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Early, Late-Stage, and Metastatic Breast Cancer Treatment Options

You should not have to live with the fear of performing a mastectomy, lumpectomy, or other invasive surgeries to treat your breast cancer or precancerous tumors. At Envita Medical Centers, a world-class integrative center for Precision Oncology, we focus on shutting down even the most advanced breast cancers quickly, with less invasive and personalized targeted methods. We treat the driving factors of your specific breast cancer with precision oncology, which goes beyond the standard cancer type and stage driven treatments.

Despite early-stage breast cancer diagnosis and treatment, there is a 30% chance of recurrence and metastases [1]. In later stages, when breast cancer spreads, it often becomes even more complicated, pointing towards the urgent need to go beyond standard breast cancer treatment options and access precision care. Our personalized precision oncology treatment protocols are designed to not only potentiate treatment responses in late-stage cancers, but it also works towards reducing chances of a recurrence or metastatic spread, like Andrea’s.

This overview will cover the basic facts about breast cancer, including:

How Does Envita Go Beyond Standard Breast Cancer Treatments?

We use detailed precision oncology algorithms to identify and target the genomic markers, immunotherapy targets, carcinogens, and metabolomic factors feeding each patient’s unique cancer drivers, which are responsible for the cause, resistance to treatment, and spread of the disease. These factors differ from person to person, despite having the same type and stage of breast cancer, which is why we personalize precision care to help our patients progress towards a holistic recovery and aim for a full return to health.

Envita’s Precision Oncology Provides Important Quality of Life Metrics

At Envita Medical Centers located in Scottsdale, Arizona, we use a powerful combination of next level conventional as well as advanced natural therapies to attack the core of your specific breast cancer and shut down its drivers, pushing you towards the goal of a long-term remission. Our expert team has been treating advanced and complex breast cancers of various types, including hormone positive, triple negative, and inflammatory breast cancer, for over 25 years.

Envita’s unique approach aims to target the exact causes of your distinct breast cancer and identify early signs of metastasis or spread, enabling us to help in halting disease progression, even before it manifests symptoms of metastatic spread to other parts of the body. Our integrative precision care aims to reduce chances of chemotherapeutic drug resistance, which is considered one of the major challenges of breast cancer treatment [2].

How Does Chemotherapeutic Drug Resistance Affect Breast Cancer Treatment?

Chemotherapeutic drug resistance, also called Multidrug Resistance (MDR) is often experienced when breast cancer patients receive multiple rounds of untargeted chemotherapy without responding to care. Maximum dose untargeted chemotherapeutic drugs may reduce the cancer cells’ capacity to absorb anti-cancer medications, while activating the cancer cells’ ability to push out the hazardous drugs that have entered the cells. Furthermore, the combination of the wrong selection of targets and high doses of chemotherapy pushes mutations and weakens the immune system overall.

Learn more about Multidrug Resistance

Envita’s Personalized Precision Oncology Approach to Counter Metastasis

In our two decades of precision oncology practice, we have successfully treated complex and metastatic breast cancer patients who were told they had no more options available to them at other well-known cancer centers. One of the least known secrets in oncology is that most cancer centers will use the same treatment regimens with few modifications straight from NCCN (National Comprehensive Cancer Network) guidelines, with little to no precision targeting. Because the NCCN guides treatment, it is not uncommon for patients to receive the same recommended treatment from multiple facilities when attempting to obtain a true second opinion. This is unfortunate for most patients because the earlier you get access to precision, the better are your chances of overcoming the disease.

According to a study published in the International Journal of Breast Cancer, “Precision medicine holds the promise of truly personalized treatment which provides every individual breast cancer patient with the most appropriate diagnostics and targeted therapies,” [3] but not everyone gets access to precision oncology in conventional cancer hospitals and clinics. In fact, “Less than 20% of all patients receive precision oncology” [4] and even the patients who do get access to precision, receive a watered-down version of precision oncology that does not compare to the level Envita provides its patients.

At Envita, Advanced Precision Oncology Algorithms Form the Bedrock of Treatment for All Our Breast Cancer Patients.

Conventional cancer hospitals and clinics follow the NCCN (National Comprehensive Cancer Network) guidelines to determine treatment based on cancer type and stage. Only after patients have failed initial rounds of NCCN guided treatments, are they considered eligible to receive precision oncology options. The precision received in a NCCN guided facility does not even compare to Envita’s Precision Algorithm which utilizes many more parameters than standard healthcare to create a customized, comprehensive treatment plan.

Envita Precision Algorithm vs.
Standard Oncology Precision Testing

At Envita Medical Centers, we go beyond standard tumor markers and imaging, which are lagging indicators typically used in conventional oncology. Instead, our focus is on collecting the latest genetic information from metastatic breast cancer cells, these cells are leading indicators which are used to drive treatment.

These leading indicators provide better genomic targeting and disease tracking, crucial for a comprehensive treatment of breast cancer. In our clinical experience, molecular precision oncology, which dives deep into patient-specific cancer, gives our patients a better chance to respond to care and overcome challenges of recurrence or metastasis.

Breast Cancer is the second leading cause of deaths in American women.*

Approximately 30% of women diagnosed with early stages of breast cancer, eventually develop recurrent advanced or metastatic disease.**

*Source: How common is breast cancer?: Breast cancer statistics. American Cancer Society. https://www.cancer.org/cancer/breast-cancer/about/how-common-is-breast-cancer.html.

**Source: O'Shaughnessy J. Extending survival with chemotherapy in metastatic breast cancer. Oncologist. 2005;10 Suppl 3:20-29. doi:10.1634/theoncologist.10-90003-20.

As many as 30% of all breast cancer patients, eventually develop recurrent advanced or metastatic diseases. According to our clinical opinion, this 30% return of disease is not always new disease but missed disease, which was not treated correctly through standard healthcare breast cancer regimens.

Mastectomies and Other Invasive Surgeries May Not Be a Cure to Breast Cancer

Breast removal surgeries like mastectomies do not always prevent breast cancer recurrence or metastasis, as the micro metastatic breast cancer cells may have already spread to other parts of the body, beyond the chest wall. These micro metastatic cells break away from a growing tumor, which may be as small as 2mm in diameter, often the size seen in early stage II or stage I fully contained tumors. Considering their tumor to be small, patients undergo surgeries, not realizing that the micro metastatic cells have already disseminated to different regions of the body, spreading the disease to stage III or stage IV.

However, these micro metastatic breast cancer cells can lie dormant, which is why they may not show up in PET scans or imaging, giving patients an illusion of being cancer free temporarily. At Envita, we use advanced immunotherapy to make these dormant or cold breast cancer cells into visible cancer, which helps us in proactively identifying and treating metastatic cancer to help improve long term remission goals.

Metastatic disease remains the underlying cause of death in the majority of breast cancer patients who succumb to their disease [5]. Most patients are shocked to learn that breast cancer can remain dormant for many years after successful treatment. While the patient may feel they have beaten the cancer, it can return suddenly and without warning as a more aggressive form of cancer that has spread throughout the body. Our precision process is designed to tackle advanced metastatic breast cancer, an area greatly lacking in conventional breast cancer treatment.

Envita's Unique Patient-Specific Treatment Options

According to research, upwards of 80% of cancer patients seek some form of integrative or adjunctive supportive care to improve their cancer outcomes and quality of life [6]. Many breast cancer patients often fail to understand that even the natural adjunctive therapies require the same level of precision as the drug targets.

It is important to understand that many oncology drugs used today are derived from plant biologics and these agents can act as supportive adjuvants and neoadjuvant, when used correctly. Neoadjuvant is used before the primary treatment to shrink the size of tumors, while adjuvants are used after the main treatment to eliminate remaining cancerous cells, if any.

To optimize treatment efficacy with the perfect combinations of leading-edge conventional and natural therapies, Envita follows a unique precision oncology approach based on the four pillars of genomic identification, immuno targeting, personalized drug design, and precision deployment. We customize this four-step process in the N-of-1 clinical trial model, where the entire treatment is built on you, based on your unique cancer expressions, rather than following the NCCN guidelines, which dictate treatment based on cancer type and stage.

It is crucial to understand that despite the same type and stage of breast cancer, different people have different cancer expressions, which is why not all of them respond similarly to the same treatment. In our clinical experience of over 25 years, precision-targeting each breast cancer patient’s unique cancer expressions helps in improving their quality of life, increasing longevity, and reducing toxicity.

Your breast cancer may be caused due to inherited genetic mutations, such as BRCA1 and BRCA2, which comprises a small percentage of all breast cancers. At Envita we find that environmental influences, such as exogenous estrogens, infections, immune deficiencies, are triggering genetic mutations which could be the driving factors for over 85% of all cases [7]. These driving factors are unique for each patient’s specific breast cancer.

Inherited factor driven genetic mutations explain why women with at least one relative who has had breast cancer are almost twice as likely to develop breast cancer. Due to gene mutations like BRCA1 and BRCA2, which are identified through our extensive genomic identification, some women may be more vulnerable to developing breast cancer than others. However, in 85% of breast cancer cases the triggering factors are not limited to these inherited genetic mutations.

Our extensive algorithm, that includes genomic identification, highlights these driving factors impacting your specific cancer’s growth and spread. A complex interplay of DNA-genes, transcriptomes, proteins, and metabolites at the cellular level can affect your cancer’s microenvironment, causing microsatellite instability, or initiating epigenetic influences on mutation. Envita’s genomic identification helps in analyzing the extent of all these irregularities at the cellular and molecular level, which form your cancer drivers.

It is not uncommon to see infections, heavy metals, or other chemical toxins triggering changes at a cellular level, causing breast cancer to develop. Irrespective of the type or stage of your breast cancer, it is crucial to understand the driving factors for establishing a unique precision-targeted plan, which helps to check metastasis in early-stage breast cancers and reduce chances of drug resistance or other complications in late-stage breast cancers.

Immunotherapy is generally not used for breast cancer in conventional oncology, but at Envita, we intend to harness its power to potentially improve the outcome for our patients. Since cancer is a disease of genetic mutations evading the immune system, immunotherapy may be the missing link in your breast cancer treatment. At Envita, we specialize in identifying the genetic mutations potentially responsible for causing your breast cancer, going far beyond the scope of PD1, PD-L1, and PARP inhibitors.

Envita’s Ultra Analytes Liquid Biopsy helps establish the actionable chemo and immuno targets for your specific breast cancer expressions. These proprietary tests analyze the latest mutations in your Circulating Tumor Cells (CTCs), collected from a blood sample. CTCs are tiny parts of a growing tumor which break away and enter your blood stream, spreading the cancer to other parts of the body. A detailed investigation of these CTCs helps identify micro metastases, allowing us to proactively treat your breast cancer before it manifests itself elsewhere in your body.

Irrespective of the stage of diagnosis, breast cancer cells can metastasize and spread to different parts of the body like the axillary regions, lymph nodes, bone, brain, or liver. In certain cases, these cancer cells may sit dormant for many years making proactive identification and treatment difficult, but our specialized treatment algorithms are designed to identify difficult to find metastatic sites, reduce the chances of tumor development, and shut the cancer down. Eliminating these potential risk factors of breast cancer metastasis, enables us to secure longer disease-free survival time for our patients.

Metabolomic rewiring of the cancer cell requires a detailed approach and key lifestyle changes along with targeted treatment to achieve long term remission.

Advanced Immunotherapy Options for Breast Cancer

Envita’s immunotherapy and immunotherapy adjunctive options aim to re-establish the immune system and reprogram it to recognize the tumors’ neo-antigens and fight the cancer. Neo-antigens are markers that guide the immune system to seek and kill cancer cells elsewhere in the body.

Our proprietary treatment options focus on re-establishing immunoreactivity so a tumor that has not been recognized by or provoked a strong response in the immune system (cold tumor), can be turned into one that has been swarmed by T- cells, creating an inflamed tumor (hot tumor).

To address some of the aggressive types of breast cancer, such as Inflammatory Breast Cancer (IBC) and triple-negative breast cancers, we use next-level transcriptional gene regulation, which helps in slowing down cancer cell mutations and allows treatment to hit the cancer targets. Modulating the levels of oncogenes and tumor suppressor genes can influence cell growth and mutation, as oncogenes cause uncontrolled cell division and growth, while tumor suppressor genes slow down cell division, repair DNA mistakes, and signal cancer cells to die off. In cancer cells, the oncogenes are dominant, as a result the tumor suppressor genes cannot function properly leading to growth and spread of the cancer.

Our treatment protocol includes sophisticated MiRNA gene silencing therapies to downregulate the oncogenes and upregulate the tumor suppressor genes. This advanced immunotherapy treatment may initiate the body’s natural defense mechanism against cancer cells, improving your chances of recovering, even from an aggressive and late-stage breast cancer.

Step 3

Personalized Drug Design Enhances Treatment Efficacy

At Envita, we use a personalized combination of FDA approved drugs, repurposed drugs, and custom compounded adjuvants to enhance the potential action against your specific breast cancer biomarkers. Biomarkers are attributes of cancer cells containing specific chemotherapy and immunotherapy targets.

FDA Approved Drugs

Optimized for your cancer mutations.

Repurposed Drugs

Off-label use of approved medications

Custom Compounded Adjuvants

Genetically typed for each patient.

Our in-depth genetic testing establishes actionable targets, enabling us to choose appropriate FDA approved drugs and repurposed drugs for your specific breast cancer, which in turn reduces the chances of drug resistance and metastasis. We adjust the dosage of these drugs to suit each patient’s individual rate of metabolism, allowing the medicines to improve tumor kill while reducing toxicity in your body.

To further optimize the benefits of this powerful combination we create adjuvant therapies, which are custom compounded at our in-house pharmacy. Adjuvant therapies may include genomic targeted phytotherapeutic agents, derived from plant extracts and herbs. These adjuvant agents may help enhance healing, as well as strengthening your immune system to aid in your progress towards remission.

We bring to you all the new treatments developed over the years in breast cancer research, and our unique precision algorithms guide us to the ones with the highest potential of response for your specific breast cancer expressions. Choosing the most suitable precision deployment mechanism aids in effectively attacking your specific breast cancer biomarkers with personalized medications, while strengthening your immune system to equip your body in better tackling the cancer. We use the latest oncology technology in the industry in combination with our proprietary precision deployment treatment modalities to help you overcome the disease. At Envita, we are very cautious about reducing impact to your healthy cells and not causing breast tissue deformities, while treating your breast cancer.

Tumor Ablation

Ablation is a quick and painless procedure for safely destroying certain tumors, without affecting the breast tissues, using extreme cold or heat. Cryoablation, radiofrequency, or microwave ablation may be used to kill the malignant or abnormal cells causing your breast cancer. These minimally invasive procedures may be used instead of surgeries. They do not require hospital stay, can be performed without general anesthesia, and are less expensive than tumor excision surgeries.

When needed, these ablative procedures can be repeated more frequently than surgeries. They also have a quicker recovery time, allowing patients to resume most of their routine activities soon after the procedure. Depending on the size, site, and type of tumor, we can use either one or a combination of the ablation techniques to precision-target your cancerous cells, while preserving the surrounding healthy cells.

Cryoablation - Scientific studies have proved that cryoablation is a safe procedure to achieve tumor necrosis aesthetically. A report of multi-institutional trial shows cryoablation successfully destroyed 100 percent of cancers < 1 cm [8]. During cryoablation, a thin, wand like hollow needle, known as the cryoprobe, is inserted through your skin, directly into the cancerous tumors in the breast.

A cooling gas is pumped into the cryoprobe to freeze the malignant or abnormal cells, which are then allowed to thaw for some time. The freezing and thawing process is repeated several times during the same treatment sessionto deactivate the tumor. This treatment can be performed within 20 to 30 minutes and in most cases does not leave any scars.

Once the tumor is shut off, it releases antigens which stimulate an immune system response, enabling your body to identify and kill cancer cells elsewhere in the body. Medical studies indicate “effects of cryoablation on immune system and possible synergic effects with systemic therapies are open and fascinating fields that deserve further attention” [9], however, here at Envita we are already capitalizing on this crucial antigen information to personalize immunotherapies which may potentially check breast cancer recurrence or metastasis.

Radiofrequency (RF) Ablation - The Radiofrequency Ablation procedure utilizes extreme heat to treat bone metastases caused by breast cancer cells, which have started spreading to distant parts of the body. Radiofrequency energy is directed to the tumors via image-guided thin electrode needles, allowing extreme heat to destroy the cancerous cells, while circulating water, directed through a second probe to the tumor site, moderates the temperature for precision care. The range of heat is also adjusted in accordance with the size of the tumor.

When cancerous tumors spread to the bone, it can cause excruciating pain and make the bones brittle. The RF Ablation procedure provides relief by destroying the tumors and dispensing a stabilizing medication to strengthen and reconstruct the bone. This minimally invasive procedure may take anywhere between 30 minutes to 2 hours. It is typically not the primary treatment for metastatic breast cancer, because tumor necrosis must be followed up with certain systemic therapies to treat the root cause of your breast cancer.

Microwave Ablation (MWA) - In a microwave ablation (MWA) procedure, electromagnetic waves are used to shrink or kill solid breast tumors either at their point of origin, or at the sites of metastasis. The specialized probes are guided to the site of the tumor with x-ray or other imaging technology, directing a field of highly focused heat to the tumor, via a microwave generator attached to the probe. This heat helps in killing the cancerous cells in a controlled and localized manner.

Medical studies show how using MWA as an adjuvant treatment for thoracic metastases of breast cancer may be beneficial [10]. The rate of post operative main complications and recurrence rate was negligible in this study. However, at Envita, we follow up MWA with other proprietary therapies to resolve the core cancer triggers, driving the growth and spread of the disease.

GTFC™ (Genetically Targeted Fractionated Chemotherapy)

To improve the efficacy of standard untargeted chemotherapy for breast cancer, we developed a precision deployment treatment method called GTFC™ (Genetically Targeted Fractionated Chemotherapy), which administers low doses but precisely targeted anti-cancer medicines to your body. GTFC increases the mechanisms of tumor kill while helping in countering the side-effects of a weakened immune system, caused by maximum dose chemotherapy [11].

The high doses of medications delivered via standard untargeted chemotherapy often impacts the healthy cells surrounding the cancer cells, resulting in side-effects of a weakened immunity manifesting as exhaustion and nausea, but GTFC™ minimizes side-effects and potentially optimizes treatment benefits. A robust immune system is key to the success of your breast cancer treatment because it plays a crucial role in checking genetic mutations.

CIPI™ (Chemo Immuno Precision Injections)

CIPI™ (Chemo Immuno Precision Injections) is one of our proprietary precision deployment mechanisms which can be used to avoid mastectomy, one of the standard breast cancer treatment options in cancer hospitals. Medical studies indicate how surgery may lead to metastasis, where the cancer cells spread to different parts of the body [12]. Some of the other treatment options are external beam radiation like Tomotherapy, IMRT (Intensity Modulated Radiation Therapy), and Cyberknife, but they may lead to side-effects like cardiac toxicity or pulmonary fibrosis, depending on the site of the tumor.

To reduce these negative side-effects of standard breast cancer care and precision target your specific cancer cells, we have developed a non-invasive image guided precision surgical procedure called CIPT™. This interventional radiology procedure is used to tackle difficult to reach tumors, and it is especially helpful against liver, lungs, and brain metastases.

Genetically targeted chemotherapy, immunotherapy, and chemo adjunctive agents are directed straight to the tumor, shutting it down intratumorally to release antigens which cause a systemic response throughout the body. This procedure empowers your immune system to seek and kill cancer anywhere else in the body.

Hormone Therapy

Hormone therapy, also called endocrine therapy, works by blocking the exposure of your breast cancer cells to specific hormones, such as estrogen and progesterone. In rare circumstances, the hormone androgen also plays a role in breast cancer growth and spread, making it an emerging area of interest in this field.

These hormone therapy medications, such as aromatase inhibitors, are often prescribed for 5 to 10 years after surgery in case of progesterone receptor (PR) or estrogen receptor (ER) positive breast cancer. In our clinical experience, we find the majority of breast cancer patients are on the wrong hormone blockades. However, our personalized precision-targeted approach helps in better understanding each patient’s individual breast cancer to improve the results of hormone therapy.

These hormone blockades may either slow down hormone production in the ovaries or limit the hormone's ability to attach to the receptors of your breast cancer cells. Receptors are cell proteins capable of attaching to certain substances in the blood, and in case of the hormone sensitive breast cancers, these receptors attach to a specific hormone, causing cancer growth and proliferation. The hormone estrogen, progesterone, or androgen can turn deadly for patients with a particular hormone receptor positive breast cancer.

At Envita, we use advanced phytotherapeutic medications along with hormone blockades to shut off endogenous and exogenous exposure to specific hormones, depending on the patient's hormone receptor status. For example, if a patient is ER positive, then the medications will block exposure to the hormone estrogen. Our personalized custom-compounded adjuvants supplement the efficacy of hormone blockades to reduce the chances of a breast cancer recurrence or metastasis.

AAIT (Autologous Adoptive Immunotherapy)

AAIT is our proprietary method to bolster the immune system of late-stage or complicated breast cancer diagnoses, allowing the medications to work effectively against your cancer. It includes a combination of four different types of personalized immunotherapies designed to complement each other, mitigating potential treatment side-effects, putting patients on the path towards a holistic recovery. This is a sophisticated procedure akin to an immune system transplant using the patient’s own immune system cells, which is available only in our Mexico center as it’s not FDA approved for cancer treatment within the United States.

Types of Breast Cancers

According to the National Cancer Institute, Breast Cancer is the most commonly diagnosed cancer, representing 14.8% of all new cancer cases in the United States. Our unique treatment approach has proven to be successful for many of these patients who had limited options in conventional healthcare. We do a free medical evaluation for all prospective patients and based on the evaluation if we think we can make a difference, only then do we take in a patient. We treat all types of Breast Cancers in different stages, including the most critical stage IV cancers. Some of the different types of breast cancers are as follows:

Ductal Carcinoma in Situ (DCIS)

DCIS is a non-invasive breast cancer, but it can increase the risk of developing an invasive form of breast cancer, a few years later.

Invasive Ductal Carcinoma (IDC)

IDC is the most common type of breast cancer, generally affecting older post-menopausal women, or those who are close to menopause.

Lobular Carcinoma in Situ (LCIS)

LCIS refers to an area of abnormal cell growth, which may increase the risk of invasive breast cancers. This is an uncommon condition, usually diagnosed in premenopausal women.

Invasive Lobular Carcinoma (ILC)

ILC is the second most common type of breast cancer, which can affect women at any age, but is commonly seen in older women.

Inflammatory Breast Cancer (IBC)

IBC is a rare and aggressive form of breast cancer manifesting itself with redness and swelling, instead of a lump. It generally affects women in their 50s.

Paget's Disease

Paget's Disease of the nipple accounts for less than 5% of all breast cancers, according to the National Cancer Institute. This rare form of cancer is usually seen in older women and may be accompanied by a DCIS or another type of invasive breast cancer.

Phyllodes Tumors

Phyllodes tumors of the breast may be cancerous (malignant), non-cancerous (benign), or a mix of both. These tumors can manifest at any age, but are more common in women in their 40's.

HER2 Status

All types of breast cancers may be either HER2 positive or HER2 negative, depending on whether their breast cancer cells have higher than normal levels of human epidermal growth factor receptor 2 (HER2). HER2 is a protein that helps breast cancer cells grow quickly, making HER2 positive breast cancers grow and spread faster than the HER2 negative cases. However, there are drugs such as tyrosine kinase inhibitors, which target this protein, enabling patients to respond to treatment.

Hormone Receptor Status

All types of breast cancers may be either hormone receptor positive or hormone receptor negative, depending on whether the hormones estrogen and progesterone are feeding your cancer. Any one or both hormones may be responsible for causing cancer growth and spread in hormone receptor positive breast cancer patients.

Triple Negative Breast Cancer

If the breast cancer is not impacted by the HER2 protein or the hormones estrogen, and progesterone, then they are called Triple Negative Breast Cancers. It is an aggressive breast cancer and is more common in younger women with the inherited BRCA1 mutation.

Male Breast Cancer

Breast Cancer in men is extremely rare, but some factors like inherited genetic mutations may lead to cancer of their breast tissues. According to the Centers for Disease Control and Prevention (CDC), about 1 out of every 100 breast cancers diagnosed in the United States is found in a man. The most common types of breast cancers affecting women also impact men.

When it comes to treating breast cancer, you have found the right place. Our expert medical team, trained over 1,500 hours to adapt to personalized precision oncology approach, leaves no stone unturned to attack each patient’s individual breast cancer from all possible angles. Their efforts, our personalized precision algorithms, and advanced integrative care, give patients a greater chance to beat their disease. If you or your loved ones have any questions regarding breast cancer, please feel free to call us at: 866-830-4576. May God bless you on your journey to healing.

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References

[1] O'Shaughnessy J. Extending survival with chemotherapy in metastatic breast cancer. Oncologist. 2005;10 Suppl 3:20-29. doi:10.1634/theoncologist.10-90003-20

[2] Ji X, Lu Y, Tian H, Meng X, Wei M, Cho WC. Chemoresistance mechanisms of breast cancer and their countermeasures. Biomed Pharmacother. 2019;114:108800. doi:10.1016/j.biopha.2019.108800 Precision Oncology News, Survey of Precision Oncology Programs Shows Continued Adoption, Though 'Success' Metrics Unclear Nov 04, 2020

[3] Eleanor E. R. Harris, "Precision Medicine for Breast Cancer: The Paths to Truly Individualized Diagnosis and Treatment", International Journal of Breast Cancer, vol. 2018, Article ID 4809183, 8 pages, 2018. https://doi.org/10.1155/2018/4809183

[4] Precision Oncology News, Survey of Precision Oncology Programs Shows Continued Adoption, Though 'Success' Metrics Unclear Nov 04, 2020

[5] Redig AJ, McAllister SS. Breast cancer as a systemic disease: a view of metastasis. J Intern Med. 2013;274(2):113-126. doi:10.1111/joim.12084

[6] Shelly Latte-Naor and Jun J. Mao. Putting Integrative Oncology Into Practice: Concepts and Approaches. Journal of Oncology Practice 2019 15:1, 7-14

[7] Hulka BS. Epidemiology of susceptibility to breast cancer. Prog Clin Biol Res. 1996;395:159-174.

[8] Sabel MS, Kaufman CS, Whitworth P, et al. Cryoablation of early-stage breast cancer: work-in-progress report of a multi-institutional trial. Ann Surg Oncol. 2004;11(5):542-549. doi:10.1245/ASO.2004.08.003

[9] Pusceddu C, Paliogiannis P, Nigri G, Fancellu A. Cryoablation In The Management Of Breast Cancer: Evidence To Date. Breast Cancer (Dove Med Press). 2019;11:283-292. Published 2019 Oct 10. doi:10.2147/BCTT.S197406

[10] Liu B, Wu Z, Mo H, et al. Safety and efficacy of microwave ablation for breast cancer thoracic metastases. Cancer Manag Res. 2018;10:5685-5689. Published 2018 Nov 14. doi:10.2147/CMAR.S176743

[11] Smith, A.J., Oertle, J. and Prato, D. (2015) Genetically Targeted Fractionated Chemotherapy. Journal of Cancer Therapy, 6, 182-198. http://dx.doi.org/10.4236/jct.2015.62021

[12] Tohme S, Simmons RL, Tsung A. Surgery for Cancer: A Trigger for Metastases. Cancer Res. 2017;77(7):1548-1552. doi:10.1158/0008-5472.CAN-16-1536

* The 3rd party actuarial response data is based on an analysis of records for 87 out of 129 patients that participated in Envita’s Treatment Program in 2020. 42 patients were removed from the cohort due to the patients’ inability to start or complete Envita’s prescribed treatment for a variety of reasons, including but not limited to, advanced disease state, disease progression, or inability to travel.

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