Stage III breast cancer is a little more advanced. These are larger tumors, probably larger than a small apple, and in that situation, sometimes the tumor is large enough or growing fast enough that there's redness over the surface of the breast, or the tumor actually has invaded in the skin of the breast, and that's called stage III, or inflammatory breast cancer.
Metastatic breast cancer, or stage IV breast cancer, where breast cancer cells -- they look just like the breast, cancer cells that are from breast tissue -- are in other organs, like liver, lung or bone. In that situation, we currently don't appear to be curing that disease. That doesn't mean that we can't help people to live longer and have better quality of life. So our goal needs to be very clear for metastatic, advanced stage, stage IV breast cancer -- all those terms are used -- that what we're doing is preserving quality of life and quantity of life.
In contrast, when we're treating early stage breast cancer, our goal, of course, is to prevent the cancer from ever growing back, to cure the woman of the breast cancer so she doesn't recur and die of breast cancer someday. So for that goal we're willing to give a little bit more intensive treatment. As long as we can keep people relatively well, we're willing to have side effects such as hair loss or low blood counts, or even other side effects, such as nausea and vomiting, if we can control them and it's for a short period of time, like three to six months. We're gaining so much on the other end, that it appears worthwhile when you do those risk versus benefit analyses.
CATHY CONLEY: Dr. Muss, what's the role of anthracyclines in both the adjuvant and metastatic settings?
