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).
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).
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).
Milan Radovich, PhD, of Indiana University School of Medicine, discusses trial findings that show patients with triple-negative breast cancer who are at high risk of relapse after receiving preoperative chemotherapy can be risk-stratified based on the presence of minimal residual disease as determined by circulating tumor DNA and circulating tumor cells (Abstract GS5-02).
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?
Gerardo Antonio Umanzor Funez, MD, of Liga Contra El Cáncer, discusses phase III findings on intravenous (IV) paclitaxel and oral paclitaxel plus encequidar (a novel P-gp inhibitor), the first orally administered taxane regimen shown to be superior to the IV formulation in terms of response and survival with less neuropathy (Abstract GS6-01).
