Highlights of the 2010 Breast Cancer Symposium
Cosponsored by the American Society of Breast Disease, The American Society of Breast Surgeons, the American Society of Clinical Oncology, the American Society for Radiation Oncology, the National Consortium of Breast Centers, and the Society of Surgical Oncology
Steady Improvement in Breast Cancer
Survival Seen Over Six Decades
A review of patient records from a study conducted at the University of Texas M. D. Anderson Cancer Center in Houston showed that 10-year breast cancer survival has steadily improved over the past six decades, a trend that investigators credit to improvements in detection and earlier surgeries and therapies that lower the risk of relapse.
“If patients are appropriately managed, they have a much better chance of surviving breast cancer today than they would have had 30 or 20, or even 10 years ago, because the therapies are constantly evolving and improving,” says Aman Buzdar, MD, professor of Medicine and Breast Medical Oncology at M. D. Anderson, who led the work.
Improved detection, with the advent of screening mammography, has helped find cancer at earlier stages, often resulting in better prognoses. For women with locally advanced breast cancer, using pre-operative systemic therapies to shrink the tumor has made surgery possible for many women deemed marginal candidates or inoperable, while adjuvant therapies can substantially change outcomes and allow many to remain disease-free.
Selecting Breast Cancer Patients for
Aromatase Inhibitor Therapy Based
on Estrogen Receptor Status Results
in High Rates of Response, Breast
A large, multicenter, randomized Phase II trial found that selecting postmenopausal breast cancer patients for aromatase inhibitor therapy based on high estrogen receptor expression in tumors resulted in high rates of response and improvements in breast conservation surgery. Researchers found that for postmenopausal women with estrogen receptor-rich tumors who are poor candidates for breast conservation therapy and are facing mastectomy, neoadjuvant aromatase inhibitor therapy (given before the main treatment) may allow women to undergo lumpectomy in 50 percent of the cases instead.
Women with Triple-Negative Breast
Cancer with BRCA Mutations Have
Improved Survival, Lower Relapse Risk
A small study has found that nearly 20 percent of women with highly aggressive, difficult-to-treat, triple-negative breast cancer (TNBC) carry a mutation in a BRCA gene, yet have a significantly lower risk of relapse and better survival than women with triple-negative breast cancer without mutations. Triple-negative breast cancers are those that lack receptors for estrogen and progesterone, as well as HER2, or human epidermal growth factor receptor 2 – all targets for effective anticancer therapies. The findings have implications for developing more personalized treatment strategies and could lead to increased use of genetic testing for some of these women.
The researchers called the results unexpected because previous studies failed to show any differences in survival. According to Ana Maria Gonzalez-Angulo, MD, associate professor of Breast Medical Oncology at the University of Texas M. D. Anderson Cancer Center, who led the work, “The findings could have therapeutic implications for TNBC patients because a class of DNA repair-inhibiting drugs, PARP inhibitors, appears to be more effective in patients with BRCA mutations.” At the same time, the findings may lead to an increase in genetic testing to identify women with triple-negative breast cancer who have BRCA1 mutations, which could provide useful information for prognosis and therapy selection.
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This article was originally published in Coping® with Cancer magazine, November/December 2010.