American Society of Clinical Oncology - Breast Cancer Sympoi

Moderate deep inspiration breath-hold using an active breathing control device reduces cardiac irradiation during left-sided breast cancer treatment, reported Todd A. Swanson, MD, PhD, William Beaumont Hospital, Royal Oak, Michigan, at the 2009 ASCO Breast Cancer Symposium during a poster discussion.

Researchers from the William Beaumont Hospital in Michigan conducted a comparative analysis of the three modalities used in accelerated partial breast irradiation (APBI) in women with early stage breast cancer and found all three methods comparable in terms of local control, survival, and cosmesis. The methods examined included interstitial brachytherapy (low and high dose), 3-D conformal external beam radiotherapy (3-D CRT), and MammoSite (MS). MammoSite is the newest of these methods, approved by the FDA in May 2002.

Many women who survive breast cancer spend a lot of time worrying about the risk of recurrence, but a study presented at the ASCO Breast Cancer Symposium in San Francisco suggests at least three-quarters of the women have as much risk of suffering a serious cardiovascular event, such as heart attack or stroke. Aditya Bradia, MD, a fellow at Johns Hopkins School of Medicine, presented the data from the study, which was a 2009 Breast Cancer Symposium Merit Award Recipient.

Poly(ADP-Ribose) Polymerase (PARP) inhibitors have been gaining increasing attention as a possible breakthrough in the treatment of triple negative breast cancer and cancers with mutations in BRCA1, BRCA2, or PTEN genes. Several studies attesting to the efficacy of PARP inhibitors in breast and ovarian cancer were presented at the 2009 ASCO Annual Meeting. Antoinette Tan, MD, assistant professor, The Cancer Institute of New Jersey, provided an “Update on the Clinical Status of PARP Inhibitors for the Treatment of Breast Cancer” in a special session at the Breast Cancer Symposium in San Francisco, California.

The identification of an association between mutations in BRCA 1/2 and hereditary breast and ovarian cancer has allowed many women to learn of their increased cancer risk at a young age and take measures to identify developing tumors early. According to Jennifer Litton, MD, assistant professor, Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, women positive for a deleterious eVmutation in one of the BRCA genes typically receive a breast cancer diagnosis 6 years earlier than did mothers or aunts with the mutation who had breast or ovarian cancer.

Breast cancer survival outcomes vary significantly according to race in the United States, but a University of Texas MD Anderson Cancer Center found that race/ethnicity did not significantly affect the rate of pathologically complete response (pCR) in women with locally advanced breast cancer treated with neoadjuvant chemotherapy.

Quality of life (QOL) is an important consideration for clinicians when treating patients. Treatments that diminish QOL can result in the patient discontinuing therapy or switching to another drug. Either can thwart efforts to control tumor growth. Beth Sherrill, MS, Global Head, Biometrics, RTI Health Solutions, Research Triangle Park in North Carolina, and associates sought to determine the effects on QOL of adding lapatinib (Tykerb) to letrozole (Femara) in women with HER2-positive metastatic breast cancer (MBC).

HER2-positive breast cancer has long been recognized as an aggressive disease, but women with small node-negative tumors are considered low risk for recurrence and do not always receive adjuvant therapy. Data presented by Heather L. McArthur, MD, MPH, Memorial Sloan-Kettering Cancer Center in New York, and colleagues in a poster session at this week’s Breast Cancer Symposium in San Francisco suggests perhaps they should. In comparing outcomes between women who received adjuvant trastuzumab for low-risk HER2-positive tumors and those treated before trastuzumab was available, they concluded adjuvant trastuzumab (Herceptin) reduces recurrence rates and mortality.

In 30% of women with early stage breast cancer who were scheduled for lumpectomy, axillary ultrasound (AUS) combined with fine-needle aspiration cytology (FNAC) allowed researchers to detect macrometastases in axillary lymph nodes prior to resection, sparing the patients from subsequent sentinel lymph node biopsy (SLNB). Data were presented at the ASCO Breast Cancer Symposium in a general session titled “Controversies in the Management of the Axilla.”

Ductal carcinoma in situ (DCIS) typically begins in a milk duct and is the most common type of noninvasive early stage breast cancer. It represents nearly one-quarter of new breast cancer diagnoses annually.

In the quest to improve personalization of cancer treatment, the CALGB (Cancer and Leukemia Group B) Cooperative in Canada discovered that women with basal type breast cancer benefit from adding paclitaxel (Taxol) to standard chemotherapy.

The results of a large, randomized, population-based study presented at the 2009 ASCO Breast Cancer Symposium indicate that the rate of death from breast cancer is 56% for women not participating in mammogram screening programs versus 4.7% for those on the recommended screening schedule.