Madeleine M.A. Tilanus-Linthorst, MD, PhD, on MRI vs Mammography: Comparing Cost and Effectiveness
2019 San Antonio Breast Cancer Symposium
Madeleine M.A. Tilanus-Linthorst, MD, PhD, of Erasmus University, reports data from the first randomized trial comparing MRI breast cancer screening with mammography in women with a familial risk. Because MRI screening detected cancer at an earlier stage, it might reduce the use of adjuvant chemotherapy and decrease breast cancer–related mortality (Abstract GS4-07).
Nadine M. Tung, MD, of Beth Israel Deaconess Medical Center, discusses cisplatin vs doxorubicin/cyclophosphamide (AC) as neoadjuvant treatment in BRCA-mutation carriers with HER2-negative breast cancer. Although cisplatin as a single agent shows activity in this setting, the pathologic complete response with this agent alone is not higher than that with standard AC chemotherapy (Abstract GS6-03).
Nicholas C. Turner, MD, PhD, of The Royal Marsden NHS Foundation Trust, discusses findings from the plasmaMATCH trial, which showed that circulating tumor DNA testing offers accurate tumor genotyping to identify patients with rare HER2 and AKT1 mutations and may enable matching them with targeted treatments (Abstract GS3-06).
Joseph Sparano, MD, of the Montefiore Medical Center, discusses three challenges:
- How can gene-expression profiles and other diagnostic tests be used to guide the use of adjuvant systemic therapy?
- Is it time to reappraise active surveillance?
- Are there diagnostic and therapeutic strategies that can identify tumors at highest risk of metastasis, and novel therapies that can block the spread of disease?
Terry P. Mamounas, MD, MPH, of Orlando Health UF Health Cancer Center, discusses 10-year results from NRG Oncology/NSABP B-42, which showed that, for postmenopausal women with hormone receptor–positive breast cancer who have completed previous adjuvant therapy with an aromatase inhibitor or with tamoxifen followed by an aromatase inhibitor, extended treatment with letrozole improved disease-free survival (Abstract GS4-01).
Marie-Jeanne T.F.D. Vrancken Peeters, MD, PhD, of the Netherlands Cancer Institute, discusses an interim study analysis showing that ultrasound-guided core biopsies of the breast in patients with excellent response on MRI after neoadjuvant systemic therapy may not be accurate enough to safely select patients with pathologic complete response for omission of surgery (Abstract GS5-06).
