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Annual screening for breast cancer with magnetic resonance imaging (MRI) has been found to be cost-effective in women aged 30 to 60 years who are BRCA1 or BRCA2 carriers or who have a 50% chance of being a carrier, and such screening is recommended in these women by many authorities. It is unclear...
Sentinel lymph node surgery provides reliable nodal staging information and is associated with less morbidity than axillary lymph node dissection in patients with clinically node-negative (cN0) breast cancer. The American College of Surgeons Oncology Group (ACOSOG) Z1071 (Alliance) trial examined...
The adjuvant use of bisphosphonates in breast cancer continues to yield seemingly contradictory data despite a sound biologic basis and smaller pilot studies suggesting that dampening bone turnover with bisphosphonates can lessen the bone reservoir of micrometastases.1,2 Early adjuvant trials with...
The effect of bisphosphonate treatment in early breast cancer is controversial, with some data indicating survival benefit in the adjuvant setting. In a study reported in the Journal of Clinical Oncology (German Adjuvant Intergroup Node-Positive Study, GAIN), Gunter von Minckwitz, MD, PhD, Chairman ...
Oncologists are getting a handle on BRCA1/2 in breast cancer, becoming more adept at treating and counseling patients with these mutations. But the BRCA mutation is only one example of a host of genetic variations that can increase breast cancer risk, according to James M. Ford, MD, Associate...
GeparTrio was an innovative phase III trial conducted by the German Breast Group, enrolling over 2,000 women with early breast cancer who were candidates for neoadjuvant chemotherapy. Patients with evidence of early response, defined as reduction in clinical tumor size by 50% or more, following two ...
In an exploratory analysis of long-term survival data from the GeparTrio trial reported in the Journal of Clinical Oncology, Gunter von Minckwitz, MD, PhD, of the German Breast Group in Neu-Isenburg and the University of Frankfurt, Germany, and colleagues found that response-guided neoadjuvant...
In a phase III trial (NSABP B-41) performed to assess the potential benefit of neoadjuvant dual HER2 blockade in HER2-positive breast cancer, André Robidoux, MD, of Centre Hospitalier de l’Université de Montréal, and colleagues in the National Surgical Adjuvant Breast and Bowel Project (NSABP)...
The duration of adjuvant systemic chemotherapy for breast cancer has been a subject of investigation, scrutiny, and meta-analysis.1,2 With the appreciation that prolonged regimens of cytotoxic chemotherapy of, for example, 1 to 2 years in duration were not superior in reducing breast cancer...
As reported in The Lancet by Aron Goldhirsch, MD, of the European Institute of Oncology in Milan, Italy, and colleagues from the Breast International Group (BIG), the comparison of 1 vs 2 years of trastuzumab (Herceptin) in patients with HER2-positive early breast cancer in the phase III HERA trial ...
The first candidate vaccine to prevent recurrence of breast cancer entered clinical trials about 8 years ago, and since then, the idea of a vaccine for secondary prevention has gained traction; more such vaccines are now in development. But this fall, it was vaccines for primary prevention that had ...
In early breast cancer patients receiving anti-HER2 therapy in the NeoALTTO trial, mutations in PIK3CA were associated with lower rates of pathologic complete response, according to a study reported at the 2013 European Cancer Congress by José Baselga, MD, Physician-in-Chief at Memorial...
In the November 15 issue of The ASCO Post, the article, “Strong Showing for Ado-Trastuzumab Emtansine in Advanced HER2-Positive Heavily Pretreated Breast Cancer,” contained the following errors in the reported outcomes data for the TH3RESA trial: The article incorrectly stated the median survival...
Radiation therapy appears to significantly decrease local recurrence in premenopausal women with node-positive and luminal A tumors, based on an analysis of two small but independent randomized series reported at the 2013 European Cancer Congress in Amsterdam.1 “Though not definitive, our study...
The effects of oral contraceptives on breast and ovarian risks are similar for women with BRCA1 or BRCA2 mutations and for women in the general population, according to analyses of observational studies. Oral contraceptive use “is inversely associated with ovarian cancer risk, whereas a modest but...
Daily manual lymphatic drainage and bandaging followed by compression garments did not result in significant improvement in lymphedema compared to a more conservative approach with compression garments only, according to a study evaluating 95 women previously treated for breast cancer with...
Researchers from Huntsman Cancer Institute at the University of Utah discovered a cellular mechanism that drives breast cancer metastasis, as well as a therapy which blocks that mechanism. The research results were recently published online in the journal Cell Reports.1 “Genetic mutations do not...
The threat of getting cancer began for me before I was born. In 1950, when my mother was pregnant with me, she was diagnosed with breast cancer and refused treatment until after she gave birth, so I have always felt that cancer was woven into my soul. For the first year of my life, I was raised by...
This issue of The ASCO Post launches a Clinical Trials Resource Guide to increase awareness of NCI-funded phase I, II, and III clinical studies for your patients with advanced cancer. All of the studies are listed on the National Institutes of Health website at ClinicalTrials.gov. The clinical...
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...
In the randomized noninferiority TARGIT-A trial reported in The Lancet, Jayant S. Vaidya, PhD, FRCS, and Michael Baum, MD, FRCS, of University College London, and colleagues compared risk-adapted radiotherapy using single-dose targeted intraoperative radiotherapy vs fractionated external-beam...
In a study reported in the Journal of the National Cancer Institute, Pan et al assessed factors associated with noncompliance with recommended radiation therapy following breast-conserving surgery for breast cancer.1 A primary factor in underuse of radiation therapy was younger patients having...
A more conservative approach that avoids radiation therapy seems to be a reasonable option for a subgroup of older women with hormone receptor–positive breast cancer at low risk of recurrence. Overall outcomes were similar with or without radiation in older women with hormone receptor–positive...
There may be a benefit for treating small HER2-positive tumors—a breast cancer subset for whom treatment recommendations have not been established but for whom there is still risk of recurrence—and this can be done with little toxicity, according to a multicenter study presented at the 2013 San...
From December 10 to 14, the American Association for Cancer Research, the Cancer Therapy & Research Center at The University of Texas Health Sciences Center at San Antonio, and Baylor College of Medicine once again hosted the San Antonio Breast Cancer Symposium (SABCS), presenting...
Royal Philips has announced that that it has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for the Spectral Breast Density Management Application for its MicroDose SI full-field digital mammography system. The application is the first spectral breast density measurement ...
Based on age and risk, an estimated 10 million women in the United States may be eligible for an agent aimed at preventing breast cancer, but chemoprevention is underutilized. Fewer than 5% of women at high risk who are offered tamoxifen for chemoprevention agree to take the drug, partly due to...
Five years of treatment with anastrozole reduced the risk of breast cancer by 53% in postmenopausal women at high risk for developing the disease, according to an analysis of the International Breast Cancer Intervention Study (IBIS)-II trial. Anastrozole reduced the risk of estrogen...
Adjuvant use of bisphosphonates reduced the risk of bone recurrence by 34% and the risk of breast cancer death by 17% in postmenopausal women with early breast cancer in a large meta-analysis conducted by the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). The potentially...
Measuring certain hormone levels could help determine a woman’s risk for breast cancer and add a key factor to current risk-prediction models, according to investigators from Harvard Medical School. Their new study results were presented at the American Association for Cancer Research (AACR) Annual ...
I read with interest the article, “Breast Cancer Vaccines for Primary Prevention Move Toward Clinical Use,” which appeared in the December 15th issue of The ASCO Post (page 28). However, information presented regarding the National Breast Cancer Coalition’s (NBCC’s) Artemis Project for a breast...
Among patients with locally advanced or metastatic estrogen receptor–positive breast cancer, fulvestrant (Faslodex) given at 500 mg “is associated with a 19% reduction in risk of death and a 4.1-month difference in median overall survival compared with fulvestrant 250 mg,” according to final...
Components of the phosphatidylinositide 3-kinase/mammalian target of rapamycin (PI3K/mTOR) pathway are deregulated in many human cancers, with about 30% of breast cancers harboring PIK3CA gene mutations. Emerging research shows that these mutations may render estrogen receptor alpha-positive tumors ...
Emerging research is suggesting that outcomes from neoadjuvant chemotherapy may be correlated with two genetic mutations that are common in breast cancer—PIK3CA and TP53. Their presence may affect response to treatment, and mutational shift after treatment may affect survival, according to studies...
The achievement of a pathologic complete response in patients with triple-negative breast cancer was boosted by the addition of carboplatin to a standard neoadjuvant chemotherapy regimen, and by the addition of veliparib, an investigational oral PARP inhibitor, plus carboplatin to a standard...
“If women are to truly participate in the decision of whether or not to be screened [for breast cancer using mammography], they need some quantification of its benefits and harms,” asserted H. Gilbert Welch, MD, MPH, Professor of Medicine, and Honor J. Passow, PhD, Instructor, at The Dartmouth...
Late last year, the American Society of Clinical Oncology and College of American Pathologists published a comprehensive update of guidelines for HER2 testing,1 the first such update since their initial landmark publication in 2007.2 This new report, summarized in this issue of The ASCO Post,...
The American Society of Clinical Oncology (ASCO) and College of American Pathologists (CAP) recently convened an Update Committee to conduct a systematic literature review and update recommendations for optimal HER2 testing. In particular, the Committee identified criteria and areas requiring...
Elevated circulating tumor cells were prognostic for survival but did not pan out as a marker for switching after one cycle of chemotherapy in patients with metastatic breast cancer. The phase III Southwest Oncology Group (SWOG) S0500 clinical trial, presented at the 2013 San Antonio Breast Cancer...
Ramucirumab added to first-line docetaxel failed to improve progression-free survival in patients with metastatic breast cancer in the large, randomized, placebo-controlled ROSE/TRIO-12 trial.1 An interim analysis of overall survival showed no advantage for the addition of ramucirumab. This study,...
For postmastectomy neuropathic pain, perineural infiltration with a combination of bupivacaine and dexamethasone is a “simple, effective, practice-changing treatment that any surgeon can do,” according to Laura J. Esserman, MD, MBA, Professor of Surgery and Radiology at the University of...
The San Antonio Breast Cancer Symposium brings together specialists from all over the world who focus on management of breast cancer. We have covered many of the important presentations in the pages of The ASCO Post and in our online Evening News. Below are summaries of additional noteworthy...
Currently, one of the most challenging problems in oncology is to accurately predict whether neoplastic lesions detected by screening tests will progress. The focus on developing ever-more sensitive cancer screening tests has produced the clinical dilemma of overdiagnosis. Overdiagnosis occurs when ...
If a randomized, controlled trial of therapy for breast cancer was submitted for publication in which 1. The drug being tested was old and ineffective, and 2. prior to randomization, the women underwent a clinical breast examination and the study coordinators knew who had the largest cancers, and...
The recent report from the Canadian National Breast Screening Study (CNBSS)—published in BMJ and reviewed in The ASCO Post, early release online—concluded that annual mammography in women aged 40 to 59 does not result in a reduction in mortality from breast cancer beyond that of physical...
As reported in BMJ by Anthony B. Miller, MD, Professor Emeritus at the Dalla Lana School of Public Health, University of Toronto, and colleagues, the 25-year follow-up of the Canadian National Breast Screening Study has shown no mortality benefit of annual mammography screening for breast cancer...
Mastectomy is unnecessary in many women with stage IV breast cancer, according to a study from Indian investigators, reported at the 2013 San Antonio Breast Cancer Symposium.1 The study randomly assigned 350 patients with metastatic breast cancer to mastectomy, complete axillary dissection, plus...
Amid studies of novel targeted therapies, genetic analyses of tumors, and new ways to approach the treatment of breast cancer, a low-tech study presented at the 2013 San Antonio Breast Cancer Symposium found that a yearlong exercise program reduced joint pain associated with aromatase inhibitors in ...
An innovative approach to streamlining the testing of novel agents in breast cancer has yielded some of its first results, which were reported at the 2013 San Antonio Breast Cancer Symposium.1 Adaptive Trial Design The veliparib/carboplatin plus standard neoadjuvant therapy regimen is currently...
There may be a benefit for treating small HER2-positive tumors—a breast cancer subset for whom treatment recommendations have not been established but for whom there is still risk of recurrence—and this can be done with little toxicity, according to a multicenter study presented at the 2013 San...