Breast Cancer Research and Treatment

HER2+ and triple-negative phenotypes in invasive lobular carcinoma might have different specific biological features

Correction to: Racial disparities in surveillance mammography among older breast cancer survivors In the original publication of the article, under the Methods section, second paragraph, the sentence that reads as "We excluded 3047 patients … surgical treatment (see Fig. 1)" should read as "We excluded 3047 patients who did not identify as black or white, 5395 who were not initially diagnosed with stage 0–III cancer or were missing stage or residence data, 2573 patients who passed away within 18 months of diagnosis, and 4716 patients who did not undergo primary surgical treatment (see Fig. 1)".

What is the best clinical pathological score to identify high-risk patients with lobular carcinoma of the breast who are likely to benefit from adjuvant chemotherapy?

ER(+)/HER2(+) and ER−/HER2(+) breast cancers might have different intracranial recurrence patterns after brain-directed radiation for brain metastases

Correction to: Breast cancer risk in relation to plasma metabolites among Hispanic and African American women In the original publication of the article, the sixth author name Krita A. Zanetti was mistakenly included as co-author. The corrected author group is given in the correction article. The original article has been corrected.

Microinvasion: could it be sufficient diagnostic criteria for the optimal treatment decision?

Is sentinel node biopsy necessary in the radiologically negative axilla in breast cancer? Abstract Purpose The steady move towards axillary conservatism in breast cancer is based on studies demonstrating that axillary node clearance affords no survival benefit in a subset of patients with a positive pre-operative axillary ultrasound (AUS). However, less attention has been paid to AUS-negative patients who receive sentinel node biopsy as standard. Methods Previously assembled systematic review data was reassessed to evaluate nodal burden amongst patients with breast cancer and a clinically and radiologically negative axilla. Results Pooled data from four cohort studies reporting pre-operative axillary ultrasound in 5139 patients with breast cancer show it has a negative predictive rate of 0.951 (95% confidence interval 0.941–0.960). Conclusions Reconsidering the use of ultrasound in patients with early breast cancer and non-palpable axillae reveals that sentinel node biopsy itself may represent surgical over-treatment in patients with a negative axillary ultrasound. The implications of this on the future of surgical management of the axilla are discussed.

Radiation oncology crossword: breast cancer

De-escalation of bone-modifying agents in patients with bone metastases from breast cancer: a systematic review and meta-analysis Abstract Purpose Bone-modifying agents (BMAs) such as bisphosphonates and denosumab are usually administered every 4 weeks (standard) in patients with bone metastases from breast cancer to prevent skeletal-related events (SREs). Recent randomized controlled trials suggest every 12-week (de-escalated) dosing interval may be non-inferior. The objective of this systematic review and meta-analysis was to compare the efficacy and harms of standard with de-escalated administration of BMA's in patients with bone metastases from breast cancer. Methods We searched Medline, PubMed, and the Cochrane Register of Controlled Trials from 1947 to March 14, 2018 and conference abstracts from (2014–March 14, 2018) for randomized clinical trials comparing every 4-week and every 12-week dosing interval of bone-modifying agents. Using PRISMA guidelines, meta-analyses were performed using random-effects models, with findings reported as risk ratios with 95% confidence intervals (CI). Results From a total of 1311 citations, we identified 8 full-text articles and 1 abstract comprising data from 5 completed randomized clinical trials (n = 1807). Zoledronate administration every 12 weeks compared to every 4 weeks produced a summary risk ratio of 1.05 (95% CI 0.88–1.25) for patients with ≥ 1 on-study SRE indicating similar efficacy. These results did not differ whether patients had received prior intravenous bisphosphonate. De-escalation was associated with a non-statistically significant lower risk of increased creatinine (summary risk ratio 0.41 [95% CI 0.15–1.16]). Currently, there are insufficient data for pamidronate and denosumab de-escalation. Conclusions These data are supportive of de-escalation of zoledronate from onset for patients with bone metastases from breast cancer.

Employment trends in young women following a breast cancer diagnosis Abstract Purpose Little is known about how a breast cancer diagnosis and treatment affects job-related outcomes in young women with breast cancer, who are an integral part of the workforce. We sought to describe employment trends among young breast cancer survivors. Methods 911 women with non-metastatic breast cancer were surveyed about employment-related outcomes 1 year post-diagnosis. Participants were enrolled in the Young Women's Breast Cancer Study an ongoing, multi-center cohort of women diagnosed with breast cancer at age ≤ 40. Results Among 911 women, median age at diagnosis was 36 years (range 17–40). Most women (80%, n = 729) were employed 1 year post-diagnosis. Among the 7% (n = 62) employed before diagnosis but who reported unemployment at 1 year, approximately half reported they were unemployed for health reasons. Among employed women, 7% said treatment affected their ability to perform their job. Women with stage-three disease (vs. stage 1 disease, odds ratio (OR): 3.73, 95% CI 1.39–9.97) and those who reported having money to pay bills after cutting back or difficulty paying bills at baseline (vs. having enough money for special things, OR 2.70, 95% CI 1.32–5.52) at baseline were more likely to have transitioned out of the workforce. Conclusions Our results suggest an impact of disease burden and socioeconomic status on employment in young breast cancer survivors. There is a need to ensure young survivors who leave the workforce following diagnosis are sufficiently supported given the potential adverse psychosocial and financial impacts of unemployment on survivors, their families, communities, and society.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com