Breast Cancer

As a tumor grows, so does its need for nutrients, with a new vascular supply necessary for a tumor to grow to a diameter

SAN DIEGO-Breast cancer patients with an inherited predisposition due to mutations of BRCA1 or BRCA2 are more likely to have an accumulation of other genetic defects than patients with no evidence of a familial clustering, according to a multinational study, said Mika Tirkkonen, of the University of Tampere, Finland.

Data from two studies presented at the 88th Annual Meeting of the American Association for Cancer Research (AACR)

Multimodality therapy-ie, surgical excision followed by appropriate systemic therapy and radiotherapy-has an established role in managing patients with locally

Breast-conserving therapy with lumpectomy and breast irradiation is an accepted standard treatment for patients with early-stage invasive breast cancer or ductal carcinoma in situ (DCIS). For both diseases, investigators have tried to identify subgroups of patients who can be "safely" treated with lumpectomy without radiation. Some data suggest that it may be reasonable to omit radiation therapy in patients with small, low-grade invasive or noninvasive tumors and/or in "elderly" patients. Additional studies are needed to better identify criteria to prospectively select appropriate patients for treatment with lumpectomy alone. [ONCOLOGY 11(9):1361-1374, 1997]

To irradiate or not to irradiate, that is the question posed by Marks and Prosnitz for women with early invasive breast cancer or ductal carcinoma in situ (DCIS) undergoing breast conservation therapy (BCT). Due in large part to mammography, there has been in the 1990s a significant increase in the percentage of women presenting with stage 0 (DCIS) and stage I breast cancer, as recorded by the Surveillance, Epidemiology and End-Results Program of the National Cancer Institute (NCI). The generally excellent outcome of these tumors with current therapy has focused research efforts on studies directed at improving quality of life and minimizing the side-effects and expense of local therapy. In this regard, Marks/Prosnitz present a concise and balanced summary of results from randomized and non-randomized clinical trials, and develop a rationale for current treatment recommendations and future studies regarding the role of breast irradiation (RT).

NEW ORLEANS--Three fourths of patients experience significant physical sensations after breast cancer surgery. For many women, these are still present years later, and many have long-term arm morbidity as well, researchers reported at the Oncology Nursing Society's 22nd Annual Congress.

NEW ORLEANS--Fatigue may be underrecognized as a disturbing symptom of breast cancer, especially in postmenopausal women, but exercise may help combat it, according to several presentations at the Oncology Nursing Society's 22nd Annual Congress.

NEW ORLEANS--Cytologic and biomarker assessment can be used to identify a cohort of women at extremely high risk for short-term breast cancer development, Carol Fabian, MD, said at the American Society of Preventive Oncology annual meeting.

SEATTLE--Breast cancer patients who report high levels of personal stress score lower on three measures of immune function than less stressed women with the disease, said Barbara L. Andersen, PhD, professor of psychology and obstetrics and gynecology, Ohio State University, Columbus.

NEW YORK--The National Alliance of Breast Cancer Organizations (NABCO), together with the National Breast Cancer Awareness Month Board of Sponsors, has created the National Breast Cancer Awareness Month (NBCAM) Online Calendar as the one-stop source for all October 1997 events.

NEW ORLEANS--Women seeking BRCA1 testing appear, as a group, to be more distressed and psychologically vulnerable than those who do not wish to be tested, according to two studies from Lombardi Cancer Center, Georgetown University, reported at the American Society of Preventive Oncology annual meeting. The women in the studies were at high risk because of a close family history of breast or ovarian cancer.

Docetaxel (Taxotere) and vinorelbine (Navelbine) have both demonstrated activity as single agents for the treatment of patients with metastatic breast cancer and non-small-cell lung

Docetaxel (Taxotere) and doxorubicin (Adriamycin) have each demonstrated significant activity in metastatic breast cancer. Thus, the combination of docetaxel and doxorubicin has been evaluated in phase I trials to

Preliminary results from phase I trials suggest that the use of docetaxel (Taxotere) and doxorubicin (Adriamycin) is a well tolerated and highly active combination regimen for

Optimal management of locally advanced breast cancer (stage III) generally includes a combination of primary chemotherapy followed by surgery (if feasible), and local radiotherapy and adjuvant chemotherapy with or

This nonblinded, multicenter, randomized phase III study compares the median time to progression (primary endpoint), response rate, and quality of life, safety, and survival of

Single-agent docetaxel (Taxotere) has been shown to be highly active in metastatic breast cancer, with an overall response rate of 47%, median time to progression of 4 months, and survival of 10 months when administered as

NEW YORK--The timing of exposure to environmental factors may be the most powerful determinant in the development of breast cancer, Mary Wolff, PhD, said in a lecture sponsored by the Irvington Institute for Immunological Research.

ASCO--A phase III multinational trial has shown docetaxel (Taxotere) to be more effective than doxorubicin (Adriamycin) as single-agent treatment of patients with metastatic breast cancer who have failed an alkylating-containing regimen.

ASCO--A brief, intensive preoperative chemotherapeutic regimen failed to improve breast cancer survival over conventional adjuvant chemotherapy in a 1,500-patient randomized trial, Dr. Eleftherios Mamounas said for the National Surgical Adjuvant Breast Project (NSABP). However, preoperative treatment often resulted in complete clinical remission prior to surgery.

ASCO--Anthracycline-based chemotherapy should join tamoxifen (Nolvadex) as standard therapy for postmenopausal breast cancer patients who have positive lymph nodes and are estrogen-receptor positive.

A new study strengthens the evidence that ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) reduce the risk of breast cancer in some women.

It is unusual to find an entire book dedicated to one therapeutic agent because a balanced, comprehensive analysis generally requires a somewhat broader perspective, particularly if it is targeted not only to the physicians treating a particular disease

Since the emergence of paclitaxel (Taxol) in 1983, clinical developmentof the taxoids has progressed at a rapid pace, with the introduction ofdocetaxel (Taxotere) into clinical trials in 1990, and international phaseII studies in 1992. Although these two taxoids are related, increasingclinical experience indicates that paclitaxel and docetaxel should notbe considered interchangeable.

SAN DIEGO--Reports from the American Association for Cancer Research annual meeting have moved researchers closer to answering the question of whether DDT and its metabolites act as a risk factor for breast cancer by mimicking endogenous estrogen.

CHICAGO--Because adjuvant systemic chemotherapy has led to real and meaningful improvement in long-term disease-free and overall survival of women with invasive breast cancer, "perhaps the primacy of surgery is not sacrosanct," said David Hyams, MD, executive medical officer of the NSABP, Allegheny General Hospital, Pittsburgh.

ASCO--Doxorubicin (Adriamy-cin) plus paclitaxel (Taxol) used in combination resulted in better overall response rates and longer time-to-treatment failure than either agent used alone as first-line treatment of metastatic breast cancer, George W. Sledge, Jr., MD, of Indiana University School of Medicine, reported at the ASCO meeting.

NEW ORLEANS--Adoption of a low-fat, high-carbohydrate diet reduces the area of mammographic densities in the breast, a strong risk factor for breast cancer, Norman F. Boyd, MD, of the Ontario Cancer Institute, Toronto, reported at the American Society for Preventive Oncology meeting.

CHICAGO--Despite an overall trend toward breast conservation, many breast cancer authorities believe that ductal carcinoma in situ (DCIS) too often is treated by mastectomy, and that axillary dissection and irradiation frequently are performed unnecessarily.