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Breast Cancer

The Search for Optimal Adjuvant Breast Cancer Chemotherapy: The End of an Era?

Using a complex and innovative study design, Budd and colleagues from the Southwest Oncology Group (SWOG) addressed, in a randomized multicenter trial,1 an issue that has been under evaluation for over 40 years—namely, what are the optimal dose and schedule for adjuvant breast cancer chemotherapy?...

Breast Cancer

Combination Treatment Every 2 Weeks May Benefit Some Women With High-Risk Early-Stage Breast Cancer

In a phase III trial (SWOG S0221) reported in the Journal of Clinical Oncology, George T. Budd, MD, of Taussig Cancer Center, Cleveland Clinic, and colleagues found no difference in disease-free survival among four different combinations of continuous or every-other-week...

Skin Cancer
Breast Cancer

Determining Why Not All Patients Respond to PD-1 Inhibitors

Recent research1 conducted by Robert H. Pierce, MD, and his colleagues investigating why PD-1 (programmed cell death protein 1) inhibitors result in remarkably durable clinical remissions in some patients with melanoma, whereas others reap a short-term benefit or no benefit at all is showing that...

Breast Cancer

FDA Approves Palbociclib in Combination With Letrozole for Advanced Breast Cancer

The U.S. Food and Drug Administration has granted accelerated approval to palbociclib (Ibrance) in combination with letrozole for the treatment of postmenopausal women with estrogen receptor–positive, HER2-negative metastatic breast cancer who have not yet received an endocrine-based therapy....

Breast Cancer

PI3K Inhibition in Hormone Receptor–Positive Breast Cancer ‘Not Ready for Prime Time’

Interest is high in studying the PI3K pathway in hormone receptor–positive breast cancer, but it is not clear which of the PI3K inhibitors under development—if any—will be a “home run.” The phase II FERGI study, reported at the 2014 San Antonio Breast Cancer Symposium, failed to meet its primary...

Breast Cancer

Nearly Half of Women Taking Tamoxifen for Primary Prevention Discontinue Its Use Before 5 Years

After 4.5 years of taking tamoxifen for primary prevention of breast cancer, 46% of women discontinued its use, according to research conducted within the Sister Study, a prospective cohort of women who had a sister diagnosed with breast cancer but did not have breast cancer themselves. Eligible...

breast cancer

Dr. Halsted’s Breast Amputation Specimens, Johns Hopkins Hospital, 1894

A Century of Progress The text and photographs on these pages represent the establishment of oncology as a viable medical specialty during the late 1800s and showcase the early medical advances and treatments in cancer. The images and captions are excerpted from a four-volume series of books titled ...

Survivorship
Breast Cancer

Mobile Patient-Centered App Tracks Breast Cancer Survivors’ Experiences

Patricia Ganz, MD, Director of Cancer Prevention and Control Research at the Jonsson Cancer Center of UCLA, and collaborators Apple and Sage Bionetworks, recently announced the launch of “Share the Journey: Mind, Body and Wellness after Breast Cancer,” a patient-centered mobile application (app)...

breast cancer

Wrestling With the Challenges of Breast Cancer

Bookmark Title: Then Came Life: Living With Courage, Spirit, and Gratitude After Breast CancerAuthor: Geralyn LucasPublisher: Gotham BooksPublication date: October 2, 2014Price: $19.89; hardcover, 240 pages Over the past decade or so, the oncology community has increased its understanding and...

Breast Cancer
Gastrointestinal Cancer

Gastric, Breast Cancer Risk in Carriers of CDH1 Gene Mutations

In a new study,1 more precise estimates of age-associated risks of gastric and breast cancer were derived for carriers of the CDH1 gene mutation, a cancer-predisposing gene that is abnormal in families meeting criteria for clinically defined hereditary diffuse gastric cancer (HDGC). David G....

Breast Cancer

SOFT Trial Results Inconclusive: Further Study Needed

The results of the SOFT trial—presented at the 2014 San Antonio Breast Cancer Symposium, reported recently by Francis et al in The New England Journal of Medicine,1 and reviewed in this issue of The ASCO Post—were not as conclusive as we had hoped. In essence, the study enrolled women with resected ...

Breast Cancer

Adjuvant Ovarian Suppression May Benefit Women With Premenopausal Breast Cancer Who Received Prior Chemotherapy

In a phase III trial (SOFT) reported in The New England Journal of Medicine, Prudence A. Francis, MD, of Peter MacCallum Cancer Centre, Melbourne, Australia, Meredith M. Regan, ScD, of IBCSG Statistical Centre at Dana-Farber Cancer Institute, Boston, and colleagues found that the addition of...

Breast Cancer
Survivorship
Thyroid Cancer

New Analysis Reports Increased Risk of Thyroid Cancer After Breast Cancer Diagnosis

Breast cancer survivors are at increased risk of developing thyroid cancer, especially within 5 years of their breast cancer diagnosis, according to a new analysis of a large national database. The study results were presented at the Endocrine Society’s 97th Annual Meeting.1 “Recognition of this...

Breast Cancer

Increasing the Use of Hypofractionated Radiation in Early-Stage Breast Cancer: The Way Forward

Bekelman and colleagues are to be congratulated on the publication of an important paper—reviewed in this issue of The ASCO Post—alerting us all to the underutilization of hypofractionated whole-breast irradiation in the treatment of early-stage breast cancer.1 As background, recent randomized...

Breast Cancer

Hypofractionated Whole-Breast Irradiation After Breast-Conserving Surgery Used in Up to One-Third of Eligible Patients

In a study reported in JAMA, Justin E. Bekelman, MD, of the University of Pennsylvania Perelman School of Medicine, and colleagues found that approximately two-thirds of patients with early-stage breast cancer for whom hypofractionated whole-breast irradiation (for 3–5 weeks) was endorsed received...

Breast Cancer

Are Physicians Choosing Wisely When Imaging for Distant Metastases in Early-Stage Breast Cancer?

Patients with early-stage breast cancer still undergo imaging for distant metastases despite evidence-based local, national, and international guidelines—and a recommendation from ASCO—to avoid such imaging, according to a retrospective review of staging imaging for distant metastases in patients...

breast cancer

Technology’s Double-Edged Sword: One Woman’s Story

Bookmark Title: Pandora’s DNA: Tracing the Breast Cancer Genes Through History, Science, and One Family TreeAuthor: Lizzie StarkPublisher: Chicago Review PressPublication date: October 2014Price: $26.95; hardcover, 336 pages If we wish to learn more about cancer, we must concentrate on the cellular ...

Breast Cancer

Breast Cancer Management in Review

Anyone who has attended the major oncology meetings knows that research from clinical trials in breast cancer often dominates the stage, with countless abstracts featuring new and updated results. To help the readers of The ASCO Post stay up to date with the latest discoveries and findings...

Breast Cancer
Issues in Oncology

Too Early to Use Genome Sequencing for Breast Cancers in the Clinic

The role of next-generation sequencing (high-throughput technologies that allow DNA and RNA to be analyzed more quickly and inexpensively than earlier techniques) in breast cancer remains unclear and at present is primarily a research tool. Therefore, clinicians should be cautious in using genetic...

Breast Cancer
Issues in Oncology

Should Oncologists Be Ordering Breast Cancer Gene Panels?

Two oncologic surgeons squared off at the 32nd Miami Breast Cancer Conference to debate whether breast cancer genetic susceptibility panel testing is ready for routine use in the clinic. J. Michael Dixon, MD, Professor of Surgery and Consultant Surgeon at the Edinburgh Breast Unit in the United...

Breast Cancer

Understanding the Role of Immune Function in the Treatment of HER2-Positive Breast Cancer

The addition of trastuzumab (Herceptin) to adjuvant chemotherapy undoubtedly transformed HER2-positive breast cancer from one of the most deadly subtypes to a highly treatable disease. Randomized phase III trials established adjuvant trastuzumab as standard of care in HER2-positive breast...

Breast Cancer

Immune Gene Profile Strongly Associated With Benefit of Adjuvant Trastuzumab in HER2-Positive Breast Cancer

In a study reported in the Journal of Clinical Oncology, Edith A. Perez, MD, of the Mayo Clinic, Jacksonville, and colleagues found that an immune function gene profile was associated with significantly improved relapse-free survival among patients with early-stage HER2-positive breast cancer who...

breast cancer

Ann Partridge, MD, MPH, Confronts Challenges Facing Young Women With Breast Cancer With Support From Conquer Cancer Foundation Improving Cancer Care Grant

Ann Partridge, MD, MPH, Associate Professor of Medicine at Harvard Medical School and Founding Director of the Program for Young Women With Breast Cancer at the Dana-Farber Cancer Institute, received a 2010 Improving Cancer Care Grant (ICCG) for her project “Improving the Care of Young Women with...

breast cancer

Triple Negative Breast Cancer Foundation Works to Change the Treatment Landscape of an Aggressive Form of Breast Cancer

Hayley Dinerman, Cofounder and Executive Director of the Triple Negative Breast Cancer Foundation, remembers how she and a group of close female friends first learned about the devastating effects of triple-negative breast cancer. It was 2005 when these new mothers, who had recently formed a...

Breast Cancer
Survivorship

Breast Cancer Management in Review

With the field of breast oncology as complex as ever, a brief update of the latest findings impacting breast cancer treatment seems timely. To that end, I have assembled highlights from a collection of newsworthy studies featured over the past year and into early 2015. Part 1 of this review, which...

Breast Cancer
Pain Management

Opioid-Reduction Strategy for Postoperative Pain After Breast Cancer Surgery

One persistent and potentially debilitating problem breast cancer patients suffer with is postoperative pain. Studies show that proper pain management is an essential component in the healing process, but undertreatment of pain symptoms remains an ongoing issue in the oncology community. Opioids,...

Breast Cancer

Should We Be Worried If Patients Tolerate Endocrine Therapy Well?

When meeting with patients to discuss adjuvant endocrine therapy for breast cancer, the question often arises, “How will I know that the treatment is working?” While the efficacy of these treatments has been demonstrated for the majority of patients in multiple large randomized clinical trials,...

Breast Cancer

Analysis Shows No Link Between Aromatase Inhibitor–Related Musculoskeletal/Vasomotor Symptoms and Relapse-Free Survival

Retrospective analyses of the ATAC, TEAM, and BIG 1-98 adjuvant endocrine therapy trials in breast cancer have suggested that treatment-emergent endocrine symptoms may be associated with superior survival outcomes. In a study reported in the Journal of Clinical Oncology, Vered Stearns, MD,...

Breast Cancer
Issues in Oncology

PRIME II and the Omission of Radiation Therapy in Low-Risk, Elderly Patients Undergoing Breast Conservation: The Time Has Come

Despite the high prevalence of breast cancer worldwide, it is important to recognize that > 40% of all cases occur in women aged 65 years or older in both the United States and the United Kingdom.1,2 Breast cancers in older patients are more often associated with indolent features and with...

Breast Cancer
Issues in Oncology

Radiotherapy or Not in Older Women Receiving Breast-Conserving Surgery and Endocrine Treatment?

In the phase III PRIME II trial, designed to assess whether whole-breast irradiation could be omitted in women aged ≥ 65 years with early-stage breast cancer undergoing breast-conserving surgery and receiving adjuvant endocrine treatment, Ian H. Kunkler, MB BChir, FRCR, of Western General Hospital, ...

Breast Cancer

Mammographic Density After Tamoxifen Initiation Linked to Improved Prognosis for Pre- and Postmenopausal Women With ER-Positive Breast Cancer

An improved prognosis for women with estrogen receptor (ER)-positive breast cancer who experience a large reduction in mammographic density following the initiation of tamoxifen treatment extends to premenopausal as well as postmenopausal women, researchers reported in the Journal of the National...

Breast Cancer

Cancer Has Left an Indelible Mark on Me

Even though today I’m cancer-free, the experience of getting a cancer diagnosis and going through treatment leaves an indelible mark on your psyche—as well as your body—that time doesn’t erase. Once you have cancer, you become a cancer survivor, and that status doesn’t change. I’ve known many...

Issues in Oncology
Breast Cancer

Informing Decision-Making About Mammography Screening

Overdiagnosis associated with breast cancer screening has been the subject of much attention in recent years. The notion that cancer screening—largely believed to be beneficial—could actually be harmful is simultaneously fascinating and difficult to believe. With the publication of multiple studies ...

Breast Cancer
Issues in Oncology

Impact of Informed Decision-Making on Breast Cancer Screening

In a study reported in Lancet, Jolyn Hersch, MApplSc, of the University of Sydney, and colleagues found that use of a decision aid containing information on overdetection in breast cancer screening was associated with an increased rate of informed choice regarding screening, a reduced rate of...

Breast Cancer
Gynecologic Cancers
Kidney Cancer
Skin Cancer
Cost of Care

NCCN Posters of Interest Included Studies in Kidney, Breast, and Endometrial Cancers, Melanoma, and Cost Issues

The quality and quantity of original research presented at the National Comprehensive Cancer Network (NCCN) Annual Conference continue to grow since poster sessions debuted a few years ago. The ASCO Post offers summaries for just a few that caught our eye, out of more than 65 presented this year....

Breast Cancer

Experts Debate: Can We Cure Metastatic Breast Cancer?

Can metastatic breast cancer ever be cured? This issue was debated at the 32nd Annual Miami Breast Cancer Conference by two experts in the field: George W. Sledge, Jr, MD, Professor of Medicine at Stanford University Medical Center, Palo Alto, California, and Clifford A. Hudis, MD, Chief of the...

Breast Cancer

Emergency Room Visits and Hospitalizations Are Common Among Women With Early Breast Cancer Receiving Chemotherapy

Emergency room visits and hospitalizations are common among patients with early breast cancer receiving chemotherapy, particularly among those receiving a regimen containing docetaxel, according to a study supported by the Ontario Institute of Cancer Research, Toronto. “In this population-based...

Breast Cancer

Unexpectedly Huge Survival Benefit With Pertuzumab and Trastuzumab in HER2-Positive Metastatic Breast Cancer

In my opinion, the combination of pertuzumab (Perjeta) and trastuzumab (Herceptin) is one of the most important advances in the field of metastatic breast cancer in the past 10 years. As recently reported by Swain, my other colleagues, and me and reviewed in this issue of The ASCO Post, the...

Breast Cancer

CLEOPATRA Overall Survival Analysis: Significant Benefit for Pertuzumab Plus Trastuzumab/Docetaxel in HER2-Positive Metastatic Breast Cancer

As reported in The New England Journal of Medicine by Sandra M. Swain, MD, of Washington Cancer Institute, MedStar Washington Hospital Center, and colleagues, the final prespecified overall survival analysis in the phase III CLEOPATRA study showed a significant 15.7-month increase in median overall ...

Breast Cancer

A Closer Look at the Disparities in Breast Cancer Outcome by Race and Ethnicity

The report from Dr. Steven Narod and colleagues recently published in JAMA1 and reviewed in this issue of The ASCO Post adds to the growing evidence regarding observed disparities in breast cancer outcomes by race and ethnicity among women in the United States. Since 1990, breast cancer death rates ...

Breast Cancer

Racial/Ethnic Differences in Diagnosis of Breast Cancer at Stage I and Subsequent Survival Reflect Biologic Differences

In a study reported in JAMA, Javaid Iqbal, MD, of Women’s College Research Institute, Toronto, and colleagues found racial/ethnic differences in the likelihood of breast cancer diagnosis at stage I and subsequent survival in U.S. breast cancer patients.1 These differences seemed largely to reflect...

Breast Cancer

Optimizing Treatment for Small, Lymph Node–Negative, HER2-Overexpressing Breast Cancers

Large, randomized phase III clinical trials showed that the addition of HER2-targeted therapy to chemotherapy for patients with early-stage, HER2-overexpressing breast cancers substantially decreased the risk of recurrence and improved survival. The chemotherapy given in these trials varied, but it ...

Breast Cancer

High Invasive Disease-Free Survival With Adjuvant Paclitaxel and Trastuzumab in Small, Node‑Negative, HER2-Positive Breast Cancers

In a phase II study reported in The New England Journal of Medicine, Sara M. Tolaney, MD, MPH, of Dana-Farber Cancer Institute, and colleagues found that adjuvant paclitaxel and trastuzumab (Herceptin) was associated with high invasive disease-free survival in women with small, node-negative,...

Breast Cancer

Increased Risk of Secondary Bone Marrow Neoplasia After Adjuvant Breast Cancer Treatment: Risk/Benefit Analysis and Biologic Insights

Ever since the early application of adjuvant chemotherapy for breast cancer decades ago, it has been recognized that there is always a price to pay for its success in reducing breast cancer mortality. Most of that “cost” is commonly considered in terms of the potential morbid short- and long-term...

Breast Cancer

Higher-Than-Expected Incidence of Marrow Neoplasms After Adjuvant Therapy for Breast Cancer

In a study reported in the Journal of Clinical Oncology, Antonio C. Wolff, MD, of Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, and colleagues found a low but higher-than-expected incidence of marrow neoplasms in patients receiving adjuvant radiation therapy or chemotherapy...

Breast Cancer

Managing Breast Cancer in 2015

Since 1990, we have seen an approximate 35% reduction in breast cancer mortality among women in the United States. Three protagonists can share this clinical success story: prevention, early detection, and better therapies. To shed light on the current state of breast cancer research and therapy,...

Skin Cancer
Breast Cancer
Multiple Myeloma
Leukemia
Colorectal Cancer
Prostate Cancer
Pancreatic Cancer

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2015 Updates

For 2 decades, the NCCN Guidelines® have been recognized as the standard of cancer care in the United States, combining evidence, experience, and choice, so that multidisciplinary cancer treatment teams—including patients—are empowered to make informed decisions about cancer care,” said Robert W....

Breast Cancer

First National Data on Breast Cancer Subtypes Mark New Era in Biomarker Epidemiology

This year’s Report to the Nation on the Status of Cancer contains the first national combined data set on the incidence of four major breast cancer subtypes by race/ethnicity, poverty level, geography, and other factors. The findings show that “there are unique racial/ethnic-specific incidence...

Breast Cancer

Anti–PD-L1 Agent Shows Activity in Early Study of Triple-Negative Breast Cancer

An investigational immunotherapy called MPDL3280A showed encouraging and durable clinical activity in heavily pretreated patients with metastatic triple-negative breast cancer, in an early study presented at the 2015 Annual Meeting of the American Association of Cancer Research (AACR).1 Responses...

Breast Cancer

Nipple-Sparing Mastectomy Shown to Be Oncologically Safe

Mastectomies that preserve the nipple and an envelope of breast skin are as safe as more radical operations for qualifying early-stage breast cancer patients, according to a meta-analysis and systematic literature review presented at the American Society of Breast Surgeons 16th Annual Meeting.1...

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