Managing high-risk breast cancer

OBJECTIVES: To identify breast cancer patients at high risk for recurrence. To describe current evidence for clinical management of early and locally advanced breast cancer and integrate this knowledge into nursing practice. DATA SOURCES: Articles, abstracts, and practice guidelines. CONCLUSION: Recent clinical trials have integrated the biology of breast cancer into individualized systemic therapy. Risk-adjusted treatment is driven by the addition of taxane therapy to systemic therapy, aromatase inhibitors, and trastuzumab into adjuvant therapy strategies. IMPLICATIONS FOR NURSING PRACTICE: The decision to initiate systemic adjuvant therapy requires knowledge of risk of relapse, integration of evidence from clinical trials, and facilitation of patient decision-making.