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Breast Cancer

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Gene Linked to Breast, Ovarian, and Uterine Cancers

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Alterations in a gene discovered last year by UT Southwestern Medical Center in Dallas scientists have been linked to breast, ovarian, and uterine cancers, the researchers reported in the February issue of Human Molecular Genetics.

Tamoxifen: Dramatic Decrease in Breast Cancer

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WASHINGTON--Researchers terminated the treatment portion of the Breast Cancer Prevention Trial (BCPT) in late March, 14 months earlier than expected, after the study’s independent monitoring committee determined that patients receiving tamoxifen (Nolvadex) had a 45% reduction in breast cancer incidence, compared to the placebo arm.

Carlson Updates NCCN Guideline on Breast Cancer

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FORT LAUDERDALE, Fla--The National Comprehensive Cancer Network (NCCN) continues to fine tune its breast cancer guideline, introduced 2 years ago. Robert Carlson, MD, of Stanford University, and chair of the Breast Cancer Guideline Committee, reviewed the proposed revisions at the NCCN’s third conference. The Network is a coalition of 16 US cancer centers.

NEW YORK--After treatment, many breast cancer patients have fears and misconceptions that hamper their sexual activity, and their partners may have them, too, Marisa Weiss, MD, said at a Cancer Care teleconference. Women may assume their partner finds them unattractive, while their partner may be afraid of causing injury.

NCCN Recommends Annual Mammography For All Women Over 40

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FORT LAUDERDALE, Fla--The National Comprehensive Cancer Network (NCCN), a consortium of 16 leading US cancer centers, has ventured into the contentious area of breast cancer screening, and in its first draft, the breast cancer screening committee has recommended annual mammography screening for all women age 40 and over.

To determine the most effective strategies for the treatment of postmenopausal hormone dependent breast cancer, we recently developed a model system in nude mice. In this model, estrogen receptor-positive human breast cancer cells (MCF-7) stably transfected with the aromatase gene are inoculated into ovariectomized, immunosuppressed (nude) mice.

Toremifene (Fareston) received FDA approval in 1997 for the first-line treatment of postmenopausal women with estrogen receptor (ER)-positive or -unknown metastatic breast cancer. Phase II and III trials have demonstrated that first-line therapy with toremifene, 60 mg/d, is as effective and as well tolerated as tamoxifen (Nolvadex), 20 or 40 mg/d, in such patients.

Various ongoing double-blind clinical trials are evaluating the use of tamoxifen (Nolvadex) as chemoprevention for breast cancer. A total of over 24,000 healthy women have been randomized to these trials, and it should be possible, by the year 2000, to detect any preventive effect of tamoxifen in healthy women. Furthermore, with the large numbers of women involved, it should be possible to evaluate prevention in subgroups of participants according to risk of the disease, particularly those women carrying high-risk genes, such as BRCA1 and BRCA2.

Tamoxifen is by far the most clinically tested antiestrogenic drug currently used as adjuvant therapy for breast cancer and it continues to provide considerable benefit in this setting. The balance from clinical trials indicates a strong association between the use of tamoxifen and an increase in uterine tumors (three to sixfold). In rats, tamoxifen is a mutagenic, genotoxic hepatocarcinogen.

Adjuvant Trials of Toremifene vs Tamoxifen: The European Experience

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When results from the phase II trials of toremifene (Fareston) and tamoxifen (Nolvadex) in metastatic breast cancer were published, the Finnish Breast Cancer Group began to plan the first trial of toremifene in an adjuvant setting. This multicenter, randomized trial is comparing toremifene (40 mg/d) to tamoxifen (20 mg/d) in postmenopausal lymph node-positive breast cancer patients.

Pivotal Trials of Letrozole: A New Aromatase Inhibitor

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Letrozole (Femara) is a nonsteroidal aromatase inhibitor that is approximately 10,000 times as potent as aminoglutethimide in vivo. Two pivotal multinational phase III trials have compared letrozole (0.5 and 2.5 mg/d) against megestrol acetate and aminoglutethimide, respectively, in patients with locally advanced or metastatic breast cancer.

Radiologic Staging Tests Unwarranted In Small Breast Cancer

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NEWPORT BEACH, Calif--Despite recommendations to the contrary, cancer specialists continue to order radiologic tests that rarely provide useful staging information about patients with early-stage breast cancer, results of a California study show.

Toremifene (Fareston), the first new antiestrogen agent for treating advanced breast cancer available in the United States in more than 19 years, is as effective as tamoxifen (Nolvadex) in clinical trials and potentially safer, Richard Gams, md, professor of internal medicine and director of hematology/oncology, Ohio State University, said at a teleconference sponsored by Schering-Plough to introduce the recently approved agent.

The aromatase inhibitor letrozole (Femara), at a dosage of 2.5 mg once daily, is an effective therapy for advanced breast cancer in postmenopausal women whose disease progresses following antiestrogen therapy, according to data published in the February 1998 Journal of Clinical Oncology. The study was conducted by the Letrozole International Trial Group and was sponsored by Novartis Pharmaceuticals Corporation.

Breast Conservation Safe in Women With Family History

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ORLANDO--Breast-conserving therapy appears to be a viable treatment option for breast cancer patients with a family history of breast cancer, Elizabeth Chabner, MD, said at the annual meeting of the American Society for Therapeutic Radiation and Oncology (ASTRO).

Expert Calls for New Concept of Race in Cancer Studies

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Cancer researchers and clinicians need to adopt a new attitude toward race classifications as interracial parentage in the United States continues to increase. “I want to uncouple race and genetics,” stated Edison Liu, MD, at the 1997 Biennial Symposium on Minorities, the Medically Underserved, and Cancer held in Washington, DC.

No Adverse Effects With RT Delay After Surgery

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VICTORIA, BC, Canada--Delaying radiation therapy for up to 5 months after surgery for breast cancer had no adverse effect on local recurrence or survival, a finding that may help lay to rest any controversy about delayed irradiation, Peter Froud, MD, reported at the San Antonio Breast Cancer Symposium.

Political Action Needed to Counter Growing Lung Cancer Threat to Women

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Women must make lung cancer as hot and as female a public issue as they have made breast cancer, urged a cancer expert speaking at the 1997 Biennial Symposium on Minorities, the Medically Underserved, and Cancer in Washington, DC. Five years from now, twice as many women will die of lung cancer than of breast cancer, warned Paul Bunn, Jr., md, Grohne/Stapp Chair in Cancer Research and director of the University of Colorado Cancer Center.

Tissue “Expanders” Improve Results of Breast Reconstruction

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Women who undergo breast reconstruction following mastectomy for breast cancer express strong satisfaction with a novel surgical approach, reported a surgeon at Georgetown University Medical Center in the January 1998 issue of Plastic and Reconstructive Surgery.

Stress of Breast Cancer Can Weaken Immune System

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In the largest study of its kind to date, Ohio State University researchers have shown that the stress women experience after breast cancer diagnosis and surgery can weaken their immune response, based on at least three different biochemical indicators.

Skin Sealant Delays Onset of Radiation-Induced Dermatitis

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LONG BEACH, Calif--Use of a polymer adhesive skin sealant (PASS) can help breast cancer patients complete prescribed radiation therapy without interruptions due to radiation-induced dermatitis, Robert H. Goebel, MD, JD, reported at a poster session of the San Antonio Breast Cancer Symposium.