaching an

advanced and incurable stage

Patients with eBC can be given therapies before and/or after surgery to reduce the size of the tumour and to prevent the cancer from returning

Bringing new treatments to patients with eBC can take a long time

Early breast cancer (eBC) refers to cancer that is confined to the breast i.e. it has not ‘metastasised’ or spread to other parts of the body1

Approximately 1.67 million new cases of breast cancer are diagnosed annually worldwide. The majority of these cases are identified in the early stages of the disease.2,3,4

RADIOTHERAPY CHEMOTHERAPYHORMONAL

THERAPYTARGETEDTHERAPIES

Treatment given before surgery may be referred to as ‘neoadjuvant’ therapy. This treatment aims to reduce the size of the tumour

Treatment after surgery is referred to as ‘adjuvant’ therapy. This treatment aims to kill any remaining cancer cells and prevent the cancer from returning

SURGERYNEOADJUVANT ADJUVANT

Even with current treatment options, almost a third of patients first diagnosed with eBC will go on to develop advanced disease, at which point it becomes incurable11

When breast cancer is diagnosed and treated in the early setting it is potentially curable5-10

EARLY STAGEBREAST CANCER

ADVANCED STAGEBREAST CANCER

Removal of the tumour through surgery is a mainstay of treatment but other treatment options may include:

Novel endpoints like pCR may help bring more effective medicines to patients faster

pCR stands for pathological complete response and means that the patient responded so well to neoadjuvant treatment that there is no tumour tissue that can be detected at the time of surgery in the affected breast +/- local lymph nodes

It has been suggested that achieving pCR in the neoadjuvant setting, followed by a one year course of adjuvant treatment, may be associated with longer-term improvements in patient outcomes12

pCR can be assessed within months rather than years,providing an early indication of how well a medicine works

‘Disease-free survival (DFS)’ is a common endpoint used to assess whether a cancer medicine works in eBC. However, it can take years to demonstrate DFS. This means it can take a long time to approve a medicine and get it to patients