Helping Patients With Breast Cancer Decide Whether to Have Reconstruction
A “nascent movement to ‘go flat’” is how an article in The New York Times characterized the decisions by some women to opt out of reconstruction following surgery for breast cancer.1 The article examined the reasons several patients made that decision, which included avoiding multiple surgeries and ...
Clinical Strategies for Improving Endocrine Therapy in Metastatic Breast Cancer
Most women with hormone receptor–positive breast cancer receive endocrine therapy as part of their treatment, but “the reality is that patients who receive antihormone therapy in the metastatic disease setting ultimately develop disease progression, ” William J. Gradishar, MD, stated at the 18th...
Androgen Receptor Antagonists May Meet ‘Unmet Need’ in Triple-Negative Breast Cancer
Although there are no androgen receptor antagonists currently approved for the treatment of breast cancer, clinical trials indicate that these agents benefit some patients with triple-negative breast cancer, Tiffany A. Traina, MD, told participants at the 18th Annual Lynn Sage Breast Cancer...
Phase III Trial Shows Ado-Trastuzumab Emtansine Noninferior to Trastuzumab/Taxane in HER2-Positive Breast Cancer
In the phase III MARIANNE trial reported in the Journal of Clinical Oncology, Perez et al found that ado-trastuzumab emtansine (formerly known as T-DM1; Kadcyla) was associated with noninferior progression-free survival compared with trastuzumab (Herceptin) plus taxane in patients with...
Updated ASTRO Guideline Expands Pool of Suitable Candidates for Accelerated Partial-Breast Irradiation
On November 17, the American Society for Radiation Oncology (ASTRO) issued an updated clinical practice statement for accelerated partial-breast irradiation for early-stage breast cancer. The updated guideline reflects recent evidence that greater numbers of patients can benefit from accelerated...
Another Step Forward for Genomic Assays in Early-Stage Breast Cancer: Findings With MammaPrint in the MINDACT Trial
Genomic assays have had a powerful influence on the management of early-stage breast cancer, particularly estrogen receptor–positive tumors. The mainstay of adjuvant treatment for early-stage, hormone receptor–positive breast cancer has been endocrine therapy, either with tamoxifen and an...
Phase III Trial Shows Improved PFS With Addition of Palbociclib to Letrozole in ER-Positive, HER2-Negative Breast Cancer
In the phase III PALOMA-2 trial reported in The New England Journal of Medicine, Finn et al found that the addition of palbociclib (Ibrance) to letrozole significantly improved progression-free survival in postmenopausal women with previously untreated advanced estrogen receptor–positive,...
Living With Metastatic Breast Cancer Is Like Walking a Tightrope
I’ve always had fibrocystic breasts and was steadfast in performing monthly breast self-exams, so I could become familiar with the terrain of my breasts and spot any subtle changes. So, in November 2002, when I felt something in my left breast that seemed different from my usual lumps, I made a...
Chemotherapy May Be Avoidable in Some Women With Early-Stage Breast Cancer Based on Clinical and Genomic Risks
In the phase III MINDACT trial reported in The New England Journal of Medicine, Fatima Cardoso, MD, of Champalimaud Clinical Center–Champalimaud Foundation, Lisbon, and colleagues found that adjuvant chemotherapy may be avoidable in women with early-stage breast cancer who are at high clinical...
Is Observation Without Surgery a Viable Strategy for Managing Ductal Carcinoma in Situ?
In a spirited debate, abounding with citations of clinical trials and other evidence, but not without humor and mutual respect, E. Shelley Hwang, MD, MPH, and Armando E. Giuliano, MD, reviewed the data and their clinical experience managing ductal carcinoma in situ and reached opposite...
1 in 6 Women Diagnosed With Breast Cancer Have a Symptom Other Than a Lump
Around one in six women (17%) diagnosed with breast cancer go to their doctor with a symptom other than a lump—the most commonly reported breast cancer symptom—according to new research presented by Koo et al at the 2016 National Cancer Research Institute (NCRI) Cancer Conference in...
Fulvestrant Superior to Anastrozole as Initial Therapy in Advanced Breast Cancer
Fulvestrant (Faslodex) was superior to anastrozole as initial treatment of hormone receptor–positive, endocrine therapy–naive, advanced breast cancer, significantly reducing the risk of disease progression or death, according to the results of the phase III FALCON study presented at the 2016...
Mammography Outcomes Improve When Physicians Compare Prior Screenings
The recall rate of screening mammography is reduced when radiologists compare with more than one prior mammogram, according to a recent study by Hayward et al in American Journal of Roentgenology. “Our findings suggest that radiologists who make comparisons with more than one prior...
Study Raises Concerns About Timely Follow-up to Positive Mammogram for the Uninsured
A study by University of North Carolina (UNC) Lineberger Comprehensive Cancer Center researchers has found that younger, uninsured women in North Carolina had higher odds of missing a 60-day window for getting follow-up after an abnormal mammogram, even though research underscores the importance of ...
Ribociclib Granted FDA Priority Review for First-Line Treatment of Hormone Receptor–Positive/HER2-Negative Advanced Breast Cancer
On November 1, the U.S. Food and Drug Administration (FDA) accepted a New Drug Application (NDA) for filing and granted Priority Review for ribociclib (LEE011) as first-line treatment of postmenopausal women with hormone receptor–positive, human epidermal growth factor receptor 2...
Breast Cancer Hormonal Therapy Persistence and Adherence Better in Black, Hispanic, and White Women With vs Without Medicare D Prescription Subsidies
In a study reported in the Journal of Clinical Oncology, Biggers et al found that persistence and adherence with hormonal therapy for breast cancer were greater among black, Hispanic, and white women with vs without low-income prescription subsidies in Medicare Part D. The study involved 25,111...
Effect of Patient Age on Outcomes in Breast Reconstruction
The most comprehensive study of its kind to date found that older women enjoy the same benefits from breast reconstruction following mastectomy for breast cancer as younger women, without a significant increase in the risk for complications. As with patients across all age groups, the benefits of...
Genetic Testing May Be Beneficial in Identifying Patients With Breast Cancer at High Risk for Venous Thromboembolism
Venous thromboembolism is a serious—and sometimes fatal—complication of cancer and chemotherapy treatment. Since breast cancer is one of the most common cancers, it accounts for a large number of cancer-related cases of venous thromboembolism. Routine thromboprophylaxis, however, is not ...
Clinical Trials Actively Recruiting Patients With Metastatic Breast Cancer
Pilot Study Title: Pilot Study of 18F-FLT-PET Imaging of the Brain in Patients With Metastatic Breast Cancer to the Brain Treated With Whole-Brain Radiation Therapy With or Without Sorafenib: Comparison With MR Imaging of the Brain Study Type: Pilot/interventional/parallel assignment Study Sponsor ...
Dexamethasone Mouth Rinse Should Be Routine Part of Everolimus Treatment
Dexamethasone mouth rinse should be given prophylactically to prevent stomatitis associated with everolimus (Afinitor)/exemestane in metastatic breast cancer, according to Hope S. Rugo, MD, principal investigator of the SWISH trial and Director of Breast Oncology and Clinical Trials Education at...
Consensus on Defining and Measuring Lymphedema Is Needed to Advance Efforts to Intervene Early and Prevent Progression
“Early intervention might prevent lymphedema progression,” Alphonse Taghian, MD, PhD, said at the 18th Annual Lynn Sage Breast Cancer Symposium in Chicago, but the lack of a universal definition of lymphedema and agreement on how to optimally measure it impedes phase III studies to test that...
Mammography-Detected Small Breast Cancers May Represent Overdiagnosis, With Survival Gains Reflecting Improved Systemic Therapy
In a study using SEER (Surveillance, Epidemiology, and End Results) data reported in The New England Journal of Medicine, Welch et al found that screening mammography has resulted in a substantial increase in detection of small breast tumors, many of which represent overdiagnosis, accompanied by...
Breast Cancer Study Finds Higher Mortality Rate in Black Women Than White Women, and the Disparity Is Growing
The Avon Foundation for Women recently released a new study on the racial disparities in breast cancer mortality in the 50 largest cities in the United States between 2005 and 2014. Published in Cancer Epidemiology,1 the study was conducted by Sinai Urban Health Institute in collaboration with the...
New SSO-ASTRO-ASCO Clinical Practice Guideline Clarifies the Question of Margins for Breast-Conserving Surgery in Ductal Carcinoma in Situ
In 2014, the Society of Surgical Oncology (SSO) and the American Society for Radiation Oncology (ASTRO) published a “Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stages I and II Invasive Breast Cancer.”1 A multidisciplinary expert guideline used a...
Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Ductal Carcinoma in Situ
A clinical practice guideline on margins for breast-conserving surgery with whole-breast irradiation in ductal carcinoma in situ has been jointly developed by the Society of Surgical Oncology (SSO), the American Society for Radiation Oncology (ASTRO), and ASCO.1-3 The recommendations were...
Study Shows Strong Evidence Supporting Radiation Boost to Tumor Bed in Ductal Carcinoma in Situ
A radiation boost to the local tumor bed following treatment with breast-conserving therapy (ie, local excision followed by whole-breast radiation therapy) improves local control for patients with ductal carcinoma in situ, according to a study of pooled data from 10 academic centers,1 presented at...
Combination of Ribociclib and Letrozole Improved Progression-Free Survival in Hormone Receptor–Positive Advanced Breast Cancer
The combination of the selective CDK4/6 inhibitor ribociclib plus letrozole significantly improved progression-free survival in hormone receptor–positive advanced breast cancer. When ribociclib was added to letrozole, progression-free survival improved by 44% compared with letrozole alone,...
Judith Balmaña, MD, PhD, on Metastatic Breast Cancer: Study Results on Lurbinectedin (Spanish Language Version)
Judith Balmaña, MD, PhD, of Vall d’Hebron University Hospital, discusses in Spanish the findings of a single-agent phase II trial on the antitumor activity of lurbinectedin in BRCA1/2-associated metastatic breast cancer patients. (Abstract 223O)
Genetic Markers Associated With Pathologic Complete Response to Neoadjuvant Therapy Identified in HER2-Positive Breast Cancer
In an analysis reported in JAMA Oncology, Fumagalli et al identified genetic markers associated with pathologic complete response among women with early-stage HER2-positive breast cancer receiving neoadjuvant therapy in the phase III NeoALTTO trial. Study Details In the NeoALTTO trial, 455...
ESMO 2016: Antitumor Activity Demonstrated With Lurbinectedin in Patients With Metastatic Breast Cancer and BRCA Mutations
Lurbinectedin showed promising clinical benefit in pretreated patients with metastatic breast cancer and BRCA1 or BRCA2 mutations, including patients previously treated with platinum, according to phase II trial results presented by Balmaña et al at the 2016 European Society for Medical...
ESMO 2016: Fulvestrant Improves Progression-Free Survival in Advanced Breast Cancer
Fulvestrant (Faslodex) significantly increases progression-free survival in women with hormone receptor–positive advanced breast cancer, particularly those with less aggressive lower-volume disease, Ellis et al reported at the 2016 European Society for Medical Oncology (ESMO) Congress in ...
First-Line Ribociclib Prolongs Progression-Free Survival in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer
In a phase III trial reported at the recent European Society for Medical Oncology Congress and in The New England Journal of Medicine by Hortobagyi et al, first-line treatment with ribociclib, a selective inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6), resulted in significantly longer...
Women With Breast Cancer Report Primary Care Physician Involvement in Care and Participation in Decision-Making
Most women with breast cancer reported high primary care physician quality, engagement, and communication, with a minority reporting high levels of primary care physician participation in treatment decisions, according to a study reported by Wallner et al in the Journal of Clinical Oncology....
ESMO 2016: Ribociclib Improves Progression-Free Survival in Advanced Breast Cancer
The addition of the CDK4/6 inhibitor ribociclib to letrozole therapy significantly improved progression-free survival in postmenopausal women with hormone receptor–positive advanced breast cancer, reported Hortobagyi et al at the 2016 European Society for Medical Oncology...
Matthew J. Ellis, PhD, MB, BCh, on Breast Cancer: Results of the FALCON Trial
Matthew J. Ellis, PhD, MB, BCh, of the Baylor College of Medicine, discusses phase III study findings on fulvestrant 500 mg vs anastrozole for hormone receptor-positive advanced disease. (Abstract LBA14)
Melanie Royce, MD, PhD, on Breast Cancer: Results From the BOLERO-4 Trial
Melanie Royce, MD, PhD, of the University of New Mexico, discusses phase II study findings on first-line everolimus plus letrozole in patients with ER+, HER2− advanced breast cancer. (Abstract 222O)
Sara A. Hurvitz, MD, on Breast Cancer: Results From the neoMONARCH Trial
Sara A. Hurvitz, MD, of the University of California, Los Angeles, discusses interim findings on abemaciclib in postmenopausal women with HR+/HER2- breast cancer. (Abstract LBA13)
Judith Balmaña, MD, PhD, on Metastatic Breast Cancer: Study Results on Lurbinectedin
Judith Balmaña, MD, PhD, of Vall d’Hebron University Hospital, discusses the findings of a single-agent phase II trial on the antitumor activity of lurbinectedin in BRCA1/2-associated metastatic breast cancer patients. (Abstract 223O)
Shou-Ching Tang, MD, PhD, on Recurrent CNS Metastases in Breast Cancer: Study Results on a Novel Conjugate
Shou-Ching Tang, MD, PhD, of the Georgia Cancer Center, discusses findings on a novel peptide–paclitaxel conjugate that crosses the blood-brain barrier and shows activity in breast cancer patients with recurrent central nervous system metastases. (Abstract 324O)
Lack of Androgen Receptor Protein May Contribute to Racial Disparities in Triple-Negative Breast Cancer Outcomes
Triple-negative breast cancer in African American women is much more likely to lack the androgen receptor protein compared with triple-negative breast cancer in European American women, and this may contribute to the racial disparity in survival outcomes among these two populations, according to a...
Affordable Care Act Increased Access to Cancer Care and Clinical Trial Participation Among Hispanics
Implementation of the Affordable Care Act (ACA) in California may have led to a significant increase in the number of Hispanic breast cancer patients at a National Cancer Institute (NCI)-designated cancer center and an increase in the number of Hispanic women who consented to participate in a...
Bevacizumab/Capecitabine vs Bevacizumab/Paclitaxel in HER2-Negative Breast Cancer
As reported in The Lancet Oncology by Christoph Zielinski, MD, of the Medical University of Vienna and the Central European Cooperative Oncology Group, and colleagues, the final results of the phase III TURANDOT trial showed that overall survival with first-line bevacizumab (Avastin)/capecitabine...
Tailoring Breast Cancer Screening for Older Women by Breast Density and Risk
A collaborative modeling study evaluating outcomes for various screening intervals for women over the age of 50 based on breast density and risk for breast cancer has found that average-risk women with low breast density undergoing triennial screening and higher-risk women with high breast density...
The Medical Profession Has to Become Culturally Sensitive to the Needs of LGBT Cancer Survivors
Despite my breast cancer diagnosis 4 years ago, I feel really lucky. My cancer was detected relatively early, stage IIB, during a routine mammogram screening—a test that many of my lesbian friends skip because they don’t want to deal with a medical system steeped in a heterosexual culture that is...
Clinical Trials Actively Recruiting Patients With Early Breast Cancer
Pilot Study Title: Pilot Trial of an Implantable Microdevice for in Vivo Drug Sensitivity Testing in Patients With Early-Stage, HER2-Positive, or Triple-Negative Breast Cancer Receiving Neoadjuvant Therapy Study Type: Pilot/interventional/single-group assignment Study Sponsor and Collaborators:...
Susan G. Komen Announces $27 Million Initiative to Reduce Breast Cancer Deaths in African American Community
The Susan G. Komen breast cancer organization gathered philanthropic, civic, medical, and business leaders in Washington, DC, September 14 to formally launch a $27 million, 10-city initiative to reduce breast cancer death rates among African American women. “African American women are almost 40%...
Metastatic Breast Cancer Alliance Launches ‘Help Keep Me in the Picture’ Campaign
To raise awareness and support for those with metastatic breast cancer, the Metastatic Breast Cancer Alliance launched its “Help Keep Me in the Picture” campaign. The campaign includes a social media initiative and a new microsite—KeepMeInThePicture.com—which shares stories from patients,...
Meena Moran, MD, on Ductal Carcinoma In Situ: Improving Local Control
Meena Moran, MD, of Yale University, discusses an analysis from 10 pooled academic institutions that showed a radiation boost after whole breast radiation therapy improves local control of this disease. (Abstract 324)
ASTRO 2016: Radiation Boost Reduces Local Tumor Recurrence for Patients With DCIS Following WBRT
A supplemental “boost” of radiation improves local control and provides an incremental benefit in decreasing breast cancer recurrence for patients with ductal carcinoma in situ (DCIS) who receive whole breast radiation therapy radiation (WBRT) following lumpectomy, according to research ...
ASCO/ASTRO/SSO Develop Focused Guideline Update on Postmastectomy Radiotherapy
As reported by Recht et al in the Journal of Clinical Oncology, a joint ASCO, American Society for Radiation Oncology (ASTRO), and Society of Surgical Oncology (SSO) panel has developed a focused guideline update of the ASCO guideline on postmastectomy radiotherapy. A recent Cancer Care Ontario...
