Breast Cancer

SAN ANTONIO--Three studies reported at the San Antonio Breast Cancer Symposium show no apparent adverse effects of hormone replacement therapy (HRT) on breast cancer and, in fact, suggest that breast cancers in patients with a history of HRT may have a more favorable prognosis in terms of histologic grade and estrogen-receptor (ER) levels.

COLLEGEVILLE, Penn--Rhône-Poulenc Rorer Inc. and the National Surgical Adjuvant Breast and Bowel Project (NSABP) have announced the initiation of a new clinical trial (B-27) utilizing docetaxel (Taxotere) in women with operable breast cancer.

BETHESDA, Md--The American Medical Writers Association is seeking applications for the 1996 Rose Kushner Awards for Writing Achievement in the Field of Breast Cancer.

SAN ANTONIO--First-line chemotherapy with docetaxel (Taxotere) produced response rates as high as 68% in a series of studies involving patients with advanced, metastatic breast cancer.

An expert panel of seven cancer researchers and a patient advocate came together at the San Antonio Breast Cancer Symposium for a roundtable discussion on tamoxifen (Nolvadex), sponsored by PRR, Inc., publisher of Oncology News International and the journal ONCOLOGY.

SAN ANTONIO--Mammographic signs of angiogenesis and neovascularity may identify a developing breast cancer years before the lesion becomes visible, Parvis Gamagami, MD, said at the San Antonio Breast Cancer symposium.

In this issue, Love and Vogel bring attention to the fact that most breast cancers are not inherited but are the result of several, varied hormonal influences. This is an important message because prevention of breast cancer for some women can be accomplished by hormone manipulation from moderate exercise, maintaining low body mass, abstention from alcohol, and lactation. The authors discuss the physiologic role of delayed pregnancy but avoid the issue in terms of preventive strategy. Many women choose to delay pregnancy in pursuit of career development for economic reasons. This makes for a difficult choice in terms of breast cancer risk, but one that should be addressed. The article proposes that lobular maturation and exposure of the breast to hormones are two key processes in breast cancer. Indeed, emerging data also suggest that excess hormonal exposure in utero may influence adult breast cancer risk.

NEW YORK--Women facing mastectomy because of high-risk early breast cancer may benefit from a new strategy that reduces tumor size, allowing conservative surgery or eliminating the need for surgery, Ian E. Smith, MD, said at the symposium of the Chemotherapy Foundation.

NEW YORK--Women seeking information about breast cancer can now turn to their computers. The National Alliance of Breast Cancer Organizations (NABCO) has established the first nonprofit organization breast cancer web site (http://www.nabco.org) to provide In-ternet users with up-to-date information about the latest research, current treatment options, support services, and links to other Internet sites.

Developed as a way to sample mammographic abnormalities in a potentially less invasive way, stereotactic technology has generated significant controversy. Speaking at the 11th International Breast Cancer Meeting in San Antonio earlier this year,

SAN ANTONIO--The NCI's clinical alert advising physicians to limit the use of tamoxifen (Nolva-dex) in early breast cancer to no more than 5 years may be a "premature judgment" that was based on a randomized trial of insufficient size, Prof. Richard Peto, of the University of Oxford's ICRF Clinical Trial Service Unit, said at the San Antonio Breast Cancer Symposium.

DNA sequence analysis of the complete p53 tumor-suppressor gene provides predictive information about breast cancer patients' response to therapy, according to a study published in the October 1995 issue of Nature Medicine. The study analyzes the associations between tumor mutations and patient outcome--especially in relation to therapy--using Sequence-Based Diagnosis, (SBD), a new concept for complete DNA sequencing. Although previous studies have examined p53 using various molecular biologic methods, this study represents the first complete sequencing of the p53 gene in a large retrospective study of a population-based cohort. The study also confirms that since mutations are found over the entire coding sequence, some could be missed using traditional DNA analysis protocols.

PARIS--When counseling women about breast cancer risk, physicians face the difficulty of translating relative risks into real-life prospects, Michael Baum, CHM, FRCS, of the Royal Marsden Hospital, London, said in a presentation at the Eighth Annual European Cancer Conference (ECCO-8).

WILMINGTON, Del--Zoladex (goserelin acetate implant), Zeneca Pharmaceuticals' gonadotropin-releasing-hormone (GnRH) agonist, has received approval for use in the treatment of advanced breast cancer in premenopausal and perimenopausal women.

WASHINGTON--An FDA advisory panel has recommended that the agency approve a new indication for a digital ultrasound system that would expand the role of ultrasound in breast disease.

NEW YORK--Two thirds of American women say they are personally doing something to decrease their chances of getting breast cancer, but many seem to be confused as to what constitutes the major breast cancer risk factors, results of a nationwide survey suggest.

SAN ANTONIO--New research suggests that abnormalities in the BRCA1 gene may be involved in the pathogenesis of sporadic breast cancers as well as familial breast and ovarian cancers.

COLUMBUS, Ohio--Women who said they used an NSAID (usually aspirin or ibuprofen) regularly for 5 years or more had a 40% lower risk of breast cancer than those who did not report such use, Dr. Randall E. Harris and his colleagues at the Ohio State University Comprehensive Cancer Center have found.

CHICAGO--Although aspirin's role in cancer prevention remains controversial, two recent studies (see "Long -term Aspirin Use Reduces Colon Cancer Risk, Study Shows" and "Regular Aspirin Use May Lower Breast Cancer Risk") show a reduced risk of colorectal and breast cancer with long-term aspirin use.

WASHINGTON--Zeneca Pharmaceuticals and its National Breast Cancer Awareness Month (NBCAM) co-sponsors have presented First Lady Hillary Rodham Clinton with the Government Leadership Award for her outstanding initiative in launching efforts to educate women about mammography.

The incidence of invasive breast cancer among women age 65 years or older is twice that among those age 35 to 44 years,

NEW YORK--The National Alliance of Breast Cancer Organizations (NABCO) has just released the 1995/96 edition of the NABCO Breast Cancer Resource List. This year's 70-page List, supported by an educational grant from Glaxo Wellcome Inc., includes more than 2,000 books, brochures, videos, hotlines, and support groups useful for women and health professionals.

In the United States, efforts to reduce mortality from breast cancer focus primarily on secondary prevention (ie, early detection

Combinations of the new agent, Taxotere (docetaxel), and Navelbine (vinorelbine), and Taxotere plus Adriamycin (doxorubicin) have both demonstrated activity in the treatment of metastatic breast cancer, according to research presented

SILVER SPRING, Md-In addition to recommending approval of Taxotere (docetaxel) at its most recent meeting (see " Panel Recommends Taxotere Be Approved for Advanced Breast Cancer"), the FDA's Oncologic Drugs Advisory Committee (ODAC) also voted on two other new drug applications and heard a presentation on a new imaging agent.

Patients are often critical of quality -of -life programs because health -care professionals developed them with little

Breast cancer is a disease that not only has a high prevalence and mortality but also profound psychological and psychosocial ramifications. Women with breast cancer fear death and face complicated medical decisions and concerns about their body image, sexuality, and relationships.1

BETHESDA, Md-Scientists from the National Cancer Institute have found a specific mutation, 185delAG, in the breast cancer 1 gene (BRCA1) in almost 1% of DNA samples from a study group of Eastern European (Ashkenazi) Jews. This is the first time that scientists have been able to show that the gene mutation is present at measurable levels not only in high-risk families but also in a specific group of the general population.

G-CSF has been available since 1991 for use in patients receiving high-dose chemotherapy/ABMT, and while it has been shown to effectively reduce the risk of febrile neutropenia, its cost effectiveness has been open to question. In this small retrospective study, five indicators of the consumption of health care resources were examined in stage III/IV breast cancer patients who received high-dose chemotherapy with ABMT or peripheral stem cell support. The study covered the time periods before and after the availability of G-CSF. The results showed that patients who received G-CSF had reductions in length of hospital stay of 20% (the purged marrow group) and 17% (nonpurged group), compared with similar groups that did not receive the growth factor; the shortest lengths of stay were seen in the peripheral stem cell group, all of whom received G-CSF. Other findings, including number of days the ANC fell below 500, total days of G-CSF use, and total days of antibiotic use, are presented. [ONCOLOGY 9(Suppl):107-110, 1995]

The 1992 metaanalysis of adjuvant therapies after surgery in early breast cancer summarizes the most extensively studied of all cancer treatments via randomized controlled trials. This study found overall benefits with use of adjuvant therapies, and their expanded use outside the clinical trial setting was assumed to be effective and implied to be cost effective. Thus, the primary remaining questions are which form of adjuvant therapy to use and how to identify which patients are unlikely to benefit. In British Columbia, the effectiveness of adjuvant therapy outside the clinical trial setting was reassuringly similar to the metaanalysis efficacy. Our decision analysis model of hypothetical cohorts of women with early breast cancer confirmed that the efficacy of adjuvant treatment is the primary determinate of its incremental cost effectiveness. Future cost-effectiveness and quality of life assessments should move from hypothetical cohorts assessed via models to prospective data collected within clinical trials or integrated health delivery system. [ONCOLOGY 9(Suppl):129-134, 1995]