Current and future directions in early breast cancer therapy

A growing proportion of women diagnosed with breast cancer present with earlier disease stages, and many will relapse and die from their disease. While survival rates are improving with the development of new systemic therapies, there is an urgency to improve treatment outcomes further in early breast cancer. Gene expression profiling is fundamentally changing our understanding of breast cancer biology at the molecular level. It is providing a refined classification of breast cancer and has reinforced the notion that breast cancer is a heterogeneous disease. This knowledge has great potential for a better selection of patients in need of adjuvant therapy, as well as for tailored treatment approaches. The use of new compounds, such as trastuzumab (Herceptin ®)and capecitabine, used in combination with established agents, also represent important advances. The development of both new technologies and novel agents will optimise systemic therapy for early stage breast cancer in the future.