Skip to main content
Erschienen in: Breast Cancer Research and Treatment 3/2016

21.10.2016 | Epidemiology

Use of complementary and alternative medicine and breast cancer survival in the Health, Eating, Activity, and Lifestyle Study

verfasst von: Marian L. Neuhouser, Ashley Wilder Smith, Stephanie M. George, James T. Gibson, Kathy B. Baumgartner, Richard Baumgartner, Catherine Duggan, Leslie Bernstein, Anne McTiernan, Rachel Ballard

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 3/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Use of complementary and alternative medicine (CAM) is common among breast cancer patients, but less is known about whether CAM influences breast cancer survival.

Methods

Health Eating, Activity, and Lifestyle (HEAL) Study participants (n = 707) were diagnosed with stage I–IIIA breast cancer. Participants completed a 30-month post-diagnosis interview including questions on CAM use (natural products such as dietary and botanical supplements, alternative health practices, and alternative medical systems), weight, physical activity, and comorbidities. Outcomes were breast cancer-specific and total mortality, which were ascertained from the Surveillance Epidemiology and End Results registries in Western Washington, Los Angeles County, and New Mexico. Cox proportional hazards regression models were fit to data to estimate hazard ratios (HR) and 95 % confidence intervals (CI) for mortality. Models were adjusted for potential confounding by sociodemographic, health, and cancer-related factors.

Results

Among 707 participants, 70 breast cancer-specific deaths and 149 total deaths were reported. 60.2 % of participants reported CAM use post-diagnosis. The most common CAM were natural products (51 %) including plant-based estrogenic supplements (42 %). Manipulative and body-based practices and alternative medical systems were used by 27 and 13 % of participants, respectively. No associations were observed between CAM use and breast cancer-specific (HR 1.04, 95 % CI 0.61–1.76) or total mortality (HR 0.91, 95 % CI 0.63–1.29).

Conclusion

Complementary and alternative medicine use was not associated with breast cancer-specific mortality or total mortality. Randomized controlled trials may be needed to definitively test whether there is harm or benefit from the types of CAM assessed in HEAL in relation to mortality outcomes in breast cancer survivors.
Literatur
1.
2.
Zurück zum Zitat Demark-Wahnefried W, Clipp EC, Lipkus IM et al (2007) Main outcomes of the FRESH START trial: a sequentially tailored, diet and exercise mailed print intervention among breast and prostate cancer survivors. J Clin Oncol 25(19):2709–2718CrossRefPubMed Demark-Wahnefried W, Clipp EC, Lipkus IM et al (2007) Main outcomes of the FRESH START trial: a sequentially tailored, diet and exercise mailed print intervention among breast and prostate cancer survivors. J Clin Oncol 25(19):2709–2718CrossRefPubMed
3.
Zurück zum Zitat Patterson RE, Neuhouser ML, Hedderson MM, Schwartz SM, Standish LJ, Bowen DJ (2003) Changes in diet, physical activity, and supplement use among adults diagnosed with cancer. J Am Diet Assoc 103(3):323–328PubMed Patterson RE, Neuhouser ML, Hedderson MM, Schwartz SM, Standish LJ, Bowen DJ (2003) Changes in diet, physical activity, and supplement use among adults diagnosed with cancer. J Am Diet Assoc 103(3):323–328PubMed
4.
Zurück zum Zitat Adams RN, Mosher CE, Blair CK, Snyder DC, Sloane R, Demark-Wahnefried W (2015) Cancer survivors’ uptake and adherence in diet and exercise intervention trials: an integrative data analysis. Cancer 121(1):77–83CrossRefPubMed Adams RN, Mosher CE, Blair CK, Snyder DC, Sloane R, Demark-Wahnefried W (2015) Cancer survivors’ uptake and adherence in diet and exercise intervention trials: an integrative data analysis. Cancer 121(1):77–83CrossRefPubMed
5.
Zurück zum Zitat Demark-Wahnefried W, Rogers LQ, Alfano CM et al (2015) Practical clinical interventions for diet, physical activity, and weight control in cancer survivors. CA Cancer J Clin 65(3):167–189CrossRefPubMed Demark-Wahnefried W, Rogers LQ, Alfano CM et al (2015) Practical clinical interventions for diet, physical activity, and weight control in cancer survivors. CA Cancer J Clin 65(3):167–189CrossRefPubMed
6.
Zurück zum Zitat Burstein HJ, Gelber S, Guadagnoli E, Weeks JC (1999) Use of alternative medicine by women with early-stage breast cancer. N Engl J Med 340(22):1733–1739CrossRefPubMed Burstein HJ, Gelber S, Guadagnoli E, Weeks JC (1999) Use of alternative medicine by women with early-stage breast cancer. N Engl J Med 340(22):1733–1739CrossRefPubMed
7.
Zurück zum Zitat Eisenberg DM, Davis RB, Ettner SL et al (1998) Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. JAMA 280(18):1569–1575CrossRefPubMed Eisenberg DM, Davis RB, Ettner SL et al (1998) Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. JAMA 280(18):1569–1575CrossRefPubMed
8.
Zurück zum Zitat Mao JJ, Palmer SC, Straton JB et al (2008) Cancer survivors with unmet needs were more likely to use complementary and alternative medicine. J Cancer Surviv 2(2):116–124CrossRefPubMed Mao JJ, Palmer SC, Straton JB et al (2008) Cancer survivors with unmet needs were more likely to use complementary and alternative medicine. J Cancer Surviv 2(2):116–124CrossRefPubMed
9.
Zurück zum Zitat Matthews AK, Sellergren SA, Huo D, List M, Fleming G (2007) Complementary and alternative medicine use among breast cancer survivors. J Altern Complement Med 13(5):555–562CrossRefPubMed Matthews AK, Sellergren SA, Huo D, List M, Fleming G (2007) Complementary and alternative medicine use among breast cancer survivors. J Altern Complement Med 13(5):555–562CrossRefPubMed
10.
Zurück zum Zitat Wanchai A, Armer JM, Stewart BR (2010) Complementary and alternative medicine use among women with breast cancer: a systematic review. Clin J Oncol Nurs 14(4):E45–E55CrossRefPubMed Wanchai A, Armer JM, Stewart BR (2010) Complementary and alternative medicine use among women with breast cancer: a systematic review. Clin J Oncol Nurs 14(4):E45–E55CrossRefPubMed
11.
Zurück zum Zitat Hedderson MM, Patterson RE, Neuhouser ML et al (2004) Sex differences in motives for use of complementary and alternative medicine among cancer patients. Altern Ther Health Med 10(5):58–64PubMed Hedderson MM, Patterson RE, Neuhouser ML et al (2004) Sex differences in motives for use of complementary and alternative medicine among cancer patients. Altern Ther Health Med 10(5):58–64PubMed
12.
Zurück zum Zitat Patterson RE, Neuhouser ML, Hedderson MM et al (2002) Types of alternative medicine used by patients with breast, colon, or prostate cancer: predictors, motives, and costs. J Altern Complement Med 8(4):477–485CrossRefPubMed Patterson RE, Neuhouser ML, Hedderson MM et al (2002) Types of alternative medicine used by patients with breast, colon, or prostate cancer: predictors, motives, and costs. J Altern Complement Med 8(4):477–485CrossRefPubMed
13.
Zurück zum Zitat McLay JS, Stewart D, George J, Rore C, Heys SD (2012) Complementary and alternative medicines use by Scottish women with breast cancer. What, why and the potential for drug interactions? Eur J Clin Pharmacol 68(5):811–819CrossRefPubMed McLay JS, Stewart D, George J, Rore C, Heys SD (2012) Complementary and alternative medicines use by Scottish women with breast cancer. What, why and the potential for drug interactions? Eur J Clin Pharmacol 68(5):811–819CrossRefPubMed
14.
Zurück zum Zitat Pedersen CG, Christensen S, Jensen AB, Zachariae R (2009) Prevalence, socio-demographic and clinical predictors of post-diagnostic utilisation of different types of complementary and alternative medicine (CAM) in a nationwide cohort of Danish women treated for primary breast cancer. Eur J Cancer 45(18):3172–3181CrossRefPubMed Pedersen CG, Christensen S, Jensen AB, Zachariae R (2009) Prevalence, socio-demographic and clinical predictors of post-diagnostic utilisation of different types of complementary and alternative medicine (CAM) in a nationwide cohort of Danish women treated for primary breast cancer. Eur J Cancer 45(18):3172–3181CrossRefPubMed
15.
Zurück zum Zitat Rebbeck TR, Troxel AB, Norman S et al (2007) A retrospective case-control study of the use of hormone-related supplements and association with breast cancer. Int J Cancer 120(7):1523–1528CrossRefPubMed Rebbeck TR, Troxel AB, Norman S et al (2007) A retrospective case-control study of the use of hormone-related supplements and association with breast cancer. Int J Cancer 120(7):1523–1528CrossRefPubMed
16.
Zurück zum Zitat Newton KM, Reed SD, LaCroix AZ, Grothaus LC, Ehrlich K, Guiltinan J (2006) Treatment of vasomotor symptoms of menopause with black cohosh, multibotanicals, soy, hormone therapy, or placebo: a randomized trial. Ann Intern Med 145(12):869–879CrossRefPubMed Newton KM, Reed SD, LaCroix AZ, Grothaus LC, Ehrlich K, Guiltinan J (2006) Treatment of vasomotor symptoms of menopause with black cohosh, multibotanicals, soy, hormone therapy, or placebo: a randomized trial. Ann Intern Med 145(12):869–879CrossRefPubMed
17.
Zurück zum Zitat McTiernan A, Rajan KB, Tworoger SS et al (2003) Adiposity and sex hormones in postmenopausal breast cancer survivors. J Clin Oncol 21(10):1961–1966CrossRefPubMedPubMedCentral McTiernan A, Rajan KB, Tworoger SS et al (2003) Adiposity and sex hormones in postmenopausal breast cancer survivors. J Clin Oncol 21(10):1961–1966CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Ernster VL, Barclay J, Kerlikowske K, Wilkie H, Ballard-Barbash R (2000) Mortality among women with ductal carcinoma in situ of the breast in the population-based surveillance, epidemiology and end results program. Arch Intern Med 160(7):953–958CrossRefPubMed Ernster VL, Barclay J, Kerlikowske K, Wilkie H, Ballard-Barbash R (2000) Mortality among women with ductal carcinoma in situ of the breast in the population-based surveillance, epidemiology and end results program. Arch Intern Med 160(7):953–958CrossRefPubMed
19.
Zurück zum Zitat Wayne SJ, Neuhouser ML, Koprowski C et al (2009) Breast cancer survivors who use estrogenic botanical supplements have lower serum estrogen levels than non users. Breast Cancer Res Treat 117(1):111–119CrossRefPubMed Wayne SJ, Neuhouser ML, Koprowski C et al (2009) Breast cancer survivors who use estrogenic botanical supplements have lower serum estrogen levels than non users. Breast Cancer Res Treat 117(1):111–119CrossRefPubMed
20.
Zurück zum Zitat Ma H, Sullivan-Halley J, Smith AW et al (2011) Estrogenic botanical supplements, health-related quality of life, fatigue, and hormone-related symptoms in breast cancer survivors: a HEAL study report. BMC Complement Altern Med 11:109CrossRefPubMedPubMedCentral Ma H, Sullivan-Halley J, Smith AW et al (2011) Estrogenic botanical supplements, health-related quality of life, fatigue, and hormone-related symptoms in breast cancer survivors: a HEAL study report. BMC Complement Altern Med 11:109CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Gruendwald J, Brendler T, Jaenicke C (2007) Physician’s desk reference for herbal products, 4th edn. Thompson Healthcare, Montvale Gruendwald J, Brendler T, Jaenicke C (2007) Physician’s desk reference for herbal products, 4th edn. Thompson Healthcare, Montvale
22.
Zurück zum Zitat Cassileth BRLC (2003) Herb-drug interactions in oncology. BC Decker I, New York Cassileth BRLC (2003) Herb-drug interactions in oncology. BC Decker I, New York
24.
Zurück zum Zitat Harlan LC, Klabunde CN, Ambs AH et al (2009) Comorbidities, therapy, and newly diagnosed conditions for women with early stage breast cancer. J Cancer Surviv 3(2):89–98CrossRefPubMedPubMedCentral Harlan LC, Klabunde CN, Ambs AH et al (2009) Comorbidities, therapy, and newly diagnosed conditions for women with early stage breast cancer. J Cancer Surviv 3(2):89–98CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Villasenor A, Ballard-Barbash R, Baumgartner K et al (2012) Prevalence and prognostic effect of sarcopenia in breast cancer survivors: the HEAL study. J Cancer Surviv 6(4):398–406CrossRefPubMedPubMedCentral Villasenor A, Ballard-Barbash R, Baumgartner K et al (2012) Prevalence and prognostic effect of sarcopenia in breast cancer survivors: the HEAL study. J Cancer Surviv 6(4):398–406CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat George SM, Irwin ML, Smith AW et al (2011) Postdiagnosis diet quality, the combination of diet quality and recreational physical activity, and prognosis after early-stage breast cancer. Cancer Causes Control 22(4):589–598CrossRefPubMedPubMedCentral George SM, Irwin ML, Smith AW et al (2011) Postdiagnosis diet quality, the combination of diet quality and recreational physical activity, and prognosis after early-stage breast cancer. Cancer Causes Control 22(4):589–598CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383CrossRefPubMed Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383CrossRefPubMed
28.
Zurück zum Zitat Greenlee H, Kwan ML, Ergas IJ et al (2014) Changes in vitamin and mineral supplement use after breast cancer diagnosis in the pathways study: a prospective cohort study. BMC Cancer 14:382CrossRefPubMedPubMedCentral Greenlee H, Kwan ML, Ergas IJ et al (2014) Changes in vitamin and mineral supplement use after breast cancer diagnosis in the pathways study: a prospective cohort study. BMC Cancer 14:382CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Greenlee H, Kwan ML, Ergas IJ et al (2009) Complementary and alternative therapy use before and after breast cancer diagnosis: the pathways study. Breast Cancer Res Treat 117(3):653–665CrossRefPubMedPubMedCentral Greenlee H, Kwan ML, Ergas IJ et al (2009) Complementary and alternative therapy use before and after breast cancer diagnosis: the pathways study. Breast Cancer Res Treat 117(3):653–665CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Wyatt G, Sikorskii A, Rahbar MH, Victorson D, Adams L (2010) Intervention fidelity: aspects of complementary and alternative medicine research. Cancer Nurs 33(5):331–342CrossRefPubMedPubMedCentral Wyatt G, Sikorskii A, Rahbar MH, Victorson D, Adams L (2010) Intervention fidelity: aspects of complementary and alternative medicine research. Cancer Nurs 33(5):331–342CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Roberts H (2010) Safety of herbal medicinal products in women with breast cancer. Maturitas 66(4):363–369CrossRefPubMed Roberts H (2010) Safety of herbal medicinal products in women with breast cancer. Maturitas 66(4):363–369CrossRefPubMed
33.
Zurück zum Zitat Greenlee H, Balneaves LG, Carlson LE et al (2014) Clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer. J Natl Cancer Inst Monogr 2014(50):346–358CrossRefPubMedPubMedCentral Greenlee H, Balneaves LG, Carlson LE et al (2014) Clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer. J Natl Cancer Inst Monogr 2014(50):346–358CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Vogel VG, Costantino JP, Wickerham DL et al (2006) Effects of tamoxifen vs raloxifene on the risk of developing invasive breast cancer and other disease outcomes: the NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 trial. JAMA 295(23):2727–2741CrossRefPubMed Vogel VG, Costantino JP, Wickerham DL et al (2006) Effects of tamoxifen vs raloxifene on the risk of developing invasive breast cancer and other disease outcomes: the NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 trial. JAMA 295(23):2727–2741CrossRefPubMed
35.
Zurück zum Zitat Burstein HJ, Temin S, Anderson H et al (2014) Adjuvant endocrine therapy for women with hormone receptor-positive breast cancer: american society of clinical oncology clinical practice guideline focused update. J Clin Oncol 32(21):2255–2269CrossRefPubMedPubMedCentral Burstein HJ, Temin S, Anderson H et al (2014) Adjuvant endocrine therapy for women with hormone receptor-positive breast cancer: american society of clinical oncology clinical practice guideline focused update. J Clin Oncol 32(21):2255–2269CrossRefPubMedPubMedCentral
36.
Zurück zum Zitat Chirgwin JH, Giobbie-Hurder A, Coates AS et al (2016) Treatment adherence and its impact on disease-free survival in the breast international group 1–98 trial of tamoxifen and letrozole, alone and in sequence. J Clin Oncol. doi:10.1200/JCO.2015.63.8619 Chirgwin JH, Giobbie-Hurder A, Coates AS et al (2016) Treatment adherence and its impact on disease-free survival in the breast international group 1–98 trial of tamoxifen and letrozole, alone and in sequence. J Clin Oncol. doi:10.​1200/​JCO.​2015.​63.​8619
37.
Zurück zum Zitat Dai Q, Franke AA, Yu H et al (2003) Urinary phytoestrogen excretion and breast cancer risk: evaluating potential effect modifiers endogenous estrogens and anthropometrics. Cancer Epidemiol Biomark Prev 12(6):497–502 Dai Q, Franke AA, Yu H et al (2003) Urinary phytoestrogen excretion and breast cancer risk: evaluating potential effect modifiers endogenous estrogens and anthropometrics. Cancer Epidemiol Biomark Prev 12(6):497–502
38.
Zurück zum Zitat Allred CD, Ju YH, Allred KF, Chang J, Helferich WG (2001) Dietary genistin stimulates growth of estrogen-dependent breast cancer tumors similar to that observed with genistein. Carcinogenesis 22(10):1667–1673CrossRefPubMed Allred CD, Ju YH, Allred KF, Chang J, Helferich WG (2001) Dietary genistin stimulates growth of estrogen-dependent breast cancer tumors similar to that observed with genistein. Carcinogenesis 22(10):1667–1673CrossRefPubMed
39.
Zurück zum Zitat Ju YH, Doerge DR, Allred KF, Allred CD, Helferich WG (2002) Dietary genistein negates the inhibitory effect of tamoxifen on growth of estrogen-dependent human breast cancer (MCF-7) cells implanted in athymic mice. Cancer Res 62(9):2474–2477PubMed Ju YH, Doerge DR, Allred KF, Allred CD, Helferich WG (2002) Dietary genistein negates the inhibitory effect of tamoxifen on growth of estrogen-dependent human breast cancer (MCF-7) cells implanted in athymic mice. Cancer Res 62(9):2474–2477PubMed
40.
Zurück zum Zitat Greenlee H, Neugut AI, Falci L et al (2016) Association between complementary and alternative medicine use and breast cancer chemotherapy initiation: the Breast Cancer Quality of Care (BQUAL) study. JAMA Oncol 2(9):1170–1176CrossRefPubMed Greenlee H, Neugut AI, Falci L et al (2016) Association between complementary and alternative medicine use and breast cancer chemotherapy initiation: the Breast Cancer Quality of Care (BQUAL) study. JAMA Oncol 2(9):1170–1176CrossRefPubMed
41.
Zurück zum Zitat Ma H, Carpenter CL, Sullivan-Halley J, Bernstein L (2011) The roles of herbal remedies in survival and quality of life among long-term breast cancer survivors-results of a prospective study. BMC Cancer 11:222CrossRefPubMedPubMedCentral Ma H, Carpenter CL, Sullivan-Halley J, Bernstein L (2011) The roles of herbal remedies in survival and quality of life among long-term breast cancer survivors-results of a prospective study. BMC Cancer 11:222CrossRefPubMedPubMedCentral
42.
Zurück zum Zitat Caan BJ, Natarajan L, Parker B et al (2011) Soy food consumption and breast cancer prognosis. Cancer Epidemiol Biomark Prev 20(5):854–858CrossRef Caan BJ, Natarajan L, Parker B et al (2011) Soy food consumption and breast cancer prognosis. Cancer Epidemiol Biomark Prev 20(5):854–858CrossRef
44.
Zurück zum Zitat Bright-Gbebry M, Makambi KH, Rohan JP et al (2011) Use of multivitamins, folic acid and herbal supplements among breast cancer survivors: the black women’s health study. BMC Complement Altern Med 11:30CrossRefPubMedPubMedCentral Bright-Gbebry M, Makambi KH, Rohan JP et al (2011) Use of multivitamins, folic acid and herbal supplements among breast cancer survivors: the black women’s health study. BMC Complement Altern Med 11:30CrossRefPubMedPubMedCentral
45.
Zurück zum Zitat Greenlee H, Kwan ML, Kushi LH et al (2012) Antioxidant supplement use after breast cancer diagnosis and mortality in the Life After Cancer Epidemiology (LACE) cohort. Cancer 118(8):2048–2058CrossRefPubMed Greenlee H, Kwan ML, Kushi LH et al (2012) Antioxidant supplement use after breast cancer diagnosis and mortality in the Life After Cancer Epidemiology (LACE) cohort. Cancer 118(8):2048–2058CrossRefPubMed
46.
Zurück zum Zitat Nechuta S, Lu W, Chen Z et al (2011) Vitamin supplement use during breast cancer treatment and survival: a prospective cohort study. Cancer Epidemiol Biomark Prev 20(2):262–271CrossRef Nechuta S, Lu W, Chen Z et al (2011) Vitamin supplement use during breast cancer treatment and survival: a prospective cohort study. Cancer Epidemiol Biomark Prev 20(2):262–271CrossRef
47.
Zurück zum Zitat Hietala M, Henningson M, Ingvar C, Jonsson PE, Rose C, Jernstrom H (2011) Natural remedy use in a prospective cohort of breast cancer patients in southern Sweden. Acta Oncol 50(1):134–143CrossRefPubMed Hietala M, Henningson M, Ingvar C, Jonsson PE, Rose C, Jernstrom H (2011) Natural remedy use in a prospective cohort of breast cancer patients in southern Sweden. Acta Oncol 50(1):134–143CrossRefPubMed
48.
Zurück zum Zitat Han E, Johnson N, DelaMelena T, Glissmeyer M, Steinbock K (2011) Alternative therapy used as primary treatment for breast cancer negatively impacts outcomes. Ann Surg Oncol 18(4):912–916CrossRefPubMed Han E, Johnson N, DelaMelena T, Glissmeyer M, Steinbock K (2011) Alternative therapy used as primary treatment for breast cancer negatively impacts outcomes. Ann Surg Oncol 18(4):912–916CrossRefPubMed
49.
Zurück zum Zitat Hathcock J (2001) Dietary supplements: how they are used and regulated. J Nutr 131(3s):1114S–1117SPubMed Hathcock J (2001) Dietary supplements: how they are used and regulated. J Nutr 131(3s):1114S–1117SPubMed
Metadaten
Titel
Use of complementary and alternative medicine and breast cancer survival in the Health, Eating, Activity, and Lifestyle Study
verfasst von
Marian L. Neuhouser
Ashley Wilder Smith
Stephanie M. George
James T. Gibson
Kathy B. Baumgartner
Richard Baumgartner
Catherine Duggan
Leslie Bernstein
Anne McTiernan
Rachel Ballard
Publikationsdatum
21.10.2016
Verlag
Springer US
Erschienen in
Breast Cancer Research and Treatment / Ausgabe 3/2016
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-016-4010-x

Weitere Artikel der Ausgabe 3/2016

Breast Cancer Research and Treatment 3/2016 Zur Ausgabe

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.