More women are having normal life expectancies after the adjuvant treatment of breast cancer and are currently faced with issues heretofore neglected. Fatigue seems to be an important component of toxicity from adjuvant chemotherapy and may be a substantial cause of long-term morbidity following therapy. Drs Paul Jacobsen and Kevin Stein present an interesting perspective on the problem of long-term fatigue after treatment of breast cancer. Why women experience such fatigue months to years following chemotherapy treatment remains to be determined. If some of the causes of fatigue could be identified, then developments in prevention could be initiated.
Several questions regarding fatigue remain unanswered.
Future research will address such issues and help to clarify this poorly understood topic. Dr Elisabeth Dupont and associates review the controversies concerning grading and staging this disease, and they provide the evidence that directs our modern management guidelines. They also describe the type of DCIS that is most likely to be associated with lymph node metastasis if the sentinel node technique and cytokeratin staining is used. Finally, they present the data that show that tamoxifen may have a role for some patients with this highly curable disease. Young women diagnosed with breast cancer have yet another challenging issue to consider following treatment of early-stage disease.