Breast Cancer

Prevention of CNS seeding early in the metastatic disease course using drugs with both intra- and extracranial activity will be crucial to improving outcomes in patients with breast cancer brain metastases.

Brain metastases arising from breast cancer constitute a clinically unmet need and a situation that portends a poor prognosis with few therapeutic options.

In this overview, we will review recent developments in the management of breast cancer brain metastases and current prospective trials of systemic therapies specifically for patients with breast cancer brain metastases, with a focus on novel pathway-specific therapies.

For many women, the prospect of tumors growing in their brain that may eventually impact their ability to communicate, interact, and remember is terrifying.

The combination of four imaging techniques together results in the ability to better differentiate between benign and malignant breast tumors, which may lead to fewer unnecessary breast biopsies.

The CALGB 369901 trial examined how frailty and older age influence the use of adjuvant hormonal therapy for breast cancer and found that while frailty can deter the start of therapy, frail patients who had started on a regimen were not much more likely to discontinue their treatment early.

Women who consume increased amounts of red meat have a higher risk of breast cancer compared with those who have a protein intake consisting largely of non–red meat such as poultry, fish, and legumes.

Obese women who have breast cancer generally have a worse prognosis compared with their non-obese counterparts. A new randomized study suggests that telephone-based intervention is a safe way to help overweight postmenopausal breast cancer patients with weight loss.

There is a need to learn more about the effect of hypofractionation on an individual patient’s breast cancer outcomes and tissue toxicities, based on both biologic and technical variables, so that the treatment decision is not primarily a matter of dollars and cents.

Customized more aggressive treatments should be given to patients with the worst prognosis. For most of the other breast patients, shorter and often milder treatment is also a humble victory in our daily struggle against cancer.

Without question, targeted therapies have revolutionized the treatment of cancer across histologies.

This review will focus on newer FDA-approved targeted therapies associated with type II chemotherapy-related cardiac dysfunction, or generally reversible cardiotoxicity, and will provide the latest information on the incidence and clinical spectrum of cardiotoxicity associated with each therapy, modifiable risk factors where known, and the mechanisms of cardiotoxicity.

In this review we discuss the rationale and underlying radiobiologic concepts for hypofractionation, and review the clinical trials and ASTRO guidelines supporting hypofractionated radiation in the treatment of breast cancer.

An 8-year follow-up of HER2-positive breast cancer patients receiving adjuvant trastuzumab shows an overall low incidence of cardiac events when administered after chemotherapy and radiotherapy.

Researchers from Harvard Medical School and Indiana University found that women who had a greater number of nevi may be more likely to develop breast cancer, independent of other breast cancer risk factors.

The breast cancer treatment landscape is changing, and the optimal adjuvant endocrine therapy for premenopausal women with hormone receptor (HR)-positive breast cancer is uncertain.

At the ASCO/AACR Joint Session on Inflammatory Cells and Cancer, Dr. Andrew Dannenberg from Weill Cornell Medical College, gave a fascinating lecture titled “Stromal Inflammation and Solid Tumors.”

As part of our coverage of the 2014 ASCO Annual Meeting, we discuss treatment strategies for breast cancer patients who harbor either the BRCA1 or BRCA2 mutation.

After surgery, adjuvant therapy with trastuzumab alone works just as well as trastuzumab combined with lapatinib for women with early-stage HER2-positive breast cancer.

Zoledronic acid given every 12 weeks was just as efficacious as the drug administered at the standard dosing schedule of every 4 weeks for breast cancer patients with bone metastases.

Metastatic breast cancer patients with insulin resistance have a significantly worse prognosis, according to the results of a study presented at the 2014 ASCO Annual Meeting.

The combined analysis of two phase III clinical trials shows that exemestane, an aromatase inhibitor, may better prevent breast cancer recurrence in women with early-stage hormone receptor–positive breast cancer, as compared with tamoxifen.

A follow-up analysis of gene expression signatures from the CALGB 40601 trial shows that certain HER2-positive early-stage breast cancer patients may not benefit from more aggressive chemotherapy treatments as part of a neoadjuvant regimen, and that patients with HER2-enriched tumors responded best to dual anti-HER2 treatment.

A new study shows that women diagnosed with cancer in one breast often opt to undergo a contralateral prophylactic mastectomy, even though they may not have a significant risk of developing cancer in the other breast.

Detectable circulating tumor cells in early breast cancer patients can predict prognosis, according to a newly published study.

An analysis of early-stage breast cancer shows that obesity raises the risk of dying from breast cancer for pre-menopausal women diagnosed with ER-positive disease.

The progress that has been made by the surgical breast oncology community is a well-deserved source of pride. This is not to say, however, that our work is complete.

Validation of sentinel lymph node (SLN) dissection (SLND) as an alternative to axillary lymph node dissection (ALND) has been a significant advance in the surgical management of breast cancer.

Molecular imaging allows accurate detection of metastatic disease. It also allows for noninvasive assessment of tumors and is a predictor of response to therapy.

However, it is becoming ever clearer that tumor characteristics can change during the course of disease. Given this change over time, other supporting techniques for guiding therapy would be of value. Molecular radionuclide imaging with positron emission tomography (PET) can potentially fulfill this need.