Breast Cancer

Oppong and King present a clear and concise review of the current data regarding lobular carcinoma in situ (LCIS) and discuss the rationale behind the current management recommendations for this disease.

In this issue of ONCOLOGY, Drs Oppong and King provide an organized and comprehensive summary of guidelines for the clinical management of patients with lobular carcinoma in situ (LCIS).

Obesity rates in the United States have increased twofold in adults and threefold in children during the past 30 years.[1] Beyond its detrimental effects on cardiovascular health, obesity increases the risk of several cancers, including postmenopausal breast cancer,[2] and it is also associated with a higher risk of recurrence and death in those who develop breast cancer.[3]

Poly(adenosine diphosphate [ADP]–ribose) polymerase (PARP) inhibitors are designed to exploit the “synthetic lethality” concept for cancer therapy.

Results of the AZURE trial revealed small improvements in disease-free and overall survival when zoledronic acid was used in addition to adjuvant therapy in a subgroup of early-stage breast cancer patients who had been postmenopausal for more than 5 years.

In an online-first article in Nature Chemical Biology (DOI: 10.1038/nchembio.695), Sebastian Nijman of the CeMM–Research Center for Molecular Medicine of the Austrian Academy of Sciences in Vienna and his colleagues describe the development of a chemical genetic approach that has identified mechanisms that can lead to resistance to PI3K inhibitors used as cancer treatments.

The U.S. Food and Drug Administration (FDA) has approved two new indications for the osteoporosis drug denosumab, as a treatment for bone loss in men receiving androgen deprivation therapy for nonmetastatic prostate cancer and in women receiving adjuvant aromatase inhibitor therapy for breast cancer.

In spite of screening recommendations that now begin only at 50 years of age, breast cancer is often diagnosed in women under the age of 40, and there are specific challenges to management of the disease in this younger population.

Triple-negative breast cancers represent a challenge for patients and clinicians, with poorer prognosis and fewer treatment options than other breast cancer subtypes. Recently, though, there have been suggestions that targeting pathways that repair DNA within tumor cells could provide benefit beyond the currently available treatments.

The safety and efficacy of breast-conserving therapy (BCT) for women with early-stage breast cancer are well established. BCT entails wide excision of the tumor and appropriate nodal evaluation, followed by radiation therapy to the breast.

Breast-conserving therapy (BCT), which includes wide local excision of the tumor followed by irradiation, has become a standard treatment option for women with early-stage invasive breast cancer.

The article by Revesz and Khan is an excellent summary of the state of our knowledge of margin width in relation to breast cancer recurrence.

Treatments vary widely for metastatic breast cancer patients, though an analysis suggests that costs per patient are relatively similar across a number of different treatments.

The results of a study that tracked BRCA mutation carriers suggest that women who inherit BRCA gene mutations develop cancer at a younger age than women in the previous generation. The study is published on-line today in the journal Cancer.

Though there is still disagreement, a new study presented at the ASCO Breast Cancer Symposium in San Francisco suggests that annual mammography and palpation of breast masses remain critical tools in early breast cancer diagnosis.

A new study presented at the American Society of Clinical Oncology Breast Cancer Symposium in San Francisco shows that there is no survival difference between having a mastectomy or breast conservation therapy in women under the age of 40.

Researchers have identified that “maintenance of global heterochromatin integrity” is a novel function of BRCA1 gene, and propose that this DNA-silencing function is linked to the role of BRCA1 as a tumor suppressor, in an article published in Nature.

Cancer Network speaks with Dr. Joseph Sparano, Professor of Medicine and Women’s Health at the Albert Einstein School of Medicine and Associate Chairman of the Department of Oncology at Montefiore Medical Center in New York, about the session he will chair at the ASCO Breast Symposium on September 8-10, in San Francisco.

Researchers at the BC Cancer Agency in Vancouver and colleagues have just published the results of a phase II study showing that olaparib (AZD2281), an oral PARP inhibitor, may be effective in treating non-BRCA-related ovarian cancer patients.

A study published online in the American Cancer Society journal Cancer suggests that when women stop going to their doctors for hormone therapy prescriptions, the physicians do not remind them to get a mammogram.

Results of a Phase I study of the novel Poly(ADP-ribose) polymerase (PARP) inhibitor veliparib (ABT-888) in solid tumors and lymphoma have just been published in Cancer Research (doi:10.1158/0008-5472.CAN-11-1227).

Improved screening practices have lead to a dramatic increase in the diagnosis of ductal carcinoma in situ (DCIS) over the past 40 years.

Few areas in breast disease elicit as much controversy as the management of DCIS. The review by Sanders and Simpson, “Can We Know What to Do When DCIS Is Diagnosed?”

It is ironic that while huge strides have been made in the treatment of invasive breast carcinoma, resulting in breast conservation for many women, the most appropriate treatment of noninvasive breast carcinoma remains a topic of hot debate.

Since 1990, death rates from breast cancer have decreased, mainly in women younger than 50 years of age (3.3% per year) vs women aged 50 years or older (2% per year), reflecting the benefit of widespread use of systemic treatment added to early detection.[1]