Breast Cancer

For many oncologists and their patients with metastatic breast cancer, these are quite confusing times. A growing body of evidence suggests that pure dose-escalation strategies of high-dose chemotherapy with stem-cell support are unlikely to provide much additional benefit in patients with advanced breast cancer.[1] In fact, selection bias may explain much of the potential benefit seen in so many single-arm high-dose chemotherapy studies.[2]

Drs. Olin and Muss provide an excellent review of current state-of-the-art treatments and treatment strategies for patients with metastatic breast cancer. They explore a number of the existing questions in the treatment of metastatic breast cancer and emphasize the need for ongoing clinical trials.

In 1999, metastatic breast cancer claimed the lives of almost 45,000 women. For the vast majority of patients, metastatic breast cancer is an incurable disease with a median survival of only 2 to 3 years after diagnosis. The

FORT LAUDERDALE, Fla-The 17 institutions of the National Comprehensive Cancer Network (NCCN) are adhering closely to their own practice guidelines for breast cancer, according to a report given by the NCCN Outcomes Committee.

The National Institutes of Health (NIH) is sponsoring a Consensus Development Conference on Adjuvant Therapy for Breast Cancer, to be held in Bethesda, Maryland, on November 1-3, 2000.

CHICAGO-Magnetic resonance imaging (MRI) was able to find tumors in two thirds of 47 patients with stage II or III occult primary breast cancer with a high degree of sensitivity, avoiding mastectomy in nearly half of the women, Elizabeth Morris, MD, reported at the 85th Annual Meeting of the Radiological Society of North America (RSNA).

ROME-The Susan G. Komen Breast Cancer Foundation has extended its breast cancer awareness programs internationally with the establishment of affiliates in Italy, Argentina, Germany, and Greece. The Dallas-based foundation has 117 local US affiliates.

At the 1999 San Antonio Breast Cancer Symposium, Dr. Susan Love, noted breast surgeon, author, and patient

ROME-A panel of cancer experts has called upon clinicians to do more to inform and counsel their patients about clinical trials. The plea was voiced during a webcast discussion sponsored by the Susan G. Komen Breast Cancer Foundation and held at the 5th Annual Multidisciplinary Symposium on Breast Diseases.

According to the first cost-effectiveness analysis of tamoxifen (Nolvadex), high-risk women who use tamoxifen to prevent breast cancer should be reimbursed by medical insurance in the same way as other preventive drugs and procedures are

n DALLAS-A vaccine for breast cancer patients using fusions of dendritic cells and cancer cells is currently in phase I clinical testing, said Jianlin Gong, MD, Division of Cancer Pharmacology, Dana-Farber Cancer Institute, and instructor in medicine, Harvard Medical School.

Younger women who undergo lumpectomy to remove noninvasive breast cancer cells are significantly more likely to experience a recurrence than older patients, in part, because physicians may not be removing enough breast tissue during

FORT LAUDERDALE, Fla-The National Comprehensive Cancer Center (NCCN) Practice Guidelines for Breast Cancer have been updated to reflect the results of new trials demonstrating the effectiveness of tamoxifen (Nolvadex) as a risk reduction agent for women treated for breast cancer.

DALLAS-University of Texas M.D. Anderson researchers plan to test whether removal of residual breast cancer cells from stem cell transplant grafts will improve the long term success of such transplants for patients with late-stage metastatic breast cancer.

In an admirably concise fashion, Dr.Pritchard summarizes the results of trials randomizing tens of thousands of women in order to evaluate various types and uses of endocrine treatment over more than 50 years. I would never have predicted these results

In addition to ovarian ablation by means of surgery or irradiation, a wide variety of endocrine agents are now available for the management of breast cancer, in both the metastatic and adjuvant settings. Currently available

Endocrine therapy is the oldest form of treatment for metastatic breast cancer. The availability of numerous new endocrine agents during the past 10 years has led to significant changes in the use of this form of therapy. This article identifies

Overexpression of the antiapoptotic protein BAG-1 has a seemingly paradoxical association with improved survival in breast cancer, according to a study reported at the 22nd Annual San Antonio Breast Cancer Symposium.

There is no clear consensus among oncologists about the degree to which elderly breast cancer patients should be subjected to aggressive diagnostic and therapeutic strategies. Physicians consequently have tended to treat elderly women

SAN ANTONIO-Measurement of radiowave absorption could offer a new noninvasive approach to the identification and diagnosis of breast cancer, investigators involved in an ongoing evaluation of the technology reported at the 22nd Annual San Antonio Breast Cancer Symposium.

Breast-conserving treatment of early-stage breast cancer confers a low risk of locoregional recurrence that does not adversely affect survival, but early local recurrence increases the likelihood of metastatic disease, M.D.

VIENNA, Austria-Women with monthly breast pain appear to have a reduced risk of breast cancer, S. A. Khan and colleagues reported at a poster session of the 9th World Congress on Pain. The study also showed that women with a high consumption of dairy products had less severe pain and that regular consumption of soy products appeared to increase the likelihood of regular breast pain. Dr. Khan is in the Departments of Surgery, State University of New York Health Science Center, Syracuse.

BETHESDA, Md-The National Institutes of Health will convene a consensus development conference on adjuvant therapy for breast cancer on November 1–3, 2000.

San Antonio-Magnetic resonance imaging (MRI) continues to show promise as a means of diagnosing and evaluating breast cancer, according to study results reported at the San Antonio Breast Cancer Symposium.

The National Institutes of Health (NIH) is sponsoring a Consensus Development Conference on Adjuvant Therapy for Breast Cancer, to be held in Bethesda, Maryland, on November 1-3, 2000.

ABERDEEN, Scotland-Primary, or neoadjuvant, chemotherapy with docetaxel (Taxotere) substantially increases the response rate in breast cancer patients who have received initial treatment with a chemotherapy combination, results of a phase III Scottish study demonstrate.

NOTTINGHAM, England-A new long-acting nonagonist antiestrogen, fulvestrant (Faslodex), significantly reduced estrogen and proges-terone receptor (ER/PR) content in breast tumors prior to surgery, compared with tamoxifen (Nolvadex) and placebo, according to a multicenter study presented at the San Antonio Breast Cancer Symposium.

BALTIMORE-Axillary lymph node status and hormone receptor status are significant prognostic factors in elderly breast cancer patients, warranting more careful consideration of lymph node dissection and adjuvant therapy, according to a review of 277 cases presented at the San Antonio Breast Cancer Symposium.

HAMBURG, germany-Elevated levels of two related tumor-associated proteases correlated with an increased risk of recurrence after definitive surgical treatment for node-negative breast cancer, German investigators reported at the San Antonio Breast Cancer Symposium.

BOSTON-The combination of weekly trastuzumab (Herceptin) and vinorelbine (Navelbine) gave promising results in a phase II study of metastatic breast cancer. After a median of 21 weekly courses of therapy, the combination has produced a 71% overall response rate (all partial responses) in 34 evaluable patients. The regimen has been well tolerated, and no patient has experienced symptomatic congestive heart failure.