Living Beyond Breast Cancer Liver and Lung Metastases Workshop - PowerPoint PPT Presentation

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Living Beyond Breast Cancer Liver and Lung Metastases Workshop PowerPoint Presentation
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Living Beyond Breast Cancer Liver and Lung Metastases Workshop

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Living Beyond Breast Cancer Liver and Lung Metastases Workshop

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  1. Living Beyond Breast Cancer Liver and Lung Metastases Workshop April 29, 2012 Paul B. Gilman, MD Lankenau Medical Center

  2. Recurrence • Local • Regional • Distant LBBC/04.29.2012

  3. Distant Metastasis • Soft-tissue • Bone • Visceral LBBC/04.29.2012

  4. Visceral Metastasis • Liver • Lung LBBC/04.29.2012

  5. Presentation of Liver/Lung Metastases • Symptomatic • Incidental finding on physical exam • Incidental finding on imaging • Laboratory studies LBBC/04.29.2012


  6. Liver MetastasisSymptoms • Nausea, anorexia, weight loss • Pain • Jaundice • Fever LBBC/04.29.2012

  7. Liver Metastasis Laboratory Evaluation • Liver function tests • Blood counts • Coagulation tests • Tumor markers LBBC/04.29.2012

  8. Liver Metastasis Imaging Evaluation • Ultrasound • CT Scan • MRI • PET-CT LBBC/04.29.2012

  9. Lung MetastasisSymptoms • Dyspnea • Cough, hemoptysis • Pain LBBC/04.29.2012

  10. Lung MetastasisLaboratory Evaluations • Sputum analysis • Tumor markers • Pulmonary Function Testing LBBC/04.29.2012

  11. Lung MetastasisImaging Evaluations • Chest x-ray • CT Scan • PET-CT LBBC/04.29.2012

  12. Diagnosis • Clinical • Laboratory • Radiologic • Pathologic LBBC/04.29.2012

  13. BiopsyTissue Diagnosis • Needle Biopsy • FNA • Core • Surgical Biopsy • Endoscopic (ultrasound) • US-guided • CT-guided LBBC/04.29.2012

  14. Biopsy Analysis • Tissue of origin • Hormone receptors • HER-2 • Biomarkers (investigational) LBBC/04.29.2012

  15. Treatment Goals • Palliation (Symptoms, QOL) • Organ Function • Improved Survival (chronic disease) LBBC/04.29.2012

  16. Treatment Objectives • Response vs. Stable (clinical benefits) • Disease Free Survival vs. Overall Survival • Toxicity LBBC/04.29.2012

  17. Treatment Approaches • Lines of Therapy (First-line, etc.) • Sequential • Combination • “Maintenance” • Investigational LBBC/04.29.2012

  18. Treatment • Local • Ablation (cryo, radiofrequency) • Radiation (external beam, brachytherapy) • Surgery • Systemic • Hormonal therapy • Chemotherapy • Targeted Therapies LBBC/04.29.2012

  19. Clinical Trials • Response • Time to Progression • Progression-Free Survival • Overall Survival • Quality of Life LBBC/04.29.2012