Breast Cancer

NEW ORLEANS-Eighteen-year results from a pivotal trial comparing lumpectomy with mastectomy have demonstrated maintenance of efficacy for the breast-sparing treatment. Matthew Poggi, MD, of the Radiation Oncology Branch of the National Cancer Institute, updated the study results at the American Society for Therapeutic Radiology and Oncology (abstract 91).

ORLANDO-Breast cancer patients who received targeted home nursing visits after a short-stay surgery used fewer postoperative health services and had improved social and family well-being, compared with patients receiving no visits or nontargeted visits. Gwen K. Wyatt, RN, PhD, associate professor of nursing, Michigan State University, presented the study results at the Era of Hope Department of Defense Breast Cancer Research Program meeting. The study included 240 female breast cancer patients. Short hospital stay was defined as 48 hours or less. Patients were 21 years of age or older and fluent in English. The majority were white, married, and employed prior to surgery.

ORLANDO-Women with a specific prohibitin fragment genotype (T allele) and a first-degree relative with breast cancer appear to be at greater risk of developing the disease than women with the prohibitin C allele genotype, reported Eldon R. Jupe, PhD, senior research scientist, Immunology and Cancer Program, Oklahoma Medical Research Foundation, Oklahoma City.

NEW ORLEANS-Template-based interstitial brachytherapy is an effective method for treating breast cancer, according to a study presented at the 44th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (abstract 147). The study is one of the first to use a template to position interstitial implants in its entire study population as part of its protocol.

NEW ORLEANS-Toxicity for low-dose-rate and high-dose-rate accelerated partial breast irradiation (APBI) (brachytherapy) is comparable to that observed in women treated with conventional whole breast external beam radiation therapy after lumpectomy, according to a 10-year study (RTOG 95-17) presented at the 44th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (abstract 146).

Sharon Krumm, PhD, RN, the Editor of Oncology Nursing, is administrator and director of nursing, Johns Hopkins Oncology Center, and assistant professor, Johns Hopkins University Schools of Medicine and Nursing. ONI is pleased to announce the creation of an Editorial Advisory Board for Oncology Nursing. Members are Catherine Coleman, RN, OCN, a consultant for breast center development, Tiburon, California, and Mary McCabe, BSN, MA, acting director, Office of Communications, National Cancer Institute, Be-thesda, Maryland. See p. 27 for more about the board members.

ORLANDO-A New Mexico study has found that Hispanic women are more likely than white women to be diagnosed with breast cancer at a younger age, are more likely to be estrogen-receptor (ER) negative, and are at greater risk for poor survival. Diane D. Crumley, PhD, research assistant professor, Division of Epidemiology and Preventive Medicine, University of New Mexico, reported the findings at the Era of Hope Department of Defense Breast Cancer Research Program meeting.

NEW ORLEANS-Radiation therapy after mastectomy reduces locore-gional recurrence rates for breast cancer patients with positive lymph nodes, positive surgical margins, or both, according to the results of a large retrospective study presented at the 44th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO abstract 153).

ORLANDO-Women in all ethnic groups who have spent their lives exercising, performing heavy household chores, or tackling a physically strenuous job had a lower risk of breast cancer than their more sedentary counterparts, according to a poster presented at the Era of Hope Department of Defense Breast Cancer Research Program meeting. "We were pleased with the results," said principal investigator Esther M. John, PhD, director of epidemiology research, Northern California Cancer Center, Union City. "It’s a message we can give women to help prevent breast cancer, and there are other health benefits to physical activity."

BOSTON-Pegfilgrastim (Neu-lasta), the longer-lasting analog of the colony-stimulating factor filgrastim (Neupogen), is safe for elderly breast cancer patients receiving myelosuppressive chemotherapy and protects against febrile neutropenia, according to a poster presented at the third meeting of the International Society of Geriatric Oncology (SIOG abstract P-23).

In just 10 years, the cost of screening mammography litigation in the United States could top $250 million a year, a recent analysis has found. The analysis, presented at this year’s American Roentgen Ray Society meeting in Atlanta, is based on a

SEATTLE, Washington-In a new endeavor, an international group of experts is creating detailed guidelines for the screening, diagnosis, and treatment of breast cancer in countries and regions of the world with limited resources. The endeavor began with the Global Summit Consensus Conference and will lead to the publication, dissemination, and translation of the first edition of the guidelines next year.

NEW ORLEANS-Having a previous pregnancy improves the prognosis for women who develop early-stage breast cancer later in life, according to a study presented at the 44th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (abstract 152). The findings suggest that a more aggressive treatment approach should be considered for those patients who have not had a pregnancy.

RESEARCH TRIANGLE PARK, North Carolina-Researchers have begun the first phase of a long-term, prospective epidemiological study designed to determine the role of genetic, environmental, and lifestyle factors in increasing the risk of breast cancer and several other diseases. The Sister Study is the first long-term follow-up study specifically designed to look at hereditary and environmental risk factors for the disease. It seeks to enroll 50,000 cancer-free women in the United States between the ages of 35 and 74 who have a sister diagnosed with breast cancer.

During the 1990s, perhaps no other therapy for women with breast cancer was more controversial than high-dose chemotherapy with autologous bone marrow and/or peripheral stem cell support. With encouraging results from late phase I and early phase II trials in the early to mid-1990s, high-dose chemotherapy was promoted by its many enthusiastic proponents as a potentially great leap forward for women with high-risk, node-positive or metastatic disease.

At first glance, high-dose chemotherapy for breast cancer makes sense. The disease is often sensitive to chemotherapy, potentially curable, and highly prevalent, which means that even a modest benefit would be tremendously important. Unfortunately, multiple clinical trials have failed to demonstrate that high-dose therapy is more effective than other chemotherapeutic approaches. Thus far, no prospective study has demonstrated a benefit based on its planned primary objective and planned analysis, and none has shown a survival advantage (see Table 1).[1-5]

Over the past decade, high-dose chemotherapy with autologous bone marrow and/or peripheral blood rescue has been increasingly used to treat women with breast cancer. Laboratory and clinical studies have shown that dose intensity may be important in treating selected patients with breast cancer. Initial phase I studies showed good response rates of short durations. Further trials in metastatic disease with high-dose chemotherapy and stem cell rescue earlier in the treatment course had been encouraging. However, the optimal timing of high-dose chemotherapy remains a question. In addition, randomized trials in high-risk early-stage breast cancer have completed accrual. Technologic improvements in stem cell procurement and hematopoietic growth factors have contributed to decreased morbidity and mortality. This review will discuss the role of such therapy in the treatment of women with breast cancer. [ONCOLOGY 16:1643-1656, 2002]

WASHINGTON-The blood of the human umbilical cord, although often discarded after childbirth, is a "very rich source" of lymphocytes potentially capable of killing cancer cells, according to Shantaram Joshi, PhD, professor of genetics, cell biology, and anatomy, University of Nebraska Medical Center, Omaha.

ORLANDO-A study reported at the Era of Hope Department of Defense Breast Cancer Program meeting adds more evidence supporting wider use of sentinel lymph node (SLN) biopsy by surgeons skilled in the technique.

ORLANDO-Weekly paclitaxel (Taxol) given as a neoadjuvant therapy for patients with locally advanced breast cancer resulted in regression of the primary tumor in 60% of patients. Albert S. Braverman, MD, professor of medicine, Downstate Medical Center of the State University of New York, Brooklyn, presented the results at the 38th Annual Meeting of the American Society of Clinical Oncology (abstract 278).

A phase II study found that the use of trastuzumab (Herceptin) in combination with docetaxel (Taxotere) and cisplatin shrank breast tumors so significantly that locally invasive cancers became undetectable in 1 of 4 women (26%) who participated in the

At the recent Department of Defense Breast Cancer Research Program "Era of Hope" meeting, held in Orlando, Fla, researchers presented a prototype for a simple test that can rapidly screen tiny samples of tissue for biomarkers of breast

EAST HANOVER, New Jersey-A phase III study to determine overall and disease-free survival of women with early breast cancer who take the aromatase inhibitor Femara (letrozole tablets) vs placebo in the adjuvant setting following 5 years of hormone therapy with tamoxifen (Nolvadex) has completed enrollment of 4,800 postmenopausal women.

NIAGARA-ON-THE-LAKE, Ontario, Canada-Female survivors of childhood cancer are generally at increased risk of developing secondary breast cancer years after their initial disease. New research, presented at the 7th International Conference for Long-Term Complications of Treatment of Children and Adolescents for Cancer, hosted by Roswell Park Cancer Institute, is shedding light on this issue and helping practitioners determine how to best screen this population.

As a result of the availability and clinical efficacy of trastuzumab (Herceptin), clinicians are now faced with a dilemma regarding the accurate identification of patients with HER2 overexpression. In the October 2002 issue of ONCOLOGY,

This supplement to ONCOLOGY includes a collection of papers focusing on the clinical development and use of capecitabine (Xeloda), a novel agent with significant activity in patients suffering from metastatic breast cancer. It is now clear that this

The demonstration of the activity of capecitabine (Xeloda) in advanced breast cancer and of the ability of capecitabine/docetaxel (Taxotere) to improve tumor response, time to disease progression, and survival in this

Available data on the use of active chemotherapy agents in advanced breast cancer suggest that sequential single-agent therapy is associated with outcomes similar to those achieved with concurrent combination therapy. Since

A recent phase III trial demonstrated that the combination of capecitabine (Xeloda) and docetaxel (Taxotere) significantly improved objective tumor response rate, time to disease progression, and overall survival compared

Capecitabine (Xeloda) offers a unique mode of action. The drug is currently being combined with other active agents in the treatment of advanced breast cancer. The recent demonstration of improved disease-free and overall