3. 3
Age adjusted female cancer incidence of Taiwan
Breast revealed a constant rising trend recently while comparing to other malignancies
Thyroid
Uterus
Stomach
Skin
Ovary
BreastBreast
ColonColon
LungLung
LiverLiver
CervixCervix
4. 4
Periodic breast cancer incidence of Taiwan 1981-2005
Female breast cancer increased in each age stratum, not so-called young-aged
only.
5. BREAST CANCER
Age-specific incidence (per 100,000)
Adapted from New Horizons in Cancer Management, SRI International.
IncidenceRatesIncidenceRates
20 25 30 35 40 45 50 55 60 65 70 75 80 85+
24 29 34 39 44 49 54 59 64 69 74 79 84
420
400
300
200
100
0
AgeAge
United
States
England
and Wales
Italy
France
Japan
58. 芳香環 抑制劑合併雙 酸鹽治療酶 磷芳香環 抑制劑合併雙 酸鹽治療酶 磷
提升預防乳癌遠端轉移及復發事件提升預防乳癌遠端轉移及復發事件
10
41
29
10
6
10
9
20
0
2
0
10
20
30
40
50
60
70
80
90
No ZOL ZOL
Death without prior recurrence
Secondary malignancy
Contralateral breast cancer
Distant recurrence
Locoregional recurrence
病人復發事件數,n
(n = 904) (n = 899)
荷爾蒙治療 vs 卓骨 合併祂 荷爾蒙治療
DFS = Disease-free survival; ITT = Intent-to-treat; ZOL = Zoledronic acid.
Gnant M, et al. Presented at: ASCO 2008. Chicago, IL. Abstract LBA4.
無先期復發之死亡
次發性惡性腫瘤
對側乳癌
間隔復發
局部復發
單獨治療 合併治療
降低復發
59. 預防性治療的選擇預防性治療的選擇
適當調整生活型態並輔以 片與維生素鈣
D
建議治療方式 :
乳癌 : 每 6 個月以 4 mg Zoledronic acid
注射治療
或其他雙 酸鹽治療方法磷
Osteoporos Int (2007) 18:1439–1450
Management of cancer treatment-induced bone loss in early
breast and prostate cancer - a consensus paper of the Belgian Bone Club
60. ONJ: Clinical DescriptionONJ: Clinical Description
Clinical features of suspectedClinical features of suspected
ONJONJ
Exposed bone in maxillofacialExposed bone in maxillofacial
area that occurs in associationarea that occurs in association
with dental surgery or occurswith dental surgery or occurs
spontaneously, with no evidencespontaneously, with no evidence
of healingof healing
Working diagnosis of ONJWorking diagnosis of ONJ
No evidence of healing afterNo evidence of healing after
6 wks of appropriate evaluation6 wks of appropriate evaluation
and dental careand dental care
No evidence of metastaticNo evidence of metastatic
disease in the jaw ordisease in the jaw or
osteoradionecrosisosteoradionecrosis
Weitzman R, et al. Crit Rev Oncol Hematol. 2007;62:148-152.
2. Breast Cancer: Age-Specific Incidence (per 100,000) Age is the most important risk factor for breast cancer. In the US, a 60-year-old white woman is 14 times as likely to develop breast cancer in a single year than a 30-year-old white woman. Two thirds of all breast cancer cases occur after menopause.
Now, osteonecrosis of the jaw is defined as exposed bone in the maxillofacial area that occurs in association with dental surgery or occurs spontaneously with no evidence of healing at 6-8 weeks. You have to make sure these patients of course don’t have metastatic bone disease like myeloma in their jaw, which is not unusual sometimes, and it’s got to be distinguished from osteoradionecrosis in patients who’ve had radiation therapy to the jaw.
