Breast Cancer

This article aims to provide an overview of The Cancer Genome Atlas findings, with a particular focus on their potential biological relevance and therapeutic implications.

New evidence now supports improved recurrence and breast cancer mortality outcomes with continued tamoxifen for up to 10 years in women of any age, and such long-duration therapy is especially important for women who remain premenopausal after their first 5 years of tamoxifen.

Can knowledge of a patient’s breast tumor genome help select the optimal treatment, and when we have an effective treatment for a group of patients-in this case, for breast cancer patients in the adjuvant setting-how long should the course of treatment be?

Women who developed a rash early in their treatment for HER2-positive breast cancer with lapatinib were more likely to go on to have pathologic complete response compared to those who did not get a rash, according to the results of an unplanned analysis of data from the NeoALTTO trial.

Concurrent administration of trastuzumab and anthracyclines resulted in a similar rate of pathologic complete response when compared to sequential administration in women with HER2-positive breast cancer, according to the results of a new study.

Two studies indicate that older women with trastuzumab-treated breast cancer and those who undergo radiation to the left chest wall may be at risk for increased rates of cardiotoxicity.

Researchers have found that the breast cancer drug exemestane may also protect cells against DNA damage from UV radiation as well as damage that occurs during inflammation and oxidative stress.

Two independent research groups have identified resistance mutations in the gene that encodes the estrogen receptor in some cases of metastatic breast cancer.

Increased doses of aerobic exercises lasting 50 to 60 minutes were found to be more effective than a standard dose of 30 minutes for managing declines in physical functioning and symptoms such as pain, hot flashes, and fatigue in women undergoing chemotherapy for breast cancer.

Patients with early-stage breast cancer who received radiation therapy had a higher risk of heart disease, due to the exposure of their heart tissue to the treatment, according to a 48-patient study by Columbia University.

A recent prospective trial showed sentinel lymph node surgery has a clinically significant high false negative rate in breast cancer patients with node-positive disease receiving neoadjuvant chemotherapy. In this interview we discuss surgical techniques that detect breast cancer in lymph nodes.

New ASCO and CAP guidelines recommend HER2 testing for all newly diagnosed breast cancer patients with either early-stage invasive or metastatic disease.

Postoperative irradiation of the internal mammary and medial supraclavicular lymph nodes of patients with early breast cancer resulted in improved survival with no increase in side effects, according to 10-year follow-up results.

T-DM1, a combination drug of trastuzumab and a cell-killing drug emtansine, significantly improved progression-free survival in women with advanced HER2-positive breast cancer whose cancer has recurred or progressed despite previous treatments, according to the results of the TH3RESA trial.

Long-term safety and efficacy results of two phase II trials indicate that dose-dense anthracycline-based chemotherapy with doxorubicin and cyclophosphamide can be safely combined with anti-HER2 therapy in women with early breast cancer.

A new meta-analysis indicated that people with diabetes are not only at an increased risk of developing breast and colon cancer, but are also at an increased risk of dying from the diseases.

The FDA today granted pertuzumab (Perjeta) accelerated approval for the treatment of patients with HER2-positive early stage breast cancer prior to surgery who are at high risk for recurrence or metastasis.

Ten-year follow up two large randomized trials in the UK show that less frequent but higher dose radiotherapy regimen are as safe and effective as the standard regimen of more frequent lower doses for women with early breast cancer post-surgery.

In order for malignancies to establish in metastatic sites, cancer cells must acquire attributes of those sites; specifically how this occurs in many cancers is relatively unknown, but a new study implicates the stroma of certain breast cancer tumors in the development of bone metastases.

Clearly there is no single therapy for all patients with TNBC, given the molecular heterogeneity of this subtype. However, new insights from further genomic analysis of TNBC suggest approaches to rational clinical trial design, and patients will undoubtedly benefit as we define the most appropriate therapeutic targets in management of this aggressive disease.

Triple-negative breast cancer (TNBC) remains a very challenging entity today, but with the identification of new targets and further optimization of therapy, the landscape for TNBC may not look so negative. In the future, “TNBC” may be considered an antiquated misnomer, as we will have identified various breast cancer subgroups based on what they “are” rather than what they “are not.”

With regard to potential research strategies relevant to the treatment of triple-negative breast cancer/basal-like breast cancer, potential targets include PTEN, INPP4B, PIK3CA, KRAS, BRAF, EGFR, FGFR1, FGFR2, IGFR1, KIT, MET, PDGFRA, and the HIF1-α/ARNT pathway. Many of these will be discussed further in this review article.

Combining four cycles of docetaxel and cyclophosphamide with 1 year of trastuzumab may be a viable treatment option for women with HER2-amplified early-stage breast cancer regardless of their TOP2A status, according to the results of a phase II study.

About 40% of women experienced a change in at least one biomarker from primary to residual breast cancer after undergoing neoadjuvant chemotherapy, according to the results of a study presented at the ASCO Breast Cancer Symposium.

Two studies presented at the ASCO Breast Cancer Symposium 2013 focused on studying cognitive function in women with early-stage breast cancer, focusing on the relationship between perceived and measurable cognitive decline, and factors that may help to predict cognitive decline.

The exposure of the heart to radiation during radiotherapy for ductal carcinoma in situ (DCIS) did not increase cardiovascular mortality or morbidity, according to a study by researchers in the Netherlands.

More than 90% of women about to undergo a mammography were unable to accurately quantify their risk for breast cancer, either over- or underestimating their risk, according to the results of a large-scale survey presented at the ASCO Breast Cancer Symposium 2013.

Expert radiologists were able to screen magnetic resonance images and rule out breast cancer diagnosis with a negative predictive value of about 99% using an abridged breast MRI protocol in a single-center study presented Saturday at the ASCO Breast Cancer Symposium 2013.

As part of our coverage for the ASCO Breast Cancer Symposium 2013, we spoke with Dr. Susan K. Boolbol, chief of the division of breast surgery at the Appel-Venet Comprehensive Breast Service at Beth Israel Medical Center in New York City, who is chairing a general session panel discussion on the overdiagnosis of breast cancer.

Results of the PrefHer study indicated that when given the option between subcutaneous trastuzumab and intravenous trastuzumab, significantly more patients with HER2-positive breast cancer preferred the subcutaneous administration.