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).
Hongchao Pan, PhD, of the University of Oxford, discusses an analysis of 86,000 women in the Early Breast Cancer Trialists’ Collaborative Group database, which showed that the risk of distant recurrence 20 years after a diagnosis of node-negative, estrogen receptor–negative early-stage breast cancer in women who discontinued endocrine therapy at 5 years is likely to be about a third lower now than in his group’s previous report (Abstract GS2-04).
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).
Priyanka Sharma, MD, of the University of Kansas Medical Center, reviews new phase III data on adding oral fluoropyrimidine to adjuvant endocrine therapy, the current standard of care, in the setting of hormone receptor–positive, HER2-negative primary breast cancer (Abstract GS1-09).
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?
Hope S. Rugo, MD, of the University of California San Francisco Comprehensive Cancer Center, discusses trial data on margetuximab plus chemotherapy, which improved progression-free survival in patients with previously treated HER2-positive metastatic breast cancer when compared with trastuzumab plus chemotherapy. Maturing data comparing overall survival also provides new insights (Abstract GS1-02).
