Breast Cancer

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ORLANDO-A New Mexico study has found that Hispanic women are more likely than white women to be diagnosed with breast cancer at a younger age, are more likely to be estrogen-receptor (ER) negative, and are at greater risk for poor survival. Diane D. Crumley, PhD, research assistant professor, Division of Epidemiology and Preventive Medicine, University of New Mexico, reported the findings at the Era of Hope Department of Defense Breast Cancer Research Program meeting.

NEW ORLEANS-Radiation therapy after mastectomy reduces locore-gional recurrence rates for breast cancer patients with positive lymph nodes, positive surgical margins, or both, according to the results of a large retrospective study presented at the 44th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO abstract 153).

ORLANDO-Women in all ethnic groups who have spent their lives exercising, performing heavy household chores, or tackling a physically strenuous job had a lower risk of breast cancer than their more sedentary counterparts, according to a poster presented at the Era of Hope Department of Defense Breast Cancer Research Program meeting. "We were pleased with the results," said principal investigator Esther M. John, PhD, director of epidemiology research, Northern California Cancer Center, Union City. "It’s a message we can give women to help prevent breast cancer, and there are other health benefits to physical activity."

BOSTON-Pegfilgrastim (Neu-lasta), the longer-lasting analog of the colony-stimulating factor filgrastim (Neupogen), is safe for elderly breast cancer patients receiving myelosuppressive chemotherapy and protects against febrile neutropenia, according to a poster presented at the third meeting of the International Society of Geriatric Oncology (SIOG abstract P-23).

SEATTLE, Washington-In a new endeavor, an international group of experts is creating detailed guidelines for the screening, diagnosis, and treatment of breast cancer in countries and regions of the world with limited resources. The endeavor began with the Global Summit Consensus Conference and will lead to the publication, dissemination, and translation of the first edition of the guidelines next year.

NEW ORLEANS-Having a previous pregnancy improves the prognosis for women who develop early-stage breast cancer later in life, according to a study presented at the 44th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (abstract 152). The findings suggest that a more aggressive treatment approach should be considered for those patients who have not had a pregnancy.

RESEARCH TRIANGLE PARK, North Carolina-Researchers have begun the first phase of a long-term, prospective epidemiological study designed to determine the role of genetic, environmental, and lifestyle factors in increasing the risk of breast cancer and several other diseases. The Sister Study is the first long-term follow-up study specifically designed to look at hereditary and environmental risk factors for the disease. It seeks to enroll 50,000 cancer-free women in the United States between the ages of 35 and 74 who have a sister diagnosed with breast cancer.

During the 1990s, perhaps no other therapy for women with breast cancer was more controversial than high-dose chemotherapy with autologous bone marrow and/or peripheral stem cell support. With encouraging results from late phase I and early phase II trials in the early to mid-1990s, high-dose chemotherapy was promoted by its many enthusiastic proponents as a potentially great leap forward for women with high-risk, node-positive or metastatic disease.

At first glance, high-dose chemotherapy for breast cancer makes sense. The disease is often sensitive to chemotherapy, potentially curable, and highly prevalent, which means that even a modest benefit would be tremendously important. Unfortunately, multiple clinical trials have failed to demonstrate that high-dose therapy is more effective than other chemotherapeutic approaches. Thus far, no prospective study has demonstrated a benefit based on its planned primary objective and planned analysis, and none has shown a survival advantage (see Table 1).[1-5]

Over the past decade, high-dose chemotherapy with autologous bone marrow and/or peripheral blood rescue has been increasingly used to treat women with breast cancer. Laboratory and clinical studies have shown that dose intensity may be important in treating selected patients with breast cancer. Initial phase I studies showed good response rates of short durations. Further trials in metastatic disease with high-dose chemotherapy and stem cell rescue earlier in the treatment course had been encouraging. However, the optimal timing of high-dose chemotherapy remains a question. In addition, randomized trials in high-risk early-stage breast cancer have completed accrual. Technologic improvements in stem cell procurement and hematopoietic growth factors have contributed to decreased morbidity and mortality. This review will discuss the role of such therapy in the treatment of women with breast cancer. [ONCOLOGY 16:1643-1656, 2002]

WASHINGTON-The blood of the human umbilical cord, although often discarded after childbirth, is a "very rich source" of lymphocytes potentially capable of killing cancer cells, according to Shantaram Joshi, PhD, professor of genetics, cell biology, and anatomy, University of Nebraska Medical Center, Omaha.

ORLANDO-A study reported at the Era of Hope Department of Defense Breast Cancer Program meeting adds more evidence supporting wider use of sentinel lymph node (SLN) biopsy by surgeons skilled in the technique.

ORLANDO-Weekly paclitaxel (Taxol) given as a neoadjuvant therapy for patients with locally advanced breast cancer resulted in regression of the primary tumor in 60% of patients. Albert S. Braverman, MD, professor of medicine, Downstate Medical Center of the State University of New York, Brooklyn, presented the results at the 38th Annual Meeting of the American Society of Clinical Oncology (abstract 278).

EAST HANOVER, New Jersey-A phase III study to determine overall and disease-free survival of women with early breast cancer who take the aromatase inhibitor Femara (letrozole tablets) vs placebo in the adjuvant setting following 5 years of hormone therapy with tamoxifen (Nolvadex) has completed enrollment of 4,800 postmenopausal women.

NIAGARA-ON-THE-LAKE, Ontario, Canada-Female survivors of childhood cancer are generally at increased risk of developing secondary breast cancer years after their initial disease. New research, presented at the 7th International Conference for Long-Term Complications of Treatment of Children and Adolescents for Cancer, hosted by Roswell Park Cancer Institute, is shedding light on this issue and helping practitioners determine how to best screen this population.

The US Food and Drug Administration has approved anastrozole (Arimidex) for the adjuvant treatment of hormone-receptor-positive early breast cancer in postmenopausal women. The approval is based on research from the Arimidex,