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Breast Cancer

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Washington, DC-“Triple-negative breast tumors are composed of mosaic cancer cells with distinct genetic aberrations,” said Jorge S. Reis-Filho, MD, PhD, a surgical pathologist at the Memorial Sloan-Kettering Cancer Center in New York, who combines traditional pathology, gene expression profiling, and genomics techniques to understand rare breast tumor types, including triple-negative diseases.

Last month brought the accelerated approval by the US Food and Drug Administration (FDA) of a fourth agent targeting the human epidermal growth factor receptor 2 (HER2) oncogene product: TDM-1 (Kadcyla), a conjugate of trastuzumab and a cytotoxic, emtansine.

At the 30th Annual Miami Breast Cancer Conference, Lisa Carey, MD, presented the major questions in managing triple-negative breast cancer. This type of breast cancer makes up approximately 15% of all breast cancer cases, is typically more aggressive, and has a higher risk of early relapse.

Risk factors for breast cancer can be parsed into genetic and biological factors, and environmental and lifestyle factors; and the general consensus is that screening and prevention strategies should be tailored based on an individual’s risk assessment.

How best to manage patients who present with ductal carcinoma in situ (DCIS), a noninvasive and early form of breast cancer, remains unclear. Treatment options range from minimal, breast-conserving surgical intervention and no follow-up treatment, to surgical intervention followed by additional treatment.

It used to be so easy. Patients with ER-positive breast cancer got 5 years of tamoxifen. You could anticipate most of the side effects. No one showed up with an armload of internet downloads ready to debate the utility of hormone therapy, the risks, and metabolism or drug interactions. No more.

As part of our coverage for the 30th Annual Miami Breast Cancer Conference, we bring you an interview with Dr. Mark Pegram, director of the breast cancer program at the Stanford Women’s Cancer Center and codirector of the molecular therapeutics program. Dr. Pegram will be discussing the potential for novel HER2 combination therapies at the conference.