Breast Cancer

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In the future, we also need to improve our ability to personalize the duration of endocrine therapy, with a goal of optimizing patient selection for extended therapy. Hopefully, clinical-pathologic indices and predictive biomarkers similar to the Oncotype DX 12-gene recurrence score or the PAM50 risk of recurrence score for adjuvant chemotherapy will soon emerge to guide adjuvant endocrine therapy.

Can knowledge of a patient’s breast tumor genome help select the optimal treatment, and when we have an effective treatment for a group of patients-in this case, for breast cancer patients in the adjuvant setting-how long should the course of treatment be?

A recent prospective trial showed sentinel lymph node surgery has a clinically significant high false negative rate in breast cancer patients with node-positive disease receiving neoadjuvant chemotherapy. In this interview we discuss surgical techniques that detect breast cancer in lymph nodes.

Long-term safety and efficacy results of two phase II trials indicate that dose-dense anthracycline-based chemotherapy with doxorubicin and cyclophosphamide can be safely combined with anti-HER2 therapy in women with early breast cancer.

Clearly there is no single therapy for all patients with TNBC, given the molecular heterogeneity of this subtype. However, new insights from further genomic analysis of TNBC suggest approaches to rational clinical trial design, and patients will undoubtedly benefit as we define the most appropriate therapeutic targets in management of this aggressive disease.

Triple-negative breast cancer (TNBC) remains a very challenging entity today, but with the identification of new targets and further optimization of therapy, the landscape for TNBC may not look so negative. In the future, “TNBC” may be considered an antiquated misnomer, as we will have identified various breast cancer subgroups based on what they “are” rather than what they “are not.”