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ATLANTA-Compared with independent double reading of mammograms, consensus double reading detects slightly more cancers while significantly decreasing recall rates, thereby minimizing the anxiety that women might experience from undergoing a second mammogram, Susan Harvey, MD, said at the 102nd Annual Meeting of the American Roentgen Ray Society (abstract 63).

WASHINGTON-About 30% of breast cancer patients show overexpression of the HER-2/neu oncogene, and trastuzumab (Herceptin), a monoclonal antibody targeting HER-2, has been shown to block the gene’s receptor activity. But because the response rate to trastuzumab "is not ideal," there is "still a need for a better therapeutic agent" aimed at HER-2, said Mong-Hong Lee, PhD, assistant professor of molecular and cellular oncology, M.D. Anderson Cancer Center.

ORLANDO-A large review of patients treated at M.D. Anderson Cancer Center suggests that survival after a first breast cancer recurrence has greatly improved over time in patients diagnosed in the last 25 years. The investigators believe that new therapies, above and beyond the anthracyclines, may be affecting survival rates.

ROCKVILLE, Maryland-The US Preventive Services Task Force (USPSTF) has recommended against the use of tamoxifen (Nolvadex) and raloxifene (Evista) for the primary prevention of breast cancer in women at low or moderate risk

Women with early-stage breast cancer treated with a docetaxel (Taxotere)-based regimen after surgery had a 32% less chance of developing disease recurrence than did women receiving one of the most effective adjuvant treatments currently available. Results from the Breast Cancer International Research Group (BCIRG) trial 001, the first phase III trial to evaluate docetaxel after breast surgery, were presented at the recent annual meeting of the American Society of Clinical Oncology (ASCO) by the BCIRG.

BETHESDA, Maryland-Researchers abruptly halted a prevention trial of estrogen/ progestin in healthy menopausal women after an independent monitoring committee found a 26% increase in invasive breast cancer among women taking the hormone replacement therapy (HRT). The committee also found that the HRT group had a greater risk of coronary heart disease, stroke, and pulmonary embolism than the placebo group.

Rubinstein and colleagues provide an excellent review of mathematical models for estimating breast cancer risk, including the risk of carrying inherited mutations of BRCA1 and BRCA2. Since we and others reviewed early models to predict the likelihood of inherited susceptibility to breast cancer,[1] newer quantitative tools, most notably by Parmigiani and colleagues,[2] have been developed. These models have been made available on CD-ROM, over the Internet, and in other electronic versions that are accessible to most clinicians and researchers. These quantitative resources constitute useful and important aids in genetic counseling.

Breast and ovarian carcinomas pose major public health problems in most Western countries. Countless attempts have been made to better understand a patient’s lifetime risk of breast cancer. The most significant etiologic risk is increasing age, followed by family history. In addition, hormonal and reproductive factors-ie, early menarche and later age at menopause, nulliparity (and, therefore, a greater number of ovulations over the patient’s lifetime), and late age at first pregnancy (greater than age 30 years)-also increase a patient’s breast cancer risk.

Women at increased risk of breast cancer have important opportunities for early detection and prevention. There are, however, serious drawbacks to the available interventions. The magnitude of breast cancer risk is a crucial factor in the optimization of medical benefit when considering the efficacy of risk-reduction methods, the adverse effects of intervention, and economic and quality-of-life outcomes. Breast cancer risk assessment has become increasingly quantitative and is amenable to computerization. The assembly of risk factor information into practical, quantitative models for clinical and scientific use is relatively advanced for breast cancer, and represents a paradigm for broader risk management in medicine. Using a case-based approach, we will summarize the major breast cancer risk assessment models, compare and contrast their utility, and illustrate the role of genetic testing in risk management. Important considerations relevant to clinical oncology practice include the role of risk assessment in cancer prevention, the logistics of implementing risk assessment, the ramifications of conveying risk information with limited genetic counseling, and the mechanisms for genetics referral. Medical professionals can embrace new preventive medicine techniques more effectively by utilizing quantitative methods to assess their patients’ risks. [ONCOLOGY 16:1082-1099, 2002]

LOS ANGELES-A large German multicenter study has shown that sentinel lymph node (SLN) biopsy for breast cancer accurately predicts the status of the axillary lymph node. In addition, the study found that physician experience and the choice of lymphography technique-blue dye or scintigraphy-influence the detection rate significantly.

MANHASSET, New York-Early clinical results suggest that capecitabine (Xeloda) may work well in several new combinations for metastatic breast cancer, according to Daniel R. Budman, MD, professor of medicine at New York University and associate director of medical oncology at North Shore University Hospital, Manhasset, New York

NANTES, France-Results of a large phase II European trial validate the antitumor activity of capecitabine (Xeloda) in metastatic breast cancer and present a strong rationale for its use earlier in the disease course, said Pierre Fumoleau, MD,

ALBUQUERQUE, New Mexico-Carboplatin (Paraplatin), vinorelbine (Navelbine), and capecitabine (Xeloda) given in combination to patients with anthracycline- and taxane-pretreated metastatic breast cancer appears active and well tolerated, according to an interim analysis reported at the 38th Annual Meeting of the American Society of Clinical Oncology (abstract 1960).

BARCELONA, Spain-In patients with metastatic breast cancer, weekly dosing with docetaxel (Taxotere) appears to provide benefits equal to those of every-3-week dosing, according to results of a multicenter, randomized, European phase II

MAYWOOD, Illinois-A novel fixed-dose schedule of uracil/tegafur (UFT) plus leucovorin (UFT/LV, also known as Orzel, investigational) achieved significant disease stabilization in advanced breast cancer, according to a phase II multicenter study reported at ASCO (abstract 240).

ORLANDO-Data from a massive pathologic reanalysis of breast cancer patients with apparently negative lymph nodes show that women with occult micrometastases have shorter disease-free survival and are more likely to die from breast cancer than are women whose nodes are negative on immunohistochemistry.