Research and understanding of the immune system,the development of methods to evaluate aspects of the immune response,and ongoing development of monoclonal antibodies are transforming the field of immunotherapy and breast cancer treatment.The ability for a breast cancer to bind with estrogen and progesterone identifies a patient with a hormone-dependent tumor.An alternative therapy for a patent who might not be able to receive trastuzumab (Herceptin)or lapatinib,which targets epidermal growth factor,would be:

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According to a meta-analysis undertaken by Rebbeck and colleagues (Rebbeck TR et al,Natl Cancer Inst 101[2]:80-87,2008),prophylactic salpingo-oophorectomy reduces the risk for breast cancer by 50% and the risk for ovarian and fallopian tube cancer by 80% in women who carry mutations in the BRCA1 or BRCA2 gene.Trastuzumab (Herceptin)is a recombinant humanized immunoglobulin B (IgB)monoclonal antibody that targets the extracellular domain of HER-2.Trastuzumab interferes with the many steps in the tumor cell cycle and sensitizes HER-2-positive cancers to other cytotoxic therapies.One agent is lapatinib,which targets epidermal growth factor and HER-2.Another therapy can be offered by aromatase inhibitors (AIs).These may be nonsteroidal,such as anastrozole and letrozole.Aromatase inhibitors are only effective in postmenopausal women.They appear to work better than tamoxifen on certain breast cancers,with fewer side effects.

Research and Understanding of the Immune System,the Development of Methods