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STAGE IV - Breast Carcinoma

STAGE I V - BREAST CARCINOMA
THERAPEUTIC OPTIONS

BREAST CARCINOMA STAGE IV (Advanced)
TMN Classification	T4NO-3M0 T1-4N3M0
Cell Type	All
Description	Any Tumor Size with or without Lymph Node Metastasis with Distant Metastasis (Liver,Bone,Brain,etc.)

LOCAL/SURGICAL MANAGEMENT

Mandatory Surgical Maneuver : FNA or Incisional Biopsy Only
Reference Studies:	Need ER-PR Status of tumor

Therapeutic Options for Local Palliation / Control: Surgery and External Beam Radiation
Reference Studies:	Local control and bone and visceral metastasis

SYSTEMIC TREATMENT: CHEMOTHERAPEUTIC & HORMONAL PROTOCOLS

RECOMMENDATION FOR STAGE IV ER/PR POSITIVE
TMN Classification	T0-4N0-3M1
Description	Any Tumor Size with or without Lymph Node Metastasis and Distant Metastasis
Recommendation	FOR BONE DISEASE ONLY: RECOMMEND HORMONAL THERAPY ONLY FOR VISCERAL INVOLVEMENT (i.e. BRAIN,LIVER,LUNG, ETC.): RECOMMEND CHEMOTHERAPY INITIALLY IF PATIENT CAN TOLERATE; OTHERWISE RECOMMEND HORMONAL THERAPY
RECOMMENDED HORMONAL PROTOCOLS
OOPHORECTOMY		TAMOXIFEN	ARIMEDEX
RECOMMENDED CHEMOTHERAPEUTIC PROTOCOLS
CLICK ON EACH PROTOCOL FOR DETAILED INFORMATION	ADRIAMYCIN CYTOXAN & TAMOXIFEN aka: AC-T	CYTOXAN METHOTREXATE 5FU & TAMOXIFEN aka: CMF-T	ORAL CYTOXAN METHOTREXATE 5FU & TAMOXIFEN aka: Classic CMF-T	5FU ADRIAMYCIN CYTOXAN & TAMOXIFEN aka: FAC-T
NOTE:

RECOMMENDATION FOR STAGE IV ER/PR NEGATIVE
TMN Classification		T0-4N0-3M1
Description		Any Tumor Size with or without Lymph Node Metastasis and Distant Metastasis
RECOMMENDED CHEMOTHERAPEUTIC PROTOCOLS
CYTOXAN METHOTHREXATE 5FU PREDNISONE aka: CMFP	CYTOXAN METHOTHREXATE 5FU VINCRISTINE PREDNISONE aka: CMFVP	ADRIAMYCIN CYTOXAN aka: AC	CYTOXAN METHOTREXATE 5FU aka: CMF	ORAL CYTOXAN METHOTREXATE 5FU aka: Classic CMF	5FU ADRIAMYCIN CYTOXAN aka: FAC

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