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Breast Cancer

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With breast cancer so often in the news, it is easy to forget that the diagnosis is an emotional and life-changing event for an individual patient. In the United States (US), an estimated 231,840 women and 2,350 men1 were diagnosed with invasive breast cancer in 2015. One in every 8 women in the US will be diagnosed with breast cancer during her lifetime. In contrast, a man’s lifetime risk is about 1 in 1000. Following skin cancer, breast cancer is the most commonly diagnosed cancer among women. During recent years, the incidence of breast cancer has been stable for Caucasian women; however, it has increased slightly for African-American women, due in part to longer life expectancy and improved screening and detection. Because of earlier detection and improved treatment, the death rate for breast cancer in the US has declined since 19891; however, it is still the second leading cause of cancer death in women, after lung cancer. In 2015, an estimated 40,290 women will die from breast cancer.

Over the past decade, the treatment options for breast cancer have expanded, especially for advanced disease. One area of progress that has made an impact in the community setting is the development of new oral medications for advanced disease.

This issue provides an overview of breast cancer in women, with a focus on the use of newer,

oral agents for the treatment of advanced disease

. Along with surgery, radiation, chemotherapy, and hormonal (anti-estrogen) therapy, the use of targeted agents has become routine in the fight against breast cancer.

Healthcare providers, including pharmacists

, have an obligation to be well informed about these agents – especially the oral drugs – in order to adequately support patients in the community setting.


Publication Date: 12/20/2015
Expiration Date: 12/20/2018
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.


Ashton Hullett, PharmD, Clinical Pharmacist (Oncology), NorthShore University HealthSystem Kellogg Cancer Center;
Cheryl Jee, PharmD, BCOP, Oncology Pharmacist, NorthShore University HealthSystem Kellogg Outpatient Pharmacy; and
Kathryn Schiavo, PharmD, Pharmacy Manager for the NorthShore University HealthSystem Kellogg Outpatient Pharmacy in Illinois.

Disclosure Statement

Dr. Ashton Hullett, Dr. Cheryl Jee, and Dr.Kathryn Schiavo report no financial or personal relationship with any commercial interest producing, marketing, reselling, or distributing a product or service that appears in this issue.

Target Audience

This accredited program is targeted to pharmacists .

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Review the risk factors and screening for breast cancer. Discuss the importance of hormone receptor and HER2 status.
    2. Describe the roles of chemotherapy, targeted therapy, and hormonal therapy in breast cancer treatment. Describe treatment for risk reduction.
    3. List 4 classes of hormonal agents and discuss their adverse effects. Name the drug(s) in each class and state their indications and recommended doses.
    4. Identify the indications, doses, adverse effects, and precautions for the 3 oral targeted drugs and 1 oral chemotherapy agent. Counsel patients about taking them properly.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

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Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

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Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

ACPE Universal Activity Number: 0428-0000-15-013-H01-P

Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Chief Editor and CE Administrator

Terry M. Baker, PharmD

Managing Editor

Tracy Farnen, PharmD

Associate Editors

James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor

Gerard Hatheway, PharmD, PhD

Editorial Advisors

Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners

Emily K.
Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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