Breast Cancer

The journal Lancet recently published an important analysis from six physicians at Weill Cornell Medical College (359:404-406, 2002), rebutting an article published in an earlier issue of Lancet (358:1340-1342, 2001) that cast doubt on the value of mammography in preventing death from breast cancer.

MIAMI BEACH, Florida-The Breast Cancer Risk Assessment Working Group is completing work on its consensus guidelines for stratifying patients into risk categories for breast cancer and managing their care accordingly. The model was outlined at the 19th Annual Miami Breast Cancer Conference.

New research presented at the 93rd annual meeting of the American Association for Cancer Research (AACR) suggests that monitoring with the serum HER2/neu oncoprotein test may help oncologists assess the effect of trastuzumab (Herceptin)-based therapy in patients with metastatic breast cancer.

The authors are to be complimented on a thoughtful and complete review of the application of the sentinel node paradigm to colorectal cancer. This paradigm is inherently quite different for colorectal cancer because, except for the occasional demonstration of variant anatomy, the technique will not alter the extent of surgery as it has done in melanoma and breast cancer.

The multistep process of carcinogenesis, which can take many years, provides many opportunities for intervention to inhibit disease progression. Effective chemoprevention agents may reduce the risk of cancer by inhibiting the initiation stage of carcinoma through induction of apoptosis or DNA repair in cells harboring mutations, or they may act to prevent promotion of tumor growth. Similarly, chemoprevention may entail blocking cancer progression to an invasive phenotype.

When the BRCA1 and BRCA2 genes for breast and ovarian cancers were first identified and a screening blood test became available, a debate ensued as to whether there was an advantage to learning one’s risk. Recently, the value of such testing was demonstrated in a study in women who were followed after being identified as carriers of a BRCA genetic mutation. Researchers at Memorial Sloan-Kettering Cancer Center have provided strong evidence that breast and ovarian cancers can be detected at an early stage in women at highest hereditary risk. Results of the study were published in a recent issue of the Journal of Clinical Oncology (20:1260-1268, 2002).

SAN ANTONIO-The aromatase inhibitor letrozole (Femara) should be considered for first-line hormonal therapy in postmenopausal women with advanced breast cancer, according to the final analysis of a pivotal phase III trial comparing the agent with tamoxifen (Nolvadex).

WASHINGTON-In recent years online chat rooms and list servers devoted to a vast array of special interests have become a staple of American life. Now a pilot project has shown that an internet support group significantly benefits women coping with breast cancer, said Mitch Golant, PhD, vice president of research and development for The Wellness Community (TWC) National, Santa Monica, California.

ChromaVision Medical Systems, Inc, announced recently that investigators using their automated cellular imaging system (ACIS) concluded that the number of metastatic tumor cells found in the sentinel lymph node correlates with the size of the primary breast tumor.

SAN ANTONIO-Updated results from a major phase III study of docetaxel (Taxotere) plus capecitabine (Xeloda) in metastatic breast cancer confirmed the value of this new combination.

SAN ANTONIO-Novel regimens pairing gemcitabine (Gemzar) and vinorelbine (Navelbine) with trastuzumab (Herceptin) showed significant antitumor activity and good tolerability in heavily pretreated HER-2-positive patients with metastatic breast cancer, in studies reported at the 24th Annual San Antonio Breast Cancer Symposium.

SAN ANTONIO-In first-line hormonal therapy for advanced breast cancer, elevated levels of HER-2/neu predict lower response rates and shorter time to disease progression, compared with normal HER-2 levels, according to a large international study.

WASHINGTON-Amid continuing controversy over the effectiveness of screening mammography for breast cancer, the US Preventive Services Task Force (USPSTF) has extended its recommendations to include women between the ages of 40 and 49, after concluding that the procedure reduces breast cancer deaths.

WASHINGTON-Black women have long been known to suffer higher breast cancer mortality and to experience worse 5-year survival rates than whites. Even controlling for disease stage, they are more likely to fail treatment and have worse outcomes, said Lisa A. Newman, MD, MPH. The question therefore arises, she said, whether these differences reflect biological variation or social inequality.

BOSTON-Excessive sun exposure is a known risk factor for the development of skin cancer, but sun exposure appears to have a protective effect against a variety of other cancers, according to speakers at a symposium on sunlight at the 168th National Meeting of the American Association for the Advancement of Science (AAAS).

WASHINGTON-A definite link exists between mammography screening and lessened breast cancer mortality, but black women do not take full advantage of cancer screening, according to Janice S. Emerson, research associate, Center for Health Research, Tennessee State University, Nashville. Speaking at the American Psychological Association Conference on Enhancing Outcomes in Women’s Health, she presented findings from an HCFA-funded project, led by Dr. Baqar A. Husaini.

Recruitment for a challenging breast cancer trial has begun at sites in more than 40 countries. It is hoped that more than 3,000 patients from approximately 600 sites will participate in a study designed to determine whether earlier use of trastuzumab (Herceptin) increases disease-free survival in women with early breast cancer.

ROCKVILLE, Maryland-Members of the Oncologic Drugs Advisory Committee (ODAC) have unanimously recommended that the Food and Drug Administration approve Zometa (zoledronic acid for injection, Novartis) for the treatment of bone metastases in patients with multiple myeloma and breast cancer, prostate cancer, lung cancer, and other solid tumors.

SAN ANTONIO-A multicenter phase II study conducted in France has shown that epirubicin (Ellence) and docetaxel (Taxotere) (ET) offer better results as first-line chemotherapy than fluorouracil (5-FU), epirubicin, and cyclophosphamide (FEC) among patients with metastatic breast cancer.

CHICAGO-Brachytherapy devices that deliver radiation therapy directly to the lumpectomy site drastically reduce the time needed for radiotherapy after surgery for early-stage breast cancer, according to two studies presented at the 87th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA).

At the 24th Annual San Antonio Breast Cancer Symposium, researchers reported a 78% overall response rate in a phase II trial of vinorelbine (Navelbine) plus trastuzumab (Herceptin) in women with HER2-positive metastatic breast cancer. According to FDA-approved labeling, vinorelbine is not indicated for metastatic breast cancer.

ORLANDO-Treatments credited with improving 5-year survival rates for patients with childhood Hodgkin’s disease may lead to an increased risk of leukemia, breast cancer, and other neoplasms years later, according to a study by the Late Effects Study Group (LESG) presented at the American Society of Hematology annual meeting (abstract 3198).

NEW YORK-Preliminary data from a pilot study show that use of recombinant human erythropoietin (epoetin alfa, Epogen, Procrit) in breast cancer patients receiving adjuvant chemotherapy increases hemoglobin levels and improves quality of life, especially energy and activity.

Despite a tight proposed domestic budget for fiscal 2003, President Bush wants to increase spending on the National Breast and Cervical Cancer Early Detection Program administered by the Centers for Disease Control and Prevention (CDC).

BETHESDA, Maryland-The scientific conflict about whether mammography saves lives has been reignited by the decision by an independent advisory committee to rescind its support for such screening and to emphasize the uncertainty of the evidence supporting it.

For many people, a picture is much more instructive and memorable than text. The second edition of the Atlas of Breast Cancer is designed for such people. With 154 pages and 213 figures, it is a graphic overview of the pathophysiology, diagnosis, and treatment of breast cancer.

SAN ANTONIO-A retrospective study presented at the 24th Annual San Antonio Breast Cancer Symposium (abstract 18) has shown that breast cancer patients selected for treatment with trastuzumab (Herceptin) combination therapy on the basis of HER-2 gene amplification by fluorescent in situ hybridization (FISH) may have improved clinical benefits.

NEW YORK -The safer and better-tolerated "stealth" form of doxorubicin has a potential for the treatment of metastatic breast cancer that has not yet been realized due to overly toxic dosing schedules, Charles L. Vogel, MD, of Cancer

SAN ANTONIO-Tamoxifen (Nolvadex) therapy not only prevents breast cancer but also benign breast disease in high-risk women, according to a study by the National Surgical Adjuvant Breast and Bowel Project (NSABP) presented at the 24th San Antonio Breast Cancer Symposium (abstract 7). Elizabeth Tan-Chiu, MD, of the NSABP, reported the findings.

SAN ANTONIO-The sequential use of docetaxel (Taxotere) after Adriamycin (doxorubicin)/cyclophosphamide (AC) as a neoadjuvant regimen in primary operable breast cancer essentially doubles the rate of pathologic complete responses (CRs),