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Breast Cancer

Can Artificial Intelligence Predict Treatment Response and Outcomes in Breast Cancer?

Artificial intelligence (AI)—computational analytics with routine imaging via radiology or pathology—can advance precision medicine in breast cancer, specifically by predicting response to therapy and calculating prognosis, according to a pioneer in the field, Anant Madabhushi, PhD, of Emory...

Breast Cancer

HR-Positive, HER2-Negative Metastatic Breast Cancer: Treatment After Disease Progression on CDK4/6 and Aromatase Inhibitors

In the phase II PACE trial reported in the Journal of Clinical Oncology, Erica L. Mayer, MD, MPH, and colleagues found no improvement in progression-free survival with the addition of palbociclib to fulvestrant—but a numeric improvement with the further addition of avelumab—in patients with hormone ...

Breast Cancer

Gedatolisib Plus Palbociclib and Endocrine Therapy in HR-Positive, HER2-Negative Advanced Breast Cancer

As reported in The Lancet Oncology by Layman et al, findings in dose-expansion groups of a phase Ib trial indicated activity of the pan-PI3K–mTOR inhibitor gedatolisib in combination with palbociclib and endocrine therapy in patients with hormone receptor (HR)-positive, HER2-negative advanced...

Breast Cancer
Issues in Oncology

Can TILs Help to Determine Outcomes in Triple-Negative Breast Cancer?

High levels of tumor-infiltrating lymphocytes (TILs) within the tumors of patients with early-stage triple-negative breast cancer may be associated with a lower risk of cancer recurrence and greater rate of survival, even without chemotherapy, according to a recent study published by Leon-Ferre et...

breast cancer

Heather McArthur, MD, MPH, on Early-Stage High-Risk ER+/HER2− Breast Cancer: New pCR Results for Pembrolizumab and Chemotherapy

Heather McArthur, MD, MPH, of UT Southwestern Medical Center, discusses phase III findings from the KEYNOTE-756 trial, which shows that adding pembrolizumab to neoadjuvant chemotherapy increases pathologic complete response (pCR) rates in patients with early-stage, high-risk, estrogen receptor–positive or HER2-negative breast cancer. (ER+/HER2−). The regimen shifted more patients to lower residual cancer burden categories (Abstract 2).

breast cancer

Natália Polidorio, MD, PhD, on Triple-Negative Breast Cancer: Impact of Race on Treatment Efficacy

Natália Polidorio, MD, PhD, of Memorial Sloan Kettering Cancer Center, discusses findings on the impact of race on pathologic complete response in patients with early-stage triple-negative breast cancer who received neoadjuvant chemoimmunotherapy vs chemotherapy alone. Such targeted research may potentially result in more informed treatment strategies and improved identification of those most likely to benefit (Abstract 15).

Breast Cancer

Giredestrant in Previously Treated Patients With ER-Positive, HER2-Negative Advanced Breast Cancer

In the phase II acelERA BC trial reported in the Journal of Clinical Oncology, Miguel Martín, MD, PhD, and colleagues found that the selective estrogen receptor (ER) antagonist and degrader giredestrant did not significantly improve progression-free survival vs physician’s choice of endocrine...

Breast Cancer

Treating DCIS: To Escalate or De-escalate?

There is much debate about the necessity of treating women with ductal carcinoma in situ (DCIS) with surgery or radiotherapy.1,2 It is disconcerting to many that patients with DCIS are treated in the same way as are women with early-stage invasive breast cancer. Many patients with DCIS have...

Breast Cancer
Supportive Care

Early Breast Cancer: Nurse-Led Follow-up Intervention and Quality of Life After Treatment

In a Danish single-institution phase III trial (MyHealth) reported in the Journal of Clinical Oncology, Saltbæk et al found that nurse-led individualized follow-up was associated with significantly better breast cancer–specific quality of life compared with usual care after completion of primary...

Breast Cancer

Early Breast Cancer: Adding Adjuvant Ribociclib to Nonsteroidal Aromatase Inhibitor Therapy

As reported in The New England Journal of Medicine by Dennis Slamon, MD, PhD, and colleagues, interim analysis of the phase III NATALEE trial has shown improved invasive disease–free survival with the addition of adjuvant ribociclib to a nonsteroidal aromatase inhibitor (NSAI) in patients with...

Breast Cancer
Issues in Oncology

Low-Dose Radiotherapy Boost in Young Patients With Breast Cancer

Researchers have found that a low-dose radiotherapy boost in addition to whole-breast radiotherapy may prevent local recurrence in young patients with breast cancer, according to new findings presented by Bosma et al at the 2024 European Breast Cancer Conference (EBCC) (Abstract 4LBA) and...

Breast Cancer
Issues in Oncology

Response to Primary Systemic Therapy Could Dictate Whether Extensive Lymph Node Removal Is Needed in Patients With Breast Cancer

Extensive removal of the lymph nodes may be safely avoided in patients with breast cancer that has metastasized to the axillary nodes if treatment is tailored to their response to therapies such as chemotherapy prior to surgery, according to new findings presented by van Hemert et al at the 2024...

Breast Cancer
Issues in Oncology

Combined PET-MRI Scan Could Benefit Patients With Early-Stage Breast Cancer

A combined positron-emission tomography–magnetic resonance imaging (PET-MRI) scanning technique could improve the treatment of some patients with early-stage breast cancer, according to new findings presented by Di Micco et al at the 2024 European Breast Cancer Conference (EBCC) (Abstract 9) and...

Breast Cancer
Issues in Oncology

Addition of Atezolizumab to Adjuvant Chemotherapy in Triple-Negative Breast Cancer

The addition of atezolizumab to postsurgery chemotherapy may not benefit patients with triple-negative breast cancer, according to findings recently presented by McArthur et al at the 2024 European Breast Cancer Conference (EBCC; Abstract 1LBA). Background Triple-negative breast cancer is often...

Breast Cancer
Supportive Care
Symptom Management
Pain Management

Effect of Exercise on Symptom Burden and Quality of Life in Patients With Metastatic Breast Cancer

Taking part in an exercise program may improve pain, fatigue, and quality of life in patients with metastatic breast cancer, according to recent findings presented by Hiensch et al at the 2024 European Breast Cancer Conference (EBCC; Abstract 1). Background “Although there’s been quite a lot of...

Breast Cancer
Immunotherapy

Updated Immune Classifier May Accurately Identify Patients With Triple-Negative Breast Cancer Who Are Unlikely to Respond to Immunotherapy

A novel genetic test may predict how patients with triple-negative early-stage breast cancer will respond to immunotherapy, according to new findings presented by Wolf et al at the 2024 European Breast Cancer Conference (EBCC) (Abstract 2LBA). The research may help patients who are unlikely to...

Breast Cancer
Immunotherapy

Pembrolizumab May Improve Breast Cancer Outcomes Regardless of Age or Menopausal Status

The addition of the immunotherapy drug pembrolizumab to chemotherapy prior to and following surgery may lead to improved outcomes in patients with breast cancer regardless of their age or menopausal status, according to new findings presented by Cardoso et al at the 2024 European Breast Cancer...

Breast Cancer

ASCO Releases Resource-Stratified Guideline for the Treatment of Metastatic Breast Cancer

ASCO has released a new guideline on the treatment of patients with metastatic breast cancer in resource-constrained settings, where maximal setting–recommended treatments are not available.1 The guideline, designed for clinicians, policymakers, and patients, provides stratified recommendations...

Breast Cancer
COVID-19

Trends in Breast Cancer Diagnoses During the COVID-19 Pandemic

Investigators may have identified a decrease in newly diagnosed breast cancer cases during the first year of the COVID-19 pandemic, according to a recent study published by Fefferman et al in Cancer Medicine. The findings highlight that breast cancer was not immune to pandemic-related stressors and ...

Breast Cancer

Metastatic Triple-Negative Breast Cancer: Sacituzumab Govitecan vs Single-Agent Chemotherapy in Previously Treated Patients

As reported in the Journal of Clinical Oncology by Aditya Bardia, MD, MPH, and colleagues, final results of the phase III ASCENT trial showed continued superior progression-free and overall survival with sacituzumab govitecan-hziy, an anti–trophoblast cell surface antigen 2 (Trop-2) antibody-drug...

Breast Cancer
Issues in Oncology

Higher BMI May Be Linked to Complications Following Autologous Breast Reconstruction

Patients with a higher body mass index (BMI) may have a greater risk of overall and specific complications following autologous breast reconstruction, according to a recent study published by Barnes et al in Plastic and Reconstructive Surgery. Background Autologous breast reconstruction—an...

Breast Cancer
Genomics/Genetics

ASCO and SSO Publish New Guideline on Germline Testing in Breast Cancer

ASCO in partnership with the Society of Surgical Oncology (SSO) has released a new guideline addressing recommendations in germline testing in patients with breast cancer.1 The guideline provides oncologists with a framework for how to approach germline testing and recommendations for who should be ...

Supportive Care
Breast Cancer
Gastrointestinal Cancer

Topical Diclofenac to Prevent Capecitabine-Associated Hand-Foot Syndrome

In an Indian single-center phase III trial (D-TORCH) reported in the Journal of Clinical Oncology, Santhosh et al found that topical diclofenac gel significantly reduced the risk of capecitabine-associated hand-foot syndrome vs placebo gel in patients with breast or gastrointestinal cancer who were ...

Breast Cancer

Patients With Early-Stage HR-Positive Breast Cancer May Be Over- or Undertreated Without Breast Cancer Index Genomic Testing

Newly published study results revealed that use of the Breast Cancer Index (BCI) test led to physicians changing their long-term antiestrogen treatment recommendations for 40% of patients with early-stage hormone receptor–positive breast cancer. The results, which suggest that many women may be...

Breast Cancer
Genomics/Genetics

Finding New Therapeutic Targets for Male Breast Cancer

Researchers have uncovered distinct alterations in the tumor genome of male patients with breast cancer that may suggest potential therapeutic targets, according to a recent study published by Assaad et al in Modern Pathology. Background Breast cancer in male patients represents less than 1% of all ...

breast cancer

Endocrine-Resistant HR-Positive/HER2-Negative Metastatic Breast Cancer

This is Part 3 of Targeting Endocrine Resistance in HR-Positive/HER2-Negative Metastatic Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Kevin Kalinsky, Manali Bhave, and Ruth O’Regan discuss the treatment of endocrine-resistant hormone receptor–positive, HER2-negative metastatic breast cancer. The patient is a 61-year-old postmenopausal female who was initially diagnosed with stage IB, ER-positive, PR-positive, HER2 IHC 1+, histologic grade 3 invasive ductal carcinoma. She was treated with lumpectomy and radiotherapy followed by nonsteroidal aromatase inhibitor for 4.5 years of therapy, during which her disease progressed. Further imaging reveals multiple bone and liver lesions. Her liver lesion is biopsied and found to be invasive ductal carcinoma, ER/PR 50%, and HER2 IHC 1+. She receives fulvestrant and ribociclib for 4 months, and then experiences new shortness of breath due to lymphangitic spread. A ctDNA reveals a pathogenic PIK3CA H1047R mutation and ESR1 D538G mutation.   The faculty discuss next steps for a symptomatic patient such as this with pathogenic mutations, sequencing of antibody-drug conjugates, and how best to manage and monitor for toxicities.

breast cancer

HR-Positive/HER2-Negative Metastatic Breast Cancer With PIK3CA Mutation

This is Part 2 of Targeting Endocrine Resistance in HR-Positive/HER2-Negative Metastatic Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Kevin Kalinsky, Manali Bhave, and Ruth O’Regan discuss the treatment of hormone receptor–positive, HER2-negative metastatic breast cancer with a PIK3CA mutation. The patient is a 62-year-old postmenopausal female who is diagnosed with invasive ductal carcinoma that is metastatic to lung, liver, and bone. Her tumor is ER and PR strongly positive and HER2-low. After 12 months of treatment with ribociclib plus an aromatase inhibitor, she has progressive disease in her liver. Biomarker testing reveals a pathogenic PIK3CA H1047R mutation.   The faculty discuss how PIK3CA and AKT pathway alterations impact treatment decision making, the clinical implications of the CAPItello-291 study, and how to approach patients who do not have targetable mutations.

breast cancer

Second-Line Treatment of HR-Positive/HER2-Negative ESR1-Mutated Metastatic Breast Cancer

This is Part 1 of Targeting Endocrine Resistance in HR-Positive/HER2-Negative Metastatic Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable.   In this video, Drs. Kevin Kalinsky, Manali Bhave, and Ruth O’Regan discuss the treatment of metastatic hormone receptor–positive, HER2-negative, ESR1-mutated breast cancer after progression on a CDK4/6 inhibitor and endocrine therapy. The patient is a 42-year-old premenopausal healthy female originally diagnosed with grade 2 invasive ductal carcinoma that is ER and PR strongly positive and HER2 0. She receives ribociclib plus an aromatase inhibitor and develops progressive disease after almost 3 years on therapy. Genetic testing reveals a pathogenic ESR1 Y537S mutation.   In the conversation that follows, the faculty discuss the role of single-agent elacestrant in patients with acquired ESR1 mutations, the impact of prior treatment duration on second-line therapy, and whether combination strategies should be considered.

Breast Cancer
Issues in Oncology

Social Determinants of Health Potentially Responsible for Low Breast Cancer Screening Rates

Investigators may have uncovered the social determinants of health hindering breast cancer screening in the United States, according to a recent systematic review published by Jhumkhawala et al in Frontiers in Public Health. Background Health disparities have consistently been associated with...

Breast Cancer

Racial/Ethnic Differences in Treatment Outcomes Among Patients With Triple-Negative Breast Cancer

In a study reported in the Journal of Clinical Oncology, Woriax et al identified racial/ethnic differences in pathologic complete response rates and overall survival among women with triple-negative breast cancer who received neoadjuvant chemotherapy. Study Details The study involved data from the...

Breast Cancer

Circulating Leukocyte Subsets After Breast Cancer Diagnosis and Treatment

In an analysis reported in JAMA Network Open, Jacob K. Kresovich, PhD, and colleagues identified differences in circulating leukocyte subsets between women who were diagnosed and treated for breast cancer vs those not diagnosed with breast cancer. As stated by the investigators: “Changes in...

Breast Cancer
Colorectal Cancer
Issues in Oncology

U.S. Individuals With Incarceration History May Have Lower Likelihood of Undergoing Cancer Screenings

Investigators have found that U.S. individuals with a history of incarceration may have worse access to and receipt of breast cancer and colorectal cancer screenings compared with those without a history of incarceration, according to a recent study published by Zhao et al in JAMA Health Forum....

Breast Cancer
Lymphoma
Survivorship

Doxorubicin Exposure and Risk of Breast Cancer in Survivors of Hodgkin Lymphoma

In a Dutch study reported in the Journal of Clinical Oncology, Neppelenbroek et al found that doxorubicin treatment was associated with an increased risk of breast cancer among adolescent and adult Hodgkin lymphoma survivors. Study Details The study involved a cohort of 1,964 female 5-year Hodgkin...

Breast Cancer

Highlights From the 2023 San Antonio Breast Cancer Symposium

Studies presented at the 2023 San Antonio Breast Cancer Symposium (SABCS) significantly moved the needle forward in our treatment of breast cancer. We are increasingly learning how to stratify risk, so we can optimize therapy and minimize our patients’ exposure to treatments that will not be...

Breast Cancer

Patients With Advanced Breast Cancer May Gain Multiple Benefits From Exercise as Part of Palliative Care

Although current ASCO guidelines recommend exercise for patients with breast cancer during adjuvant therapy with curative intent, the guidelines state that more study is needed regarding the effects of exercise for patients with metastatic breast cancer. The results of the PREFERABLE-EFFECT trial...

Breast Cancer

Some Patients With Breast Cancer May Safely Avoid Locoregional Irradiation After Neoadjuvant Chemotherapy

It may be possible for some patients with breast cancer to avoid adjuvant regional nodal irradiation safely, according to the results of the NRG Oncology/NSABP B-51/RTOG 1304 clinical trial presented at the 2023 San Antonio Breast Cancer Symposium.1 These findings particularly apply to patients...

Breast Cancer

IDEA Trial: Might Radiation One Day Be Safely Omitted for Younger, Favorable-Risk, Postmenopausal Patients With Breast Cancer?

Investigators used low recurrence scores on a genomic assay as guidance for selection of favorable-risk patients, and they found most postmenopausal patients (aged 50–69) with stage I hormone receptor–positive breast cancer who omitted adjuvant radiation therapy but continued endocrine therapy for...

Breast Cancer

Expert Point of View: Laura Huppert, MD

Invited discussant Laura Huppert, MD, of the University of California, San Francisco, Comprehensive Cancer Center, focused her remarks on the need for biomarkers for selection of immunotherapy as part of neoadjuvant chemotherapy for hormone receptor–positive, HER2-negative breast cancer. “Hormone...

Breast Cancer

Neoadjuvant Chemoimmunotherapy Improves Pathologic Complete Response Rates in Subgroup Analysis of KEYNOTE-756

Pembrolizumab added to neoadjuvant chemotherapy followed by adjuvant pembrolizumab plus endocrine therapy improved pathologic complete responses in patients with early-stage, high-risk, estrogen receptor (ER)-positive, HER2-negative breast cancer, according to updated results of the phase III...

Breast Cancer

Long-Term Follow-up Supports Postneoadjuvant T-DM1 Over Trastuzumab in Early, High-Risk, HER2-Positive Breast Cancer

At a median follow-up of 8.4 years, adjuvant use of ado-trastuzumab emtansine (T-DM1) continued to improve invasive disease–free survival and overall survival compared with trastuzumab in patients with HER2-positive early breast cancer with residual invasive disease after neoadjuvant therapy. These ...

Breast Cancer

Expert Point of View: Heather Han, MD

Heather Han, MD, Research Director, Department of Breast Oncology, Moffitt Cancer Center, Tampa, commented on the latest update from the NATALEE trial: “Despite the established standard adjuvant therapy, many patients with hormone receptor–positive, early-stage breast cancer (including stages...

Breast Cancer

NATALEE Trial: Long-Term Results on Ribociclib Combination Therapy in Early-Stage Breast Cancer

Invasive disease–free survival continued to be significantly improved for patients with hormone receptor–positive, HER2-negative, early-stage breast cancer who received the CDK4/6 inhibitor ribociclib plus a nonsteroidal aromatase inhibitor compared with a nonsteroidal aromatase inhibitor alone....

Breast Cancer

Novel PI3K Inhibitor as Part of Triplet Improves Outcomes in Hormone Receptor–Positive, HER2-Negative Breast Cancer

The addition of inavolisib to first-line treatment with palbociclib plus fulvestrant more than doubled progression-free survival in patients with recurrent PIK3CA-mutated, hormone receptor–positive, HER2-negative advanced breast cancer, according to a late-breaking primary analysis of the phase III ...

Breast Cancer

HER2CLIMB-02: Tucatinib Plus T-DM1 Extends Progression-Free Survival vs T-DM1 Alone in Advanced HER2-Positive Breast Cancer

Adding the antibody-drug conjugate ado-trastuzumab emtansine (T-DM1) to the HER2-targeted agent tucatinib extended progression-free survival by about 2 months vs treatment with T-DM1 alone among patients with unresectable, locally advanced or metastatic HER2-positive breast cancer, according to...

Breast Cancer

8-Year Follow-up of MINDACT Trial: Locoregional Breast Cancer Recurrence in Patients Undergoing Breast-Conserving Surgery

In a long-term analysis of the EORTC 10041/BIG 03-04 MINDACT trial reported in the Journal of Clinical Oncology, Alaeikhanehshir et al found that the 70-gene signature was not independently predictive of locoregional recurrence among women undergoing breast-conserving surgery for early breast...

Breast Cancer

IDEA Trial: Might Radiation One Day Be Safely Omitted for Younger, Favorable-Risk, Postmenopausal Patients With Breast Cancer?

Investigators used low recurrence scores on a genomic assay as guidance for selection of favorable-risk patients, and they found most postmenopausal patients (aged 50–69) with stage I hormone receptor–positive breast cancer who omitted adjuvant radiation therapy but continued endocrine therapy for...

Breast Cancer

Enobosarm in Previously Treated Patients With AR-Positive, ER-Positive, HER2-Negative Advanced Breast Cancer

In a phase II trial (Study G200802) reported in The Lancet Oncology, Palmieri et al found that the novel selective androgen receptor (AR) modulator enobosarm was active in previously treated patients with AR-positive, estrogen receptor (ER)-positive, HER2-negative locally advanced or metastatic...

Breast Cancer

Long-Term Follow-up of the Anthracyclines in Early Breast Cancer (ABC) Trials

As reported in the Journal of Clinical Oncology by Charles E. Geyer Jr, MD, and colleagues, long-term follow-up of the ABC trials (USOR 06-090, NSABP B-46-I/USOR 07132, and NSABP B-49 [NRG Oncology]) showed that noninferiority of adjuvant nonanthracycline therapy was not demonstrated vs...

Breast Cancer
Pain Management
Symptom Management

Hyperbaric Oxygen Therapy for Late Local Toxic Effects in Patients Receiving Adjuvant Radiotherapy for Breast Cancer

In a Dutch study (HONEY) reported in JAMA Oncology, van der Molen et al found that patients with breast cancer and late local toxic effects after adjuvant radiotherapy who completed hyperbaric oxygen therapy (HBOT) had reductions in pain and fibrosis. However, only a minority of patients offered...

Breast Cancer
Issues in Oncology

Does Annual Breast Cancer Screening Starting at Age 40 Offer Benefit?

Investigators have found that annual breast cancer screening beginning at age 40 and continuing to at least 79 may result in the greatest reduction in mortality with minimal risks, according to a recent study published by Monticciolo et al in Radiology. Background Breast cancer is the second most...

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