Breast Cancer

The detection of cytokeratin 19-positive/HER2-positive circulating tumor cells in early breast cancer patients both before and after adjuvant chemotherapy predicts extremely poor outcomes, according to European investigators.

Carlos L. Arteaga, MD, will be presented with the Gianni Bonadonna Breast Cancer Award at the 2009 ASCO Breast Cancer Symposium in San Francisco. Dr. Arteaga, who is a professor of medicine and cancer biology at Vanderbilt University School of Medicine and director of the breast cancer research program of the Vanderbilt-Ingram Cancer Center in Nashville, will deliver the Bonadonna lecture at the symposium.

An MRI study of risk factors for breast cancer in young women, including teenagers, concluded that risk assessment and prevention should start much earlier in life than previously recommended. The Canadian study suggests using imaging techniques that avoid patient exposure to ionizing radiation.

Researchers from Houston’s M.D. Anderson Cancer Center evaluted the prevalence and impact of off-label therapies in breast cancer and found that nearly 35% of women were treated with off-label chemotherapy at some point during their care.

Two new studies reported at this year’s ASCO meeting demonstrated the effect of a new class of targeted therapy called poly (ADP-ribose) polymerase (PARP) inhibitors on traditionally difficult-to-treat breast cancers-so-called “triple-negative” breast cancer and BRCA1/2-deficient breast cancers.

Many women have turned to natural forms of hormone replacement for menopause since learning that conventional hormone replacement therapy (HRT) may increase their risks of breast cancer and other health problems. Most women have assumed that “natural” or “bioidentical” HRT is safer than conventional HRT. However, recent research has shown that this is not the case and that, in fact, the risks are probably similar.

Researchers at the University of Michigan discovered a gene that over expresses in about 20% of breast cancers. In order to protect their promising find, they quickly filed for a patent.

The American Civil Liberties Union and the Public Patent Foundation at Benjamin N. Cardozo School of Law filed a lawsuit charging that patents on two human genes associated with breast and ovarian cancer stifle research that could lead to cures and limit women’s options regarding their medical care.

Information on the relative health benefits and risks of alcohol consumption seems to come out on a monthly basis, but the early days of 2009 were particularly flooded with such reports. Three high-profile studies offered more evidence of a significant association between alcohol consumption and breast cancer risk.

The management of breast cancer in women under the age of 40 continues to challenge oncologists despite many recent therapeutic advances. The higher rates of breast cancer recurrence and death in this cohort strongly correlate with unfavorable clinicopathologic features

Breast cancer is the most common cancer in women, with over 180,000 new diagnoses of invasive disease annually in the United States, based on recent estimates.[1] Despite advances in therapy, over 40,000 women still die of breast cancer each year in the US.[1] While most women with breast cancer present with early-stage, potentially curable disease, young women face higher risks of recurrence and death compared to older women, which leads to challenges in selecting the optimal treatment strategy for these patients. The clinician is typically confronted with an otherwise healthy patient facing a life-threatening disease, and we are inclined to offer therapies with maximal benefit and minimal longterm toxicity, in the face of frequently inadequate or evolving data on how to achieve this.

Younger women with breast cancer present important management challenges due in part to differences in both tumor biology and individual patient factors. In his article, Peppercorn provides a comprehensive overview of these issues with a particular focus on questions surrounding systemic therapy options.

Breast cancer is the leading cause of cancer-related deaths in young women, and survival rates for young women with breast cancer are lower than for older women with breast cancer. This inferior survival is seen in spite of the fact that younger women often receive more aggressive therapy, as detailed in Dr. Peppercorn’s thoughtful review.[1]

A new federally funded University of Pennsylvania School of Medicine study aims to learn whether women at high risk of breast cancer can use exercise to meaningfully reduce their risk of getting the disease.

Asian-American women who consumed large amounts of soy as children have a 58% reduced risk of breast cancer, according to a study conducted at National Cancer Institute’s Clinical Genetics Branch.

The majority of postmenopausal breast cancer patients have tumors that express hormone receptors, so advances in endocrine therapy are clearly important. The optimal use of an expanding array of agents is the subject of active investigation, and presentations at SABCS 2008 added insight regarding the relative efficacy of the various approaches in hormone-sensitive early breast cancer patients.

PHOENIX, Ariz.-Accurate local staging with imaging modalities is important for guiding breast cancer treatment in order to achieve clear margins and avoid recurrent disease.

Estrogen-receptor positive advanced breast cancer patients who have become resistant to endocrine therapies can derive clinical benefit from 6-mg daily doses of estradiol, according to a phase II study from St. Louis’ Washington University .

Evidence continues to mount that a regular yoga practice can support emotional well-being in cancer patients. The latest study by a group at Wake Forest University School of Medicine in Winston-Salem, N.C., found that restorative yoga eased fatigue in women with breast cancer.

Based on preclinical data, antiangiogeneic therapy for cancer is both logical and rational. Tumors secrete proangiogenic factors, and the design of agents that target these factors has great potential to add to and in some cases replace cytotoxic chemotherapy.

Numerous preclinical and clinical studies have demonstrated a role for angiogenesis in the growth and progression of breast cancer. Elevated vascular endothelial growth factor (VEGF) levels have been demonstrated in association with poor outcomes, and thus, this finding is an attractive target for therapeutic intervention.

Tumor angiogenesis, an important step in breast cancer development, invasion, progression, and metastasis, is regulated by the expression of proangiogenic factors such as vascular endothelial growth factor (VEGF).[1-6] Higher levels of VEGF expression are associated with poor clinical outcomes and decreased survival in patients with breast cancer.

One of the potential side effects of chemotherapy is cardiac toxicity. The resulting damage to the heart can range from non–life-threatening events to devastating heart failure. The spectrum of these events can occur almost immediately, during a drug infusion, or as a delayed complication later in the patient’s life. Oncology nurses not only need to be familiar with identifying and intervening in acute cardiac events, but also in some instances will need to monitor for delayed cardiac toxicities during the continuum of the patient’s life.

Ixabepilone is indicated in combination with capecitabine (Xeloda) for the treatment of patients with metastatic or locally advanced breast cancer resistant to prior anthracycline and paclitaxel treatment (or for whom this treatment is contraindicated). Anthracycline resistance is defi ned as progression within 6 months of adjuvant therapy or 3 months of treatment for metastatic breast cancer; paclitaxel resistance is defi ned as progression on therapy or within 12 months of adjuvant therapy, or 4 months of treatment for metastatic breast cancer.

The article “PET Scan in the Diagnosis and Management of Breast Cancer” by Jame Abraham and coworkers is a complete, updated review of the existing scientific literature about clinical indications for positron-emission tomography (PET) in this malignancy.