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breast cancer

Improved Long-Term Quality-of-Life Measures in Women Undergoing Breast Conservation vs Mastectomy and Reconstruction for Early Breast Cancer

In a study reported in JAMA Surgery, Hanson et al found no difference in long-term satisfaction with breasts among women with early breast cancer who underwent breast-conserving surgery with radiation therapy vs mastectomy and breast reconstruction without radiation therapy. Women who underwent...

ASCO Honors 2021 Special Awards Recipients

Researchers, patient advocates, and global oncology leaders who have worked to reshape cancer care around the world are among the recipients of ASCO’s Special Awards—the Society’s highest honors—and the Women Who Conquer Cancer Mentorship Awards from Conquer Cancer, the ASCO Foundation. “The...

ASTRO Names Class of 2019 Fellows Designation

The American Society for Radiation Oncology (ASTRO) has selected 26 members to receive the ASTRO Fellow (FASTRO) designation. The 2019 class of Fellows were recognized during ASTRO’s 61st Annual Meeting in Chicago. The ASTRO Fellows program recognizes individuals who have made significant...

breast cancer

Patient-Reported Cosmetic Outcomes With Radiotherapy in Early Breast Cancer

As reported in the Journal of Clinical Oncology by Shaitelman et al, 3-year outcomes of a phase III noninferiority trial indicate that hypofractionated whole-breast irradiation (HF-WBI) followed by a tumor bed boost is not inferior to conventionally fractionated whole-breast irradiation (CF-WBI)...

breast cancer

TGFβ Polymorphism and Radiation-Induced Fibrosis in Breast Cancer

In an analysis reported in JAMA Oncology, Benjamin D. Smith, MD, of the Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, and colleagues found that a single nucleotide polymorphism (C−509T) in the transforming growth factor β1 (TGFβ1) gene was associated with...

breast cancer

TGFβ Polymorphism and Radiation-Induced Fibrosis in Breast Cancer

In an analysis reported in JAMA Oncology, Grossberg et al found that a single nucleotide polymorphism (C−509T) in the transforming growth factor β1 (TGFβ1) gene was associated with higher risk of radiation-induced fibrosis in women with early breast cancer. Study Details The...

SIDEBAR: Expect Questions from Your Patients

Women who have already undergone mastectomy and chemotherapy may question why additional breast cancer treatment is needed. Benjamin D. Smith, MD, of MD Anderson Cancer Center in Houston said that he frequently has patients referred to him who initially express their preference to avoid radiation...

breast cancer

Many Women Treated for High-risk Breast Cancer Do Not Receive Recommended Postmastectomy Radiation Therapy

Despite major studies showing that postmastectomy radiation therapy improves survival for women with high-risk breast cancer and evidence-based guidelines supporting the use of postmastectomy radiotherapy, 45% of these patients do not receive such treatment, according to an analysis of data from...

breast cancer

Study Questions Use of Partial Breast Brachytherapy in Older Women

Partial breast brachytherapy is less effective and more toxic than whole-breast irradiation when used after lumpectomy, suggests an analysis of Medicare claims data. In the 2000–2007 study of more than 130,000 older women with breast cancer—the largest of its kind to date—the rate of mastectomy in...

health-care policy

Rising Costs in Radiation Oncology Linked to Medicare Coverage

In the ongoing debate over how to control rising cancer care costs, it is vital to identify usage patterns of expensive new technologies. A recent study examined the relationship between Medicare reimbursement and the increasing use of intensity-modulated radiation therapy (IMRT).1 The ASCO Post...

SIDEBAR: Difference between Efficacy and Effectiveness

One of the reasons large population-based studies are important is based on the “difference between efficacy—does a treatment work in a highly controlled setting of a phase III randomized clinical trial—and effectiveness—does a treatment work in general practice,” according to Benjamin D. Smith,...

SIDEBAR: Expect Questions from Your Patients

“Our study provides critical interim companion data to awaited randomized trials and may help clinicians and patients quantify the risk-benefit ratio of brachytherapy compared with standard therapy,” Benjamin D. Smith, MD, said of a study comparing lumpectomy and either whole-breast irradiation or...

breast cancer

Will Study Showing Increased Complications Compared to Whole-breast Irradiation Put the Brakes on Brachytherapy?

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Older women treated for invasive...

breast cancer
global cancer care

Breast Cancer and Noncommunicable Diseases: Where in the World Do We Start?

As the world’s most common cancer among women, and the most likely reason around the globe that a woman will die of cancer, breast cancer affects countries at all economic levels. Despite the common misconception that breast cancer is primarily a problem of high-income countries, the majority of...

breast cancer

Reducing Incidental Cardiac Irradiation during Breast Radiotherapy  

In the treatment of breast cancer, a wealth of data from prospective clinical trials and meta-analyses has documented the benefits of radiation to prevent local-regional recurrence and improve survival. Accordingly, important quality indicators in breast cancer care include: (1) receipt of...

breast cancer

For Women ≥ 70 Years with Early Breast Cancer, Adding Radiotherapy to Lumpectomy and Tamoxifen Does Not Increase Survival 

Long-term follow-up of Cancer and Leukemia Group B (CALGB) trial 9343 confirmed and extended 5-year results that in women age ≥ 70 years with clinical stage I, estrogen receptor (ER)-positive breast cancer treated with lumpectomy followed by tamoxifen, “irradiation adds no significant benefit in...

breast cancer

Cautious Comments on the TARGIT-A Trial

Numerous randomized trials have demonstrated that whole-breast irradiation plays an important role after breast-conserving surgery for invasive breast cancer. A recent meta-analysis of these trials indicated that whole-breast irradiation decreased the risk of total breast cancer relapse events and...

breast cancer
cost of care

Benjamin D. Smith, MD, on Mastectomy vs Lumpectomy: Complications and Costs

Benjamin D. Smith, MD, of the MD Anderson Cancer Center, discusses the higher complication rates and economic burdens of mastectomy plus reconstruction vs lumpectomy plus radiation in early breast cancer (Abstract S3-07).

breast cancer
cost of care

SABCS 2015: Mastectomy Plus Reconstruction Has Higher Complication Rates and Costs Than Lumpectomy Plus Radiation

Among the various guideline-concordant local therapy options available for women with early-stage breast cancer in the United States, mastectomy plus reconstruction had the highest complication rates and complication-related costs for both younger women with private insurance and older women on...

breast cancer
issues in oncology

Reduced Short-Term Effects With Hypofractionated Whole-Breast Irradiation After Breast-Conserving Surgery

In a randomized trial reported in JAMA Oncology, Shaitelman et al found that hypofractionated whole-breast irradiation resulted in reduced short-term effects compared with conventional fractionation in women with stage 0 to II breast cancer undergoing breast-conserving surgery. Study Details In...

lung cancer

Outcomes With Lobectomy, Sublobar Resection, and Stereotactic Ablative Radiotherapy in Medicare Patients With Early-Stage NSCLC

In a study on use of the most common definitive therapies for non–small cell lung cancer (NSCLC) in Medicare patients reported in JAMA Surgery, Shirvani et al found that lobectomy was associated with improved outcome vs sublobar resection and that stereotactic ablative radiotherapy may be of...

issues in oncology

Medicaid or No Insurance Associated With Worse Cancer-Specific Survival in Nonelderly Patients

In a study reported in the Journal of Clinical Oncology, Walker et al found that among nonelderly patients with the top 10 most lethal cancers, those with Medicaid or no insurance were more likely to present with advanced disease and less likely to receive cancer-directed surgery or radiation...

prostate cancer

Minority of Older Patients With Low-Risk Prostate Cancer Managed by Observation

Most older men with low-risk prostate cancer receive upfront treatment, despite absence of clear survival benefit and potential for morbidity. In a retrospective cohort study reported in JAMA Internal Medicine, Hoffman et al found that use of observation as management in this setting varied widely...

breast cancer

Needle Biopsy Underused in the United States, Adversely Affecting Breast Cancer Treatment

In a study reported in the Journal of Clinical Oncology, Eberth et al found that needle biopsy is underused in diagnosis and treatment of breast cancer, with a number of surgeon factors contributing to underuse. The study involved Medicare data from 89,712 patients with breast cancer seen between...

breast cancer

Study Identifies Risk of Chemotherapy-Related Hospitalization for Early-Stage Breast Cancer Patients

Oncologists now have a new understanding of the toxicity levels of specific chemotherapy regimens used for women with early-stage breast cancer, according to research from The University of Texas MD Anderson Cancer Center. The retrospective study, reported in the Journal of Clinical Oncology by...

breast cancer

Rates of Breast Reconstruction After Mastectomy Increase, but Use Varies Widely According to Numerous Factors

In a study reported in the Journal of Clinical Oncology, Jagsi et al found that use of breast reconstruction in patients with breast cancer undergoing mastectomy has increased over time but varies according to a number of treatment and demographic characteristics. Study Details The study involved ...

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