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Living Beyond Breast Cancer Liver and Lung Metastases Workshop

Living Beyond Breast Cancer Liver and Lung Metastases Workshop. April 29, 2012. Paul B. Gilman, MD. Lankenau Medical Center. Recurrence. Local Regional Distant. LBBC/04.29.2012. Distant Metastasis. Soft-tissue Bone Visceral. LBBC/04.29.2012. Visceral Metastasis. Liver Lung.

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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

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