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).
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?
Sara M. Tolaney, MD, MPH, of Dana-Farber Cancer Institute, discusses phase II findings on patients receiving T-DM1 monotherapy as adjuvant treatment for stage I HER2-positive breast cancer, a regimen associated with few recurrences in the study population (Abstract GS1-05).
Joerg Heil, MD, PhD, of the University Hospital Heidelberg, discusses findings on how accurately this technique can diagnose residual disease and pathologic complete response after neoadjuvant chemotherapy in patients with breast cancer. These data may help tailor, de-escalate, and potentially avoid unnecessary surgeries (Abstract GS5-03).
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).
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).