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Breast Cancer

Low-Fat Diet Reduces Mortality in Breast Cancer Subset

The final survival analysis of the landmark Women’s Intervention Nutrition Study (WINS) confirmed that a low-fat diet can reduce the risk of dying for a subset of breast cancer patients.1 At the San Antonio Breast Cancer Symposium, Rowan T. Chlebowski, MD, PhD, of the Los Angeles Biomedical...

Breast Cancer

Contralateral Prophylactic Mastectomy: Know the Data When Discussing the Option With Patients

Oncologists need a better understanding of why women choose contralateral prophylactic mastectomies without indication, and they need data to counter their patients’ misperceptions about this treatment choice. “Many women who choose [contralateral prophylactic mastectomy] are not at increased risk...

Breast Cancer

Fulvestrant Surpasses Anastrozole in First-Line Treatment of Metastatic Breast Cancer

Fulvestrant (Faslodex) at a 500-mg dose was superior to anastrozole as first-line therapy for advanced hormone receptor–positive breast cancer in the phase II FIRST study.1 Overall survival and time to disease progression were significantly better with fulvestrant than with the current standard of...

Breast Cancer

Tamoxifen Prevention of Breast Cancer Extends More Than 16 Years

The benefits of tamoxifen as primary prevention of breast cancer are well established. The good news is that the benefits live on, with a protective effect that extends up to 22 years. At a median follow-up of 16 years, women treated with 5 years of tamoxifen enjoyed a 29% reduction in the risk of...

Breast Cancer

BOLERO-1: Everolimus Plus Trastuzumab/Paclitaxel Misses the Mark in First‑Line HER2-Positive Advanced Breast Cancer

The addition of everolimus (Afinitor) to weekly trastuzumab (Herceptin) plus paclitaxel in the first-line metastatic breast cancer setting did not improve outcomes in the phase III BOLERO-1/TRIO-019 but did provide a “signal” in the hormone receptor–negative subset. The study was reported at the...

Breast Cancer

Pembrolizumab Holds Promise in Breast Cancer, Early Studies Suggest

Single-agent treatment with the immunotherapy drug pembrolizumab produced a “signal of activity” and led to some durable responses in patients with metastatic triple-negative breast cancer, Rita Nanda, MD, of the University of Chicago, reported at the 2014 San Antonio Breast Cancer Symposium.1...

Breast Cancer

Neoadjuvant Therapy in Triple-Negative Breast Cancer: Impact of Subtype

Among women with triple-negative breast cancer, overall, basal-like and non–basal-like tumors were equally likely to demonstrate a pathologic complete response to neoadjuvant chemotherapy, but they responded differently to the addition of carboplatin and bevacizumab (Avastin) to a standard...

Breast Cancer

Ovarian Suppression Plus Hormonal Therapy May Be Practice-Changing in Premenopausal Hormone Receptor–Positive Early-Stage Breast Cancer

Results of the large International Breast Cancer Study Group (IBCSG)-coordinated SOFT trial present a convincing argument for the addition of ovarian function suppression to adjuvant hormonal therapy to reduce the risk of tumor recurrence in younger women with hormone receptor–positive early-stage...

Breast Cancer

Mammographically Dense Breasts Highly Prevalent Among American Women

A study on the prevalence of mammographically dense breasts in the United States “estimated that approximately 43% of women aged 40 to 74 years have heterogeneously or extremely dense breasts, corresponding to approximately 27.6 million U.S. women,” researchers reported in the Journal of the...

Breast Cancer

Four-Gene Panel Predicts Response to Letrozole

At the 2014 San Antonio Breast Cancer Symposium, a research team led by Michael Dixon, MD, of Western General Hospital in Edinburgh, shed light on the development of endocrine resistance and presented a four-gene messenger RNA (mRNA) profile that can predict response to letrozole with a high degree ...

Breast Cancer

News Roundup From the 2014 San Antonio Breast Cancer Symposium

Highlighted here are summaries of four abstracts presented at the 2014 San Antonio Breast Cancer Symposium: They focus on the EPO-ANE-3010 clinical trial of epoetin alfa (Epogen, Procrit) in anemic patients with metastatic breast cancer, a New York Cancer Consortium trial of fulvestrant (Faslodex)...

Breast Cancer
Issues in Oncology

Dr. Mary-Claire King Proposes Population Screening in All Young Women for BRCA Mutations

It is not enough for Mary-Claire King, PhD, to have identified the germline BRCA1 mutation associated with hereditary breast and ovarian cancers. Her clinically applicable discovery is one of the world’s greatest in genetics and one for which she has been highly lauded. But not one to rest on her...

Breast Cancer

E1199 Update: It’s Weekly Paclitaxel for Triple‑Negative Breast Cancer

An update of clinical trial E1199 showed that weekly paclitaxel and every-3-week docetaxel were both more effective than every-3-week paclitaxel in preventing deaths and tumor recurrences, according to Joseph Sparano, MD, Professor of Medicine and Women’s Health at the Albert Einstein College of...

Breast Cancer

Enzalutamide Shows Encouraging Activity in Triple‑Negative Breast Cancer

The androgen receptor inhibitor enzalutamide (Xtandi) showed encouraging activity as a single agent in advanced triple-negative breast cancer patients expressing the androgen receptor, according to an international study presented at the 2014 San Antonio Breast Cancer Symposium.1 Enzalutamide...

Breast Cancer

Atypical Hyperplasia as a Predictor of Future Breast Cancer: Focus on Chemoprevention and Screening

Atypical hyperplasia of the breast has “special importance as a predictor of future breast cancer,” according to a special report in The New England Journal of Medicine.1 That special importance is based on the high incidence of atypical hyperplasia—found in around 10% of the 1 million breast...

Breast Cancer
Colorectal Cancer
Hepatobiliary Cancer
Lung Cancer

Twenty Years After a Diagnosis …  and Counting

In 1995, I was diagnosed with advanced colorectal cancer and given little chance to live. The dire diagnosis came years after being assured by several physicians that the problem I was having with rectal bleeding and anemia was nothing more than the result of an internal hemorrhoid. Busy raising...

Breast Cancer

Iniparib: The Fairy Tale Dream Comes to an End

The first poly ADP ribose polymerase (PARP) inhibitor was developed in the early 1990s. Since then, the activity of PARP inhibitors has been explored in a variety of settings, including and perhaps most enthusiastically in the treatment of cancer. The greater dependence of several cancers on PARP,...

Breast Cancer

No Benefit of Adding Iniparib to Gemcitabine/Carboplatin in Metastatic Triple‑Negative Breast Cancer

In a phase III trial reported in Journal of Clinical Oncology, Joyce O’Shaughnessy, MD, of Baylor Charles A. Sammons Cancer Center, Dallas, and colleagues found that the addition of iniparib to gemcitabine and carboplatin did not improve overall survival or progression-free survival in patients...

Breast Cancer

Shedding Light on the Mystery of Male Breast Cancer

Male breast cancer represents less than 1% of  all breast cancers, which partially explains why so little is known about the disease. Two presentations at the 2014 San Antonio Breast Cancer Symposium focused on the characteristics of male breast cancer drawn from a large international registry and...

Breast Cancer

TNT Trial Supports Platinums in BRCA-Mutated Breast Cancer

The TNT trial, presented at the 2014 San Antonio Breast Cancer Symposium, provided no evidence that unselected advanced triple-negative breast cancer patients are more likely to respond to carboplatin than to docetaxel.1 However, patients with BRCA1/2 mutations do have a greater response and a...

Breast Cancer

Palbociclib as Initial Endocrine-Based Therapy in Postmenopausal Women With Metastatic Breast Cancer

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.   On February 3, 2015, palbociclib (Ibrance) was granted...

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...

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