Breast Cancer

Breast-conserving surgery without radiation therapy is not an effective treatment for early-stage breast cancer, a Harvard Medical School study concludes.

SAN FRANCISCO--Use of estrogen supplements may lower breast cancer mortality, an American Cancer Society study has shown. The study, which was discussed at the ACS's science writers meeting, followed 400,000 women who provided data about their cancer risk factors. After 9 years, breast cancer mortality was 16% lower in those women who used estrogen, suggesting that their tumors were less aggressive.

Although most studies of the relationship between oral contraceptives (OCs) and breast cancer have focused on a possible causative role for OCs, new data suggest that breast cancer patients with a history of OC use may actually fare better than women who have never taken the pill.

African-American breast cancer patients survive as long as their Caucasian counterparts, a new study with up to a 40-year follow-up shows. The study, conducted at the University of Chicago, also found that African-American women do not have more aggressive cancer.

It is widely accepted that the causation of cancer is the result of environmental exposures (including endogenous hormone exposure) and genetic susceptibility. Ultimately, to prevent breast cancer, we must understand both the environmental and genetic components.

It is perhaps not surprising that the increased incidence of a disease that has a major impact on mortality in young women (even though the absolute risk of death from breast cancer in this age group is low) should create so much interest. Yet, despite decades of research, it is by no means clear that everyone would agree with King and Schottenfeld that the appropriate approach to breast cancer prevention is one that "focuses on the physiologic effects of the sex steroid hormones and their potential interactions with family history." However, this tantalizing statement appearing at the end of the abstract of their article fortunately is elaborated upon at the end of the article itself. This elaboration refers specifically to physical activity, energy consumption, obesity, pregnancy history and exogenous estrogens and their potential interactions with family history, with which many will agree.

Drs. King and Schottenfeld have provided an interesting review of the literature in their attempts to relate changes in breast cancer incidence over time to secular changes in postulated risk factors.

Breast cancer incidence rates in the United States rose by 24% between 1973 and 1991. Mortality during this period, however, remained stable. Both the 5-year relative survival rate and the rates of in situ and stage I

SAN ANTONIO--Screening mam-mography significantly improves breast cancer survival in women ages 40 to 49, compared with other methods of cancer detection, a Minnesota study suggests.

BETHESDA, Md--Concerned that a New England Journal of Medicine article reporting no link between fat intake and breast cancer might deter women from joining the diet-cancer segment of the NIH-sponsored Women's Health Initiative (WHI), its top leaders took an unusual step.

PARIS--The luteinizing hormone-releasing hormone (LHRH) agonist goserelin (Zoladex) proved as effective as surgical ovariectomy in premenopausal women with estrogen and/or progestogen receptor-positive metastatic breast cancer, a randomized multicenter study has shown.

Data presented at the 18th Annual San Antonio Breast Cancer Symposium in Boulder, Colorado, shows that moderate-dose DaunoXome, NeXstar Pharmaceuticals' liposomal formulation of daunorubicin, is well-tolerated and has promising efficacy in treating advanced breast cancer. Moreover, the limited toxicity observed in this trial, particularly the absence of cardiotoxicity, suggests that DaunoXome may be useful in ameliorating the side effects that accompany high-dose anthracycline-based chemotherapy for metastatic breast cancer. The data, generated in a phase II study funded by NeXstar, were presented by P.S. Hupperets, MD, of the Akademisch Ziekenhuis, in Maastricht, The Netherlands.

PITTSBURGH--Victor Vogel, MD, MHS, will lead a newly established joint breast cancer program of the University of Pittsburgh Cancer Institute and Magee-Womens Hospital. He will also join the University of Pittsburgh as professor of medicine and epidemiology.

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

In clinical trials, screening mammography has been shown to reduce mortality from breast cancer by about 25% to 30% among women aged 50 years and older after only 5 to 6 years from the initiation of screening. Among women 40 to 49 years old, the evidence supporting the efficacy of screening mammography is less convincing.

his article discusses the costs and benefits of mammographic screening in the workplace. The cost of mammography itself and of diagnostic work-up are two of the largest costs involved.

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.