Radiation therapy, which is standard treatment for many breast cancers, may be especially important for triple-negative breast cancer.
Triple-negative breast cancer, by definition estrogen-receptor, progesterone-receptor and HER2 negative, does not have as many treatment options as other breast cancers. Hormonal therapy and Herceptin (trastuzumab) for HER2 positive cancer are not effective.
Two recent studies highlighted the importance of radiation for triple-negative breast cancer.
Lumpectomy plus radiation better than mastectomy alone
A July 20 study in the Journal of Clinical Oncology found that women with small, node-negative, triple-negative breast cancer treated with mastectomy alone had a "significant increased risk" of local-regional recurrence compared to women treated with lumpectomy (breast conserving surgery) plus radiation. The authors noted that future studies are warranted to investigate the benefit of radiation after mastectomy in triple-negative breast cancer.
After mastectomy, chemotherapy plus radiation better than chemotherapy alone
Almost on cue, an August 16 study in Radiotherapy and Oncology evaluated the benefit of radiation after mastectomy in triple-negative breast cancer. (Link may be found on the postmastectomy radiotherapy (PMRT) page of our website.)
For women with early-stage triple-negative breast cancer treated with a mastectomy, chemotherapy plus radiation was "more effective" than chemotherapy alone. Recurrence rates and overall survival rates were significantly better in the group treated with radiation.
In both studies, women with triple-negative breast cancer treated with radiation fared better than those not treated with radiation.
Triple-negative breast cancer is a special situation. At our LATESTBreastCancer.com website, subscribers may create a profile based on their personal diagnosis to see the latest breast cancer news and research applicable to them. Our goal is to make internet research more efficient, and less overwhelming, for women with breast cancer.
Wednesday, August 31, 2011
Monday, August 29, 2011
Lumpectomy for Large, Lobular Breast Tumors? Treatment before surgery may make it possible
Is lumpectomy an option for breast cancer patients with large lobular tumors? According to two new studies, shrinking the tumors with chemo or hormonal therapy before surgery may allow some women to opt for a lumpectomy instead of a mastectomy.
If lumpectomy ends up being an option, how do you know if it's right for you? MD Anderson has developed an index to predict recurrence after chemotherapy followed by lumpectomy. Today we'll share a recent study on its effectiveness.
Links to all studies and a ScienceDaily.com news story may be found on the breast conserving surgery (lumpectomy) page of the LATESTBreastCancer.com website.
Annals of Surgical Oncology: "Neoadjuvant Chemotherapy Increases the Rate of Breast Conservation in Lobular-Type Breast Cancer Patients"
A July Annals of Surgical Oncology study from Vienna evaluated whether neoadjuvant (before surgery) chemotherapy resulted in more lumpectomies for women with lobular breast cancer.
The study leader, Dr. Florian Fitzal was quoted by ScienceDaily.com,
In addition, there was no difference in local recurrence between lobular and ductal cancers treated with breast conserving surgery, or between lobular patients treated with lumpectomy or mastectomy.
Breast Cancer Research and Treatment: "Invasive lobular carcinoma: response to neoadjuvant letrozole therapy"
Femara (letrozole) is an aromatase inhibitor used to treat hormone receptor positive breast cancer in post-menopausal women. An August 26 study in Breast Cancer Research and Treatment examined the effectiveness of Femara alone as neoadjuvant therapy in women with "estrogen receptor rich" lobular breast cancer. Women were considered for treatment if they had large operable or locally advanced breast cancer or were unfit for surgery. There was no control group. All study participants received Femara.
After 3 months of Femara, the average reduction in tumor volume was 61%, measured by ultrasound. At the time of publication, 40 of 63 patients underwent surgery, 31 of those were breast conserving surgeries. 21 patients continued with Femara alone, and 19 remained controlled at a median of 2.8 years.
The authors concluded that there is a "high rate of response" to Femara in post-menopausal women with estrogen receptor rich invasive lobular carcinoma.
The Risk of Local Recurrence After Breast Conserving Therapy in Patients Receiving Neoadjuvant Chemotherapy
Even if neoadjuvant chemotherapy can reduce tumor size, is a lumpectomy the right choice for you?
MD Anderson has developed a prognostic index to evaluate the risk of recurrence for patients treated with breast conserving surgery after neoadjuvant chemotherapy. (Link to the original study.) A score from 0 to 4 is calculated based on four factors. For each factor, a zero or one is assigned. For example,
Solitary tumors = 0; Multifocal = 1
Tumors less than or equal to 2cm = 0; Greater than 2cm = 1.
Initial lymph node status of N0 or N1 = 0; N2 or N3 = 1
Lymphovascular space invasion = 1; No invasion = 0.
The numbers are totalled to reach the prognostic index score.
An August 26 Annals of Surgical Oncology study evaluated the index in 551 patients treated from 2001 to 2005 with chemo, surgery (mastectomy or lumpectomy) and radiation. (The study does not distinguish between lobular or ductal breast cancer.)
For patients with a prognostic index score of 0, 1 or 2, the 5-year local-regional recurrence (LRR) free survival rates were similar between women treated with mastectomy and lumpectomy. However, when the score was 3 or 4, the 5-year LRR-free survival was significantly lower for patients treated with lumpectomy (69%) compared to mastectomy (93%).
The authors concluded, "The prognostic index can be used to identify patients at high risk for LRR who may be considered for more extensive surgery or enrollment into clinical trials evaluating novel strategies for local-regional control."
In addition to the prognostic index score, MD Anderson publishes several prognostic calculators to aid in the neoadjuvant chemotherapy decision process. Individual treatment decisions are based on many factors. Tools such as the prognostic index and calculators are factors to be considered, but ultimate decisions are made between a patient and her doctor.
Today's summary only highlights the most recent research on breast conserving surgery and neoadjuvant therapy. Two-years worth of news and research on every breast cancer test and treatment option may be found on the treatment pages of the LATESTBreastCancer.com website. Subscribers may create a profile based on their personal diagnosis to personalize their research.
If lumpectomy ends up being an option, how do you know if it's right for you? MD Anderson has developed an index to predict recurrence after chemotherapy followed by lumpectomy. Today we'll share a recent study on its effectiveness.
Links to all studies and a ScienceDaily.com news story may be found on the breast conserving surgery (lumpectomy) page of the LATESTBreastCancer.com website.
Annals of Surgical Oncology: "Neoadjuvant Chemotherapy Increases the Rate of Breast Conservation in Lobular-Type Breast Cancer Patients"
A July Annals of Surgical Oncology study from Vienna evaluated whether neoadjuvant (before surgery) chemotherapy resulted in more lumpectomies for women with lobular breast cancer.
The study leader, Dr. Florian Fitzal was quoted by ScienceDaily.com,
"Up until now it had been the view that neoadjuvant chemotherapy hardly had any benefits in cases of lobular breast cancer due to the poor response rate of the cancer, however no one had yet examined the question of the breast preservation rate."The study found that after neoadjuvant chemotherapy, 45% of the women originally scheduled for mastectomy were able to have breast conserving surgery instead.
In addition, there was no difference in local recurrence between lobular and ductal cancers treated with breast conserving surgery, or between lobular patients treated with lumpectomy or mastectomy.
Breast Cancer Research and Treatment: "Invasive lobular carcinoma: response to neoadjuvant letrozole therapy"
Femara (letrozole) is an aromatase inhibitor used to treat hormone receptor positive breast cancer in post-menopausal women. An August 26 study in Breast Cancer Research and Treatment examined the effectiveness of Femara alone as neoadjuvant therapy in women with "estrogen receptor rich" lobular breast cancer. Women were considered for treatment if they had large operable or locally advanced breast cancer or were unfit for surgery. There was no control group. All study participants received Femara.
After 3 months of Femara, the average reduction in tumor volume was 61%, measured by ultrasound. At the time of publication, 40 of 63 patients underwent surgery, 31 of those were breast conserving surgeries. 21 patients continued with Femara alone, and 19 remained controlled at a median of 2.8 years.
The authors concluded that there is a "high rate of response" to Femara in post-menopausal women with estrogen receptor rich invasive lobular carcinoma.
The Risk of Local Recurrence After Breast Conserving Therapy in Patients Receiving Neoadjuvant Chemotherapy
Even if neoadjuvant chemotherapy can reduce tumor size, is a lumpectomy the right choice for you?
MD Anderson has developed a prognostic index to evaluate the risk of recurrence for patients treated with breast conserving surgery after neoadjuvant chemotherapy. (Link to the original study.) A score from 0 to 4 is calculated based on four factors. For each factor, a zero or one is assigned. For example,
Solitary tumors = 0; Multifocal = 1
Tumors less than or equal to 2cm = 0; Greater than 2cm = 1.
Initial lymph node status of N0 or N1 = 0; N2 or N3 = 1
Lymphovascular space invasion = 1; No invasion = 0.
The numbers are totalled to reach the prognostic index score.
An August 26 Annals of Surgical Oncology study evaluated the index in 551 patients treated from 2001 to 2005 with chemo, surgery (mastectomy or lumpectomy) and radiation. (The study does not distinguish between lobular or ductal breast cancer.)
For patients with a prognostic index score of 0, 1 or 2, the 5-year local-regional recurrence (LRR) free survival rates were similar between women treated with mastectomy and lumpectomy. However, when the score was 3 or 4, the 5-year LRR-free survival was significantly lower for patients treated with lumpectomy (69%) compared to mastectomy (93%).
The authors concluded, "The prognostic index can be used to identify patients at high risk for LRR who may be considered for more extensive surgery or enrollment into clinical trials evaluating novel strategies for local-regional control."
In addition to the prognostic index score, MD Anderson publishes several prognostic calculators to aid in the neoadjuvant chemotherapy decision process. Individual treatment decisions are based on many factors. Tools such as the prognostic index and calculators are factors to be considered, but ultimate decisions are made between a patient and her doctor.
Today's summary only highlights the most recent research on breast conserving surgery and neoadjuvant therapy. Two-years worth of news and research on every breast cancer test and treatment option may be found on the treatment pages of the LATESTBreastCancer.com website. Subscribers may create a profile based on their personal diagnosis to personalize their research.
Friday, August 26, 2011
The New Breast Cancer News Blog
Variety is the spice of life. Over the next few weeks, we're going to experiment with some different approaches to our breast cancer news blog. We'd love your input.
What we do now
At LATESTBreastCancer.com, we read breast cancer research journals and news reports every day. We share what we learn in two ways.
The website
First, we add links to latest news and research to our database and website - LATESTBreastCancer.com. The links are sorted by breast cancer test or treatment option. You may explore the latest research on any option under the Treatments tab.
For example, the tamoxifen page of our website has links to medical journal abstracts, news reports, general descriptions and FDA information, all in reverse chronological order. Every time we find a new study on tamoxifen, a link is added to the page.
The blog
We use this blog to highlight some of the news and research we add to the website. Until now, the blog discussed the latest developments on an almost daily basis. It was akin to a daily newspaper. We are starting to wonder if this is the most efficient (or interesting) way to share the news.
What we plan to do over the next few weeks
Over the next few weeks, we are going to try a variety of formats for the news blog. We'll continue to highlight the latest developments. However, instead of a daily run-down of headlines, we'll sort the data to present it in a more meaningful way.
Future news blogs will be sorted by topic, such as complementary therapies or side-effects, and by patient, with blogs for the newly-diagnosed, triple-negative or metastatic patients.
Don't worry, we'll continue to share media headlines. Our plans include -
We're also going to share research you may not hear from other sources. Topics will include -
How you can help
We want this news blog to be interesting and meaningful. To be our best, we need your input and feedback. As we experiment with new styles, please let us know what works and what doesn't. If there's something you'd like to see, we'd love to hear about it. If you miss the daily news update, we want to know that too.
To share your feedback, please leave a comment, send an email, make a comment on our Facebook page or send us a tweet (@ann_latestbc).
The new blog will start this week. We're looking forward to keeping you posted.
What we do now
At LATESTBreastCancer.com, we read breast cancer research journals and news reports every day. We share what we learn in two ways.
The website
First, we add links to latest news and research to our database and website - LATESTBreastCancer.com. The links are sorted by breast cancer test or treatment option. You may explore the latest research on any option under the Treatments tab.
For example, the tamoxifen page of our website has links to medical journal abstracts, news reports, general descriptions and FDA information, all in reverse chronological order. Every time we find a new study on tamoxifen, a link is added to the page.
The blog
We use this blog to highlight some of the news and research we add to the website. Until now, the blog discussed the latest developments on an almost daily basis. It was akin to a daily newspaper. We are starting to wonder if this is the most efficient (or interesting) way to share the news.
What we plan to do over the next few weeks
Over the next few weeks, we are going to try a variety of formats for the news blog. We'll continue to highlight the latest developments. However, instead of a daily run-down of headlines, we'll sort the data to present it in a more meaningful way.
Future news blogs will be sorted by topic, such as complementary therapies or side-effects, and by patient, with blogs for the newly-diagnosed, triple-negative or metastatic patients.
Don't worry, we'll continue to share media headlines. Our plans include -
News Alerts - Important studies making headlines. Issues you may want to discuss with your doctor now.
Buzzworthy - A weekly round-up of studies that garnered media attention. (Note, the studies that generate headlines are not always clinically relevant now. Some interesting discoveries are made in biology labs or animal studies. These will not make a difference in humans for some time.)
We're also going to share research you may not hear from other sources. Topics will include -
Under the Radar - Important studies that did not make headlines, but may make a difference in your treatment decisions.
The Cutting Edge - News and research on fresh, new options, available now.
Up-and-Coming - News and research on options not currently available, but making progress in clinical trials.
How you can help
We want this news blog to be interesting and meaningful. To be our best, we need your input and feedback. As we experiment with new styles, please let us know what works and what doesn't. If there's something you'd like to see, we'd love to hear about it. If you miss the daily news update, we want to know that too.
To share your feedback, please leave a comment, send an email, make a comment on our Facebook page or send us a tweet (@ann_latestbc).
The new blog will start this week. We're looking forward to keeping you posted.
Subscribe to:
Posts (Atom)
