Highlights of the 2012 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
New Device May Reduce Need for
Follow-Up Surgery after Lumpectomy
A study has determined that the use of MarginProbe, a novel device that helps ensure that sufficient tissue is removed during a lumpectomy, results in fewer additional surgeries, without the cost of having to remove larger amounts of tissue. This could translate into reduced risks associated with follow-up surgeries and increased odds of preserving the cosmetic appearance of the breast after lumpectomy.
In current practice, it takes one or two weeks to obtain pathology results that indicate if sufficient tissue was removed in the first operation. MarginProbe may shorten this wait time to about five minutes, enabling detection of cancer at or near the surface of removed tumor tissue specimens while the person undergoing surgery is in the operating room. Consequently, the device reduces the risk of obtaining specimens with positive margins. This, in turn, leads to fewer people having to undergo repeat surgeries.
Study Refines Risk of Recurrence and
Survival in Women with Node-Positive,
ER-Positive Breast Cancer Treated
A retrospective study has shown that the recurrence score predicts favorable versus unfavorable outcomes after chemotherapy for women with estrogen receptor-positive breast cancer that has spread to axillary lymph nodes. The results of this study refine risk of recurrence and death in node-positive, ER-positive women who are treated with adjuvant chemotherapy plus hormonal therapy, and may help tailor the extent of adjuvant chemotherapy in these women.
Recurrence score has previously been reported to be prognostic of distant recurrence and survival outcomes for people with node-negative and node-positive disease treated with adjuvant hormonal therapy, as well as for people with up to three positive nodes treated with adjuvant endocrine therapy plus adjuvant chemotherapy. This study demonstrates that recurrence score is a significant predictor of favorable and unfavorable outcomes after adjuvant hormonal therapy plus chemotherapy in women with ER-positive breast cancer with any number of positive nodes.
“The number of positive nodes is a strong prognostic factor in breast cancer patients. The risk increases with more positive nodes. However, even within the nodal categories, the [recurrence score] further subdivides patients into distinct risk levels. So, it is an additional prognostic factor because it accounts for the biology of the disease,” says lead author Eleftherios P. Mamounas, MD, medical director of the Cancer Center at Aultman Hospital in Canton, OH.
Bone Scan, Liver Ultrasound, and
Chest X-Ray Found Not Effective for
Detection of Metastases in Early-Stage Breast Cancer
Analysis of pooled data from eight published studies revealed that bone scan, liver ultrasound, and chest X-ray very rarely detect metastases in women with newly diagnosed asymptomatic breast cancer. This finding raises concern over the routine use of these screening tests, particularly for stage I and stage II breast cancer, where metastases detection rates are lowest.
“Our literature analysis suggests that these three tests are of little use in screening women for metastases, and likely result in a lot of false negatives in early-stage disease. But a full picture would require a head-to-head comparison of these radiological tests with more sensitive imaging, such as CT or PET,” says study author Stuart-Allison Moffat Staley, MPH, a medical student at the University of North Carolina School of Medicine. While metastases detection rates were higher in women with stage III cancer, performing radiological tests may still be unnecessary if women are also assessed with more sensitive imaging.
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