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Breast Cancer

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Breast-conserving therapy with lumpectomy and breast irradiation is an accepted standard treatment for patients with early-stage invasive breast cancer or ductal carcinoma in situ (DCIS). For both diseases, investigators have tried to identify subgroups of patients who can be "safely" treated with lumpectomy without radiation. Some data suggest that it may be reasonable to omit radiation therapy in patients with small, low-grade invasive or noninvasive tumors and/or in "elderly" patients. Additional studies are needed to better identify criteria to prospectively select appropriate patients for treatment with lumpectomy alone. [ONCOLOGY 11(9):1361-1374, 1997]

To irradiate or not to irradiate, that is the question posed by Marks and Prosnitz for women with early invasive breast cancer or ductal carcinoma in situ (DCIS) undergoing breast conservation therapy (BCT). Due in large part to mammography, there has been in the 1990s a significant increase in the percentage of women presenting with stage 0 (DCIS) and stage I breast cancer, as recorded by the Surveillance, Epidemiology and End-Results Program of the National Cancer Institute (NCI). The generally excellent outcome of these tumors with current therapy has focused research efforts on studies directed at improving quality of life and minimizing the side-effects and expense of local therapy. In this regard, Marks/Prosnitz present a concise and balanced summary of results from randomized and non-randomized clinical trials, and develop a rationale for current treatment recommendations and future studies regarding the role of breast irradiation (RT).

NEW ORLEANS--Three fourths of patients experience significant physical sensations after breast cancer surgery. For many women, these are still present years later, and many have long-term arm morbidity as well, researchers reported at the Oncology Nursing Society's 22nd Annual Congress.

NEW ORLEANS--Cytologic and biomarker assessment can be used to identify a cohort of women at extremely high risk for short-term breast cancer development, Carol Fabian, MD, said at the American Society of Preventive Oncology annual meeting.

SEATTLE--Breast cancer patients who report high levels of personal stress score lower on three measures of immune function than less stressed women with the disease, said Barbara L. Andersen, PhD, professor of psychology and obstetrics and gynecology, Ohio State University, Columbus.

NEW YORK--The National Alliance of Breast Cancer Organizations (NABCO), together with the National Breast Cancer Awareness Month Board of Sponsors, has created the National Breast Cancer Awareness Month (NBCAM) Online Calendar as the one-stop source for all October 1997 events.

NEW ORLEANS--Women seeking BRCA1 testing appear, as a group, to be more distressed and psychologically vulnerable than those who do not wish to be tested, according to two studies from Lombardi Cancer Center, Georgetown University, reported at the American Society of Preventive Oncology annual meeting. The women in the studies were at high risk because of a close family history of breast or ovarian cancer.

ASCO--A phase III multinational trial has shown docetaxel (Taxotere) to be more effective than doxorubicin (Adriamycin) as single-agent treatment of patients with metastatic breast cancer who have failed an alkylating-containing regimen.

ASCO--A brief, intensive preoperative chemotherapeutic regimen failed to improve breast cancer survival over conventional adjuvant chemotherapy in a 1,500-patient randomized trial, Dr. Eleftherios Mamounas said for the National Surgical Adjuvant Breast Project (NSABP). However, preoperative treatment often resulted in complete clinical remission prior to surgery.

ASCO--Anthracycline-based chemotherapy should join tamoxifen (Nolvadex) as standard therapy for postmenopausal breast cancer patients who have positive lymph nodes and are estrogen-receptor positive.

Since the emergence of paclitaxel (Taxol) in 1983, clinical developmentof the taxoids has progressed at a rapid pace, with the introduction ofdocetaxel (Taxotere) into clinical trials in 1990, and international phaseII studies in 1992. Although these two taxoids are related, increasingclinical experience indicates that paclitaxel and docetaxel should notbe considered interchangeable.

SAN DIEGO--Reports from the American Association for Cancer Research annual meeting have moved researchers closer to answering the question of whether DDT and its metabolites act as a risk factor for breast cancer by mimicking endogenous estrogen.

CHICAGO--Because adjuvant systemic chemotherapy has led to real and meaningful improvement in long-term disease-free and overall survival of women with invasive breast cancer, "perhaps the primacy of surgery is not sacrosanct," said David Hyams, MD, executive medical officer of the NSABP, Allegheny General Hospital, Pittsburgh.