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Approximately 20% of all breast cancers are human epidermal growth factor receptor 2 (HER2)-positive. Prior to the era of HER2-targeted therapy, HER2-positive breast cancer was characterized by a poor prognosis.1,2 The development of the first HER2-targeted therapy, trastuzumab (Herceptin), led to...
Approximately 15% of patients with breast cancer have tumors that overexpress the HER2 protein and these patients can benefit from HER2-targeted therapies. The American Society of Clinical Oncology recently released a clinical practice guideline on systemic therapy for patients with advanced...
Breast magnetic resonance imaging (MRI) is superior to more commonly used imaging modalities in preoperative breast cancer staging and should be a key element in routine workup. But despite its high sensitivity for catching cancers, breast MRI still does not deliver maximum value for the patient....
The U.S. Food and Drug Administration has approved a new indication for gadobutrol (Gadavist) injection for intravenous use with magnetic resonance imaging (MRI) of the breast to assess the presence and extent of malignant breast disease. The approval is based on priority review of two multicenter...
Improved relapse-free survival following treatment with adjuvant trastuzumab (Herceptin) appears to be associated with a heightened state of immunologic function, according to genomic analysis that resulted in a 14-gene profile predictive of outcomes in the landmark NCCTG (Alliance) N9831 trial.1...
The good news for younger women with hormone receptor–negative early breast cancer is that adding goserelin (Zoladex), a luteinizing hormone–releasing hormone (LHRH) agonist, to chemotherapy can prevent sudden menopause, better preserve ovarian function and fertility, and lead to successful...
A joint analysis of two important phase III clinical trials—TEXT (Tamoxifen and Exemestane Trial) and SOFT (Suppression of Ovarian Function Trial)—showed that exemestane plus ovarian function suppression was superior to tamoxifen plus ovarian suppression in preventing recurrence in premenopausal...
Even now, 3 years after I was diagnosed with breast cancer, I’m still struggling with how it is possible to have a normal mammogram and 6 months later be confronted with stage II estrogen/progesterone–positive, HER2-positive breast cancer. The news was especially devastating to hear because it...
Analysis of data for 10,197 women treated for nonmetastatic inflammatory breast cancer treated over a 12-year-period found that the use of trimodality treatment (chemotherapy, surgery, and radiation therapy) fluctuated annually between 58.4% and 73%. “Underutilization of trimodality therapy...
Brain metastases are a devastating complication of cancer, and occur in up to 50% of patients with advanced human epidermal growth factor 2 (HER2)-positive breast cancer. Management of brain metastases requires individualized coordination between the traditional treatment modalities for...
As many as half of all patients with metastatic HER2-positive breast cancer develop brain metastases over time. The American Society of Clinical Oncology recently released a clinical practice guideline on disease management for patients with advanced HER2-positive breast cancer and brain...
TH3RESA is a randomized phase III open-label study, reported in The Lancet Oncology and summarized in this issue of The ASCO Post, which examined the activity of ado-trastuzumab emtansine (Kadcyla) in heavily pretreated HER2-positive metastatic breast cancer.1 Formerly known as T-DM1,...
There are few treatment options for breast cancer patients with progressive disease after two or more HER2-directed regimens for recurrent or metastatic disease. In the open-label phase III TH3RESA trial reported in The Lancet Oncology by Ian E. Krop, MD, PhD, of the Dana-Farber Cancer Institute,...
Women who have small (≤ 1 cm), node-negative breast tumors “have an excellent prognosis without chemotherapy,” concluded the authors of a prospective cohort study involving 4,113 women with T1a,b, N0, M0 breast cancer. “Size and tumor subtype may identify patients in whom the rate of recurrence...
Editor’s note: In the July 10 issue of The ASCO Post, this article by Marie Krejci as told to Jo Cavallo was published; however, the published version was incomplete in that it did not reflect important updates made by Ms. Krejci. We apologize to Ms. Krejci for this error and to our readers for any ...
Despite evidence from a number of prospective, randomized controlled trials showing that screening mammography reduces breast cancer mortality, screening mammography has been the subject of continual debate, controversy, and conflicting guidelines. Recently, the Swiss Medical Board, tasked with...
In a New England Journal of Medicine “Perspective” article, Nikola Biller-Andorno, MD, PhD, of the University of Zurich and Harvard Medical School, and Peter Jüni, MD, of the University of Bern, provide the rationale for a recent report by the Swiss Medical Board advocating the phasing out of...
Obesity and physical inactivity are associated with an increased risk of developing and dying of breast cancer via several proposed mechanisms. Two studies presented at the 2014 ASCO Annual Meeting explored the relationships among exercise, weight loss, and breast cancer risk. One study was...
The majority of women with BRCA1 and BRCA2 mutations experience sexual dysfunction, menopausal symptoms, cognitive and stress issues, and poor sleep following risk-reducing salpingo-oophorectomy, according to results of a study from the Abramson Cancer Center and the Perelman School of Medicine at...
Theorizing that an exaggerated perceived benefit from contralateral prophylactic mastectomy may have led to the substantial increase in its use in recent years, researchers from the University of Minnesota in Minneapolis used a Markov simulated decision-analytic model to evaluate the magnitude of...
Centrosomes, the primary microtubule organizing centers within cells, are commonly amplified in tumors, but the role of centrosome amplification in tumorigenesis is unclear. Centrosome amplification is not favored in nontransformed cells, with extra centrosomes being spontaneously lost in the...
Detecting circulating plasma tumor DNA in patients with early-stage cancer has the potential to influence selection of adjuvant systemic therapy. In a study reported in Clinical Cancer Research, Beaver and colleagues found that plasma tumor DNA could be detected both before and after surgery in...
Genome instability and DNA damage in cancer can be induced by mutations in genes involved in pre-mRNA splicing and biogenesis and export of messenger ribonucleoprotein (mRNP). Instability can be mediated by R-loops formed by DNA-RNA hybrids and displaced single-stranded DNA. The TREX-2 complex is...
Title: The Silver Lining: A Supportive & Insightful Guide to Breast CancerEditors: Hollye Jacobs, RN, MS, MSWPublishing Platform: CreateSpace Publication information: Simon & Schuster, published March 2014. Available at Amazon, Barnes and Noble, Indiebound, and other local bookstores....
All truths are easy to understand once they are discovered; the point is to discover them.” —Galileo Galilei There are several “truths” in breast oncology that have been discovered over the years, become widely understood, and changed the way we practice. Prospective randomized studies have...
Elevated circulating tumor cells are associated with poor prognosis in metastatic breast cancer. In a phase III trial (Southwest Oncology Group [SWOG] S0500) reported in Journal of Clinical Oncology, Jeffrey B. Smerage, MD, PhD, Clinical Associate Professor in Medical Oncology at the University of...
The most recent ASCO Clinical Practice Guideline update—summarized in this issue of The ASCO Post—represents the latest chapter in the ongoing evolution of adjuvant endocrine therapy for hormone-sensitive breast cancer.1 Rather than including a comprehensive review of the 2010 guidelines, this...
ASCO has released a focused update of its clinical practice guideline on adjuvant endocrine therapy in women with hormone receptor–positive breast cancer.1 The focused update, formulated by Harold J. Burstein, MD, PhD, of Dana-Farber Cancer Institute, Boston, and colleagues in the ASCO Update...
Triple-negative breast cancer is now recognized as a very complex subtype for which one treatment will not be applicable to all, according to Mohammad Jahanzeb, MD, Professor of Clinical Medicine at the University of Miami and Director of the UM Sylvester Deerfield Campus, who gave an update on...
Postmenopausal women who in the past 4 years had undertaken regular physical activity equivalent to at least 4 hours of walking per week had a lower risk for invasive breast cancer compared with women who exercised less during those 4 years, according to data published recently in Cancer...
A recent study reporting the absolute 20-year survival benefit from contralateral prophylactic mastectomy was less than 1% for women with stage I and II breast cancer without BRCA mutations runs counter to common perceptions about the risk of contralateral breast cancer among these women and the...
For women with stage I and II breast cancer without BRCA mutations, the absolute 20-year survival benefit from contralateral prophylactic mastectomy was less than 1%, regardless of age, estrogen receptor status, and cancer stage, according to a decision analysis study using a Markov model to...
Pfizer Inc announced that the company has initiated a multicenter, open-label expanded access program in the United States for the investigational oral CDK 4/6 inhibitor, palbociclib. Through the program, palbociclib is being made available for use in combination with letrozole for postmenopausal...
Most patients who choose to have breast reconstruction following mastectomy are satisfied with the decision-making process. Reasons for not choosing reconstruction vary by race and include the desire to avoid additional surgery and fear of implants. These and other conclusions of an analysis of...
TRIM44 family overexpression is associated with carcinogenesis, and TRIM44 has been identified as a prognostic gene. In a study reported in Journal of the National Cancer Institute, Ong and colleagues attempted to identify therapeutic strategies for patients with TRIM44 overexpression. Genomic and...
The response among patients to news reports about mutations in a gene known as PALB2 raising the risk of breast cancer “has been predictable,” Theodora Ross, MD, PhD, wrote in The New York Times.1 As an example, Dr. Ross, Director of the Cancer Genetics Program at The University of Texas...
The last thing I expected to find when I returned home after a summer vacation celebrating my 50th birthday was a letter from my gynecologist saying the routine mammogram I had before I left found suspicious-looking calcifications in my right breast and that I should see a surgeon right away. Being ...
In a study of the use of breast cancer screening modalities in the Medicare population reported in Journal of the National Cancer Institute, Brigid K. Killelea, MD, MPH, FACS, and colleagues at Yale University School of Medicine, Yale Cancer Center, and Yale–New Haven Hospital, New Haven,...
In a study reported in JAMA and reviewed in this issue of The ASCO Post, Friedewald and colleagues1 showed that the addition of tomosynthesis to digital mammography2 resulted in a decrease in the screening recall rate3 and an increase in the cancer detection rate.4,5 This retrospective analysis of...
In a large multicenter study reported in JAMA, Sarah M. Friedewald, MD, of the Advocate Lutheran General Hospital, Center for Advanced Care, Park Ridge, Illinois, and colleagues found that use of tomosynthesis plus digital mammography reduced the recall rate and increased the cancer detection rate...
More than 4.3 million women with limited access to health care received breast and cervical cancer screening and diagnostic services in the first 20 years of the Centers for Disease Control and Prevention (CDC) National Breast and Cervical Cancer Early Detection Program. From 1991 to 2011, 56,662...
The recent publication by Antoniou et al on risk of breast cancer in PALB2 carriers,1 reviewed in this issue of The ASCO Post (page 47), is a contribution to the interesting history of the PALB2 gene, and an important milestone in the expansion of hereditary cancer susceptibility testing in the...
In a study reported in The New England Journal of Medicine, Antonis C. Antoniou, PhD, Reader in Cancer Risk Prediction and Cancer Research UK Senior Cancer Research Fellow at the University of Cambridge, and colleagues identified lifetime risk of breast cancer in families with germline...
Despite its acceptance as standard of care for early-stage breast cancer almost 25 years ago, barriers still exist that preclude patients from receiving breast-conserving therapy, with some patients still opting for a mastectomy, according to research from The University of Texas MD Anderson Cancer ...
Recent concerns about potential overdiagnosis and overtreatment of ductal carcinoma in situ of the breast (DCIS) led researchers in the Netherlands to study late effects of treatment, such as cardiovascular disease, morbidity, and mortality in a large population-based cohort of DCIS patients....
In the Cancer and Leukemia Group B (CALGB) 70103 study, comorbidity was associated with shorter overall survival among older women with early-stage breast cancer and good functional status receiving adjuvant chemotherapy. “The presence of four or more conditions appeared to be a threshold for...
Analyses of data from 27,404 people aged 65 and older participating in the National Health Interview Survey (NHIS) from 2000 through 2010 suggest that overscreening for prostate, breast, cervical, and colorectal cancer screening “is common in both men and women, which not only increases health care ...
In a study reported in Clinical Cancer Research, Patani and colleagues investigated whether distinct transcriptional responses were associated with the reported increased effectiveness of the estrogen receptor (ER) antagonist fulvestrant (Faslodex) over the aromatase inhibitor anastrozole in...
Inhibition of the PD-1/PD-ligand1 (PD-L1) axis has shown considerable therapeutic promise in several cancers. Tumor PD-L1 protein expression may predict response to drugs targeting this pathway, but its measurement has been limited by the lack of standardized immunohistochemical methods and...
The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies for people with breast cancer. The studies include phase I and II, interventional, and observational trials evaluating new therapies; diagnostic tools; genetic counseling; the association ...