Breast Cancer

Oncology NEWS International guest editor Dr. Andrew D. Seidman recommends SABCS 2008 lectures on modern molecular science, molecular profiling, and the American Association of Cancer Research distinguished lectureship in breast cancer research.

Insight into the molecular workings of HER2-positive breast cancer has paved the way for targeted agents that are showing great promise in clinical trials, according to a presentation at SABCS 2008. José Baselga, MD, from Barcelona, offers a primer on pertuzumab, trastuzumab-DM1, heat shock protein 90, and other agents that will provide “tremendous opportunity” in HER2-positive cancer treatment.

Emerging knowledge about breast cancer biology must be integrated into clinical trials in order to personalize treatment in patients with early breast cancer. Two speakers at an educational session on clinical trial design discussed our advancing understanding of basic science and the ways in which that can change and refine the design of clinical trials.

Estrogen-receptor–positive advanced breast cancer patients who have become resistant to endocrine therapies can derive clinical benefit from 6-mg daily doses of estradiol, according to a phase II study conducted at Washington University in St. Louis.

Combining endocrine therapy with signal transduction inhibition is an effective means of overcoming endocrine resistance in at least some populations of patients with breast cancer. Stephen R.D. Johnston, MA, PhD, director of clinical research and development at the Royal Marsden Hospital in London, discussed the data on this emerging strategy during an SABCS plenary lecture.

Aromatase inhibitors were associated with greater reductions in the risk of breast cancer recurrence in comparison with tamoxifen, according to a meta-analysis involving nearly 20,000 hormone receptor-positive early breast cancer patients.

Women with breast cancer who have isolated tumor cells or micrometastases in their sentinel lymph nodes are at increased risk for recurrence, even if their cancer otherwise has favorable features. Adjuvant systemic therapy, however, can attenuate that elevated risk, according to the findings of a major Dutch study.

The American Association for Cancer Research will provide scientific expertise to Love/Avon Army of Women, an organization that seeks to link more than one million women volunteers with cancer researchers across the country to discover breast cancer causes and to aid in prevention.

CHICAGO-Targeted radiation of breast cancer after lumpectomy reduces treatment time from six and a half weeks to five days, while reducing pain and improving cosmetic outcome, according to a study presented at RSNA 2008 (abstract SSC19-02).

BOSTON-Acupuncture alleviates severe vasomotor symptoms as effectively as the antidepressant venlafaxine (Effexor) in breast cancer patients receiving anti-estrogen therapy, according to research from the Henry Ford Health System in Detroit.

In this issue of ONCOLOGY, Houchens and Merajver[3] have commendably attempted to summarize the results of existing research into the molecular determinants of this aggressive disease. The authors have focused specifically on classical prognostic and predictive markers, although these are not specific to the IBC breast tumor subtype.

Inflammatory breast cancer (IBC) is an aggressive and lethal form of breast cancer. It is also an entity for which no consensus exists regarding its clinical definition. The current nomenclature is considered a misnomer since its clinical presentation is not caused by inflammatory components but mainly by lymphatic obstruction.

Since its early descriptions by Lee and Tannenbaum in 1924, inflammatory breast cancer (IBC) has been recognized as the most aggressive and lethal form of primary breast cancer. With distinct clinical, pathologic, biologic, and molecular features, IBC presents unique challenges and opportunities to breast oncologists and breast cancer researchers.

In the United States, approximately 180,000 women are diagnosed with breast cancer annually.

Anthracyclines have occupied a prominent position in the adjuvant systemic treatment of early breast cancer for decades. Th is position was supported by the evidence from the latest overview of the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) showing an absolute survival benefit of about 4% at 10 years for anthracycline-containing regimens versus CMF-like regimens.

An increase in birth length by 2 cm is associated with a 9% increase in breast cancer risk, according to a study reported in PLoS Medicine, online. Isabel dos Santos Silva, MD, PhD, a professor of epidemiology at the London School of Hygiene and Tropical Medicine and colleagues, examined 32 studies involving 22,058 breast cancer cases.

Endocrine therapy plays a critical role in the management of early-stage hormone receptor–positive breast cancer, providing a nearly 50% reduction in the risk of distant and local recurrence.

The University of California, San Francisco (UCSF) Center of Excellence for Breast Cancer Care has launched BreastCancerTrials.org, a free, nonprofit, clinical trial matching service that provides nationwide information for individuals diagnosed with or at risk for breast cancer.

The drug tamoxifen does not prevent or treat estrogen receptor (ER)-negative breast cancer, but it can make the disease easier to find, researchers reported in a recent issue of the Journal of the National Cancer Institute (100:1448-1453, 2008).

STOCKHOLM-Clinical guidelines and decision-making tools off er evidence based data and prognostic estimates that can help streamline treatment tailoring. But physicians should not rely blindly on these applications as they don’t always off er defi nitive answers, according to a presentation at ESMO 2008.

Early-stage breast cancer patients who receive a more intensive course of radiation to their whole breast over 3 weeks is as effective as the standard, less-intensive 5-week whole-breast radiation and offers patients more convenience at a lower cost, thereby providing a better quality of life, according to a randomized, long-term study presented September 22, 2008, in the plenary session at the 50th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO), held in Boston.

Acupuncture is as effective and longer-lasting in managing the common debilitating side effects of hot flashes, night sweats, and excessive sweating (vasomotor symptoms) associated with breast cancer treatment and has no treatment side effects compared to conventional drug therapy, according to a first-of-its-kind study presented September 24, 2008, at the American Society for Therapeutic Radiology and Oncology’s 50th Annual Meeting in Boston.

WASHINGTON-Loss of HER2 positivity is common among women with initially HER2-positive breast cancer who do not have a pathologic complete response (pCR) to neoadjuvant chemotherapy with trastuzumab (Herceptin), according to a report at the ASCO 2008 Breast Cancer Symposium (abstract 150).

This installment of Second Opinion examines the case of a patient with a new diagnosis of breast cancer presenting to our multidisciplinary breast cancer second opinion clinic.

Carcinomas arising from the breast represent a heterogeneous group of tumors of distinct biologic subtypes that have been shown to be diverse in terms of response to therapy and prognostic outcomes.

The Metastatic Breast Cancer Advocacy Working Group, a cooperative of patient advocates from seven countries, released a consensus report urging other advocacy groups, health-care corporations and professionals, government, academia, community/religious organizations, and all other relevant breast cancer stakeholders worldwide to take action on three priority areas for women living with metastatic breast cancer (MBC)

As Calabrich and colleagues illustrate in their comprehensive review in this issue of ONCOLOGY, there is a seemingly endless array of mechanisms by which the HER2-positive breast cancer cell can escape the control of trastuzumab (Herceptin).

WASHINGTON-Molecular breast imaging appears to be a promising adjunctive modality for breast cancer screening among women with an elevated risk of breast cancer who have dense breast tissue, according to a report at the ASCO 2008 Breast Cancer Symposium (abstract 68).

In 2008, it is estimated that over 1 million women worldwide will be diagnosed with breast cancer, of which 172,695 will be classified as “triple-negative.”[1] The triple-negative phenotype encompasses a breast tumor subtype that is clinically negative for expression of the estrogen and progesterone receptors (ER and PR) and lacks overexpression of the HER2 protein, with unique prognostic and therapeutic implications.

Some clinical trials of HER2-targeted therapies have found that patients assessed to have HER2-negative breast cancer nonetheless derive benefit. Is this a real benefit stemming from unrecognized biological factors in the adjuvant setting?