Breast Cancer

Few areas in breast disease elicit as much controversy as the management of DCIS. The review by Sanders and Simpson, “Can We Know What to Do When DCIS Is Diagnosed?”

It is ironic that while huge strides have been made in the treatment of invasive breast carcinoma, resulting in breast conservation for many women, the most appropriate treatment of noninvasive breast carcinoma remains a topic of hot debate.

Since 1990, death rates from breast cancer have decreased, mainly in women younger than 50 years of age (3.3% per year) vs women aged 50 years or older (2% per year), reflecting the benefit of widespread use of systemic treatment added to early detection.[1]

Dapagliflozin, the experimental diabetes medication being developed by Bristol-Myers Squibb and AstraZeneca was found to raise the risk of both bladder and breast cancers. The data were presented at the American Diabetes Association Meeting in San Diego, Calif. at the end of June.

Personalized cancer care is generally thought of as using molecular information from tumors in order to identify which therapeutic agents will be most effective in a given patient.

The Early Breast Cancer Trialists' Collaborative Group overviews published in 2005 confirm that local control in breast cancer matters, and they highlight that achieving local control in the modern era is not improved simply by more extensive surgery but instead by the combination of surgery, systemic and hormonal chemotherapies, and radiation therapy.[1,2]

Researchers at the Institute for Cancer Research (ICR) in London, driven by the unmet need of personalized cancer treatments for a greater subset of tumors have identified genes in breast tumor cells that sustain and grow the tumors that are potential targets for drug development.

Scientists at the NCI have designed a novel protein, HER2-Affitoxin, aimed to treat HER2-positive breast cancer. In vitro experiments and mouse breast cancer models show that the agent is highly effective in eradication of HER2-over expressing cancer cell as well as tumors in mice.

Many doctors do not properly adhere to current guidelines for offering breast and ovarian cancer counseling and testing services to their female patients, according to a new study from the Division of Cancer Prevention and Control at the CDC.

Results from a prospective study of 1023 newly-diagnosed HER2-positive metastatic breast cancer patients show that treatment with trastuzumab (Herceptin) and chemotherapy independently resulted in statistically significant improvement in median overall survival from the time central nervous system (CNS) metastases were diagnosed.

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Researchers at the Vanderbilt-Ingram Cancer Center and the Vanderbilt University School of Medicine have parsed the large and heterogeneous triple-negative breast cancer (TNBC) category of patients into 6 molecularly distinct subgroups. This may be an important step towards delineating these patients as specific genetic subtypes to channel them to appropriate targeted therapy trials.

Triple-negative breast cancer (TNBC) continues to carry a poor prognosis. However, novel prognostic and potentially predictive biomarkers may soon improve that bleak outlook, according to a series of studies presented on Saturday at the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.

Live coverage of the ASCO session on PARP inhibitors and DNA repair, with speakers Michael Kastan, Judy Garber, and Elisabeth Plummer.

A study published online on May 10, 2011 in the British Journal of Cancer has shown evidence for a new prognostic factor in breast cancer: an increase in cancer stem cell population after primary systemic therapy. The study results indicate that putative cancer stem cells may be chemoresistant to conventional anthracycline-based chemotherapy and may have a role in disease progression following chemotherapy treatment.

Melanie Bone, MD, was not yet 40 years old and had four young children when she was diagnosed with stage III breast cancer. “Even though I am a doctor and surgeon, I learned firsthand about the side effects of cancer treatment,” said Dr. Bone, a nutritional gynecologist. “I was too sick to work, so I spent time thinking about how to make the cancer experience easier for future cancer patients.”

David Mankoff speaks on new developments in imaging and recommends ASCO sessions on imaging clinical trials.

A 57-year-old patient presents for evaluation of right nipple discomfort. The patient has family history of a mother and sister with premenopausal breast cancer.

In 2004, Dr. Leisha Emens and I reviewed the use of trastuzumab (Herceptin), the monoclonal antibody directed against the HER2 protein, in the treatment of breast cancer.

A 33-patient Phase 1/2 study in Europe published in the European Journal of Cancer has shown that a new chemotherapy combo of a novel taxoid, cabazitaxel, and capectiabine shows promise in previously treated metastatic breast cancer patients.

In a prospective study published online first on March 28, 2011 in the Journal of Clinical Oncology, researchers have shown, for the first time, that annual MRI screenings can reduce breast cancer-related mortality in women with a BRCA1 or BRCA2 mutation.

Many historical evolutions of concepts have emerged regarding lobular neoplasia (LN) since 1865, when Cornil first described this entity as “intraepithelial breast carcinoma in lobules.

Breast cancers of lobular histology are not frequently encountered, but are nevertheless the second most common histologic subtype of breast cancer after ductal adenocarcinoma.

A 40-year-old premenopausal woman with a new diagnosis of invasive lobular carcinoma occurring in a background of lobular carcinoma in situ presents to a multidisciplinary second opinion clinic.

The study represents one of the largest cancer genomics investigations reported, with more than 10 trillion chemical bases of DNA sequenced. While its results underscore the complexity of breast cancer biology, the mutations uncovered may provide further clues to inform personalized therapy of this common breast cancer subtype.

“Hallmarks of Cancer”, published in the journal Cell in 2000 provided a conceptual framework for the evolution of cancer as well as an all-encompassing review of the cancer field to date. The article is updated in the March 4th, 2011 issue of Cell.

Women over 50 years old with early breast cancer confined to one breast who took 20 mg of tamoxifen daily for 5 years were less likely to relapse than those who took the drug for 2 years.

Researchers at the University of Milan sought to assess the clinical relevance of biopsying primary breast cancers and secondary metastatic liver lesions to evaluate the occurrence of important markers.

The American Society of Clinical Oncology (ASCO) updated its recommendation last month on the role of bone-modifying agents in the prevention of skeletal-related events (SREs) for metastatic breast cancer patients with bone metastases.

Breast cancer has long been described as a very heterogeneous disease, and clinicians have struggled with identifying the appropriate treatment program for an individual patient on the basis of multiple variables, including histology, nuclear grade, tumor size, nodal status, hormone receptor status, and a variety of prognostic factors.