OVERVIEW OF ACTIVITY
Historically, surgery has been the primary mode of treatment for early breast cancer. The diagnostic, surgical and medical management of breast cancer, however, has escalated in complexity because of numerous advances in novel technologies and available adjunctive medical therapies. Hence, the multifaceted treatment of breast cancer now requires the input of an interdisciplinary group of expert care providers. This paradigm shift has created the challenge of ensuring that major clinical advances in local and systemic breast cancer therapy are effectively disseminated among all members of the cross-functional team. To bridge the gap between research and patient care, Breast Cancer Update for Surgeons uses one-on-one interviews with leading breast cancer investigators to efficiently distill the latest research developments in the field so that they may be incorporated into clinical practice where appropriate. By providing access to the latest data and expert perspectives, this CME program assists breast surgeons in the formulation of up-to-date clinical management strategies.

LEARNING OBJECTIVES

• Critically appraise and develop an evidence-based approach to the management of the axilla in carefully selected patients with localized breast cancer and a positive sentinel lymph node biopsy.
• Adopt criteria for the selection of patients who can safely be considered for nipple-sparing mastectomy.
• Determine the utility of genomic assays in counseling patients with DCIS or ER-positive early breast cancer about their risk of developing invasive disease or recurrence and the potential benefits of radiation therapy or adjuvant chemotherapy, respectively.
• Evaluate recently presented data supporting the extended use of adjuvant tamoxifen beyond 5 years for patients with ER-positive early breast cancer, and, where appropriate, integrate these findings into clinical practice.
• Counsel appropriately selected patients with breast cancer about participation in ongoing clinical trials.

ACCREDITATION STATEMENT
Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CME credit is no longer available for this issue

CREDIT DESIGNATION STATEMENT

CME credit is no longer available for this issue

HOW TO USE THIS CME ACTIVITY
This CME activity contains an audio component. To receive credit, the participant should listen to the audio MP3s.

CME credit is no longer available for this issue

CONTENT VALIDATION AND DISCLOSURES
Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education. We assess potential conflicts of interest with faculty, planners and managers of CME activities. Real or apparent conflicts of interest are identified and resolved through a conflict of interest resolution process. In addition, all activity content is reviewed by both a member of the RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

FACULTY — Dr Wolmark had no real or apparent conflicts of interest to disclose. The following faculty (and their spouses/partners) reported real or apparent conflicts of interest, which have been resolved through a conflict of interest resolution process: Dr Borgen — Advisory Committee and Consulting Agreement: Genomic Health Inc. Dr Rugo — Contracted Research: Agensys Inc, a subsidiary of Astellas Pharma US, Amgen Inc, Eisai Inc, Genentech BioOncology, GlaxoSmithKline, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, MacroGenics Inc, Merck, Novartis Pharmaceuticals Corporation, Plexxikon Inc; Speakers Bureau: Genomic Health Inc. Dr Willey — Advisory Committee and Speakers Bureau: Genomic Health Inc, Invuity Inc.

EDITOR — Dr Love is president and CEO of Research To Practice, which receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Algeta US, Allos Therapeutics, Amgen Inc, ArQule Inc, Astellas, Aveo Pharmaceuticals, Bayer HealthCare Pharmaceuticals, Biodesix Inc, Biogen Idec, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Daiichi Sankyo Inc, Dendreon Corporation, Eisai Inc, EMD Serono Inc, Foundation Medicine Inc, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Incyte Corporation, Lilly USA LLC, Medivation Inc, Merck, Millennium: The Takeda Oncology Company, Mundipharma International Limited, Novartis Pharmaceuticals Corporation, Onyx Pharmaceuticals Inc, Prometheus Laboratories Inc, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Spectrum Pharmaceuticals Inc and Teva Oncology.

RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and reviewers for Research To Practice have no real or apparent conflicts of interest to disclose.

This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantors.

This activity is supported by educational grants from Celgene Corporation, Genentech BioOncology and Prometheus Laboratories Inc.

Hardware/Software Requirements:
A high-speed Internet connection
A monitor set to 1280 x 1024 pixels or more
Internet Explorer 7 or later, Firefox 3.0 or later, Chrome, Safari 3.0 or later
Adobe Flash Player 10.2 plug-in or later
Adobe Acrobat Reader
(Optional) Sound card and speakers for audio
A high-speed Internet connection

Last review date: July 2013
Expiration date: July 2014