Local –regional recurrence in women with small node-negative, HER2-positive breast cancer: results from a prospective multi-institutional study (the APT trial)

ConclusionLRR in this select group of early-stage patients with HER2-positive disease receiving effective anti-HER2 therapy is extremely low. If  confirmed in additional studies, future investigational efforts should focus on de-escalating local therapy.
Source: Breast Cancer Research and Treatment - Category: Cancer & Oncology Source Type: research

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In conclusion, sufficient evidence is now available to suggest that breast conservation after neoadjuvant chemotherapy is safe and effective for selected patients. Though neoadjuvant chemotherapy may increase the complexity of breast conservative treatment, a close collaboration between a multidisciplinary team and use of oncoplastic surgical techiques permit to optimize oncological and cosmetis outcomes. PMID: 30352955 [PubMed - in process]
Source: Annali Italiani di Chirurgia - Category: Surgery Tags: Ann Ital Chir Source Type: research
AbstractTreatment for ductal carcinoma in-situ (DCIS) has historically been extrapolated from studies of invasive breast cancer. Accepted local therapy approaches range from small local excisions, with or without radiation, to bilateral mastectomies. Systemic treatment with endocrine therapy is often recommended for hormone positive patients. With improvements in imaging, pathologic review, and treatment techniques in the modern era, combined with new information regarding tumor biology, the management of DCIS is rapidly evolving. A multidisciplinary approach to treatment is now more important than ever, with a shift towar...
Source: Journal of Mammary Gland Biology and Neoplasia - Category: Cancer & Oncology Source Type: research
Triple-negative breast cancer (TNBC) (estrogen receptor-negative, progesterone receptor-negative, and HER2-negative) is viewed as an aggressive subgroup of breast cancer. Treating patients with TNBC remains clinically challenging. It ’s now well established than radiation therapy is able to improve locoregional control in breast cancer patients both after breast conserving surgery or mastectomy, with positive impact in high-risk patients for long-term survival. Biologic characterization of breast tumor different subtypes, in p articular the heterogeneous subtype of TNBC could permit to adapt the treatment plan.
Source: Critical Reviews in Oncology Hematology - Category: Cancer & Oncology Authors: Source Type: research
AbstractBackground/purposeThe 21-gene recurrence score (RS) assay evaluates the likelihood of distant recurrence and benefit of chemotherapy in lymph node-negative, estrogen receptor (ER)-positive, HER2-negative breast cancer patients. The RS categories are associated with the risk of locoregional recurrence (LRR) in some, but not all studies.MethodsWe reviewed the institutional database to identify consecutive female patients with node-negative, ER+/HER2 − breast carcinoma tested for the 21-gene RS assay and treated at our center from 2008 to 2013. We collected data on clinicopathologic features, treatment, and outc...
Source: Breast Cancer Research and Treatment - Category: Cancer & Oncology Source Type: research
Abstract This large population‐based study compared breast‐conserving surgery with radiation therapy (BCT) with mastectomy on (long‐term) breast cancer‐specific (BCSS) and overall survival (OS), and investigated the influence of several prognostic factors. Patients with primary T1‐2N0‐2M0 breast cancer, diagnosed between 1999‐2012, were selected from the Netherlands Cancer Registry. We investigated the 1999‐2005 (long‐term outcome) and the 2006‐2012 cohort (contemporary adjuvant systemic therapy). Cause of death was derived from the Statistics Netherlands (CBS). Multivariable analyses, per time cohort, ...
Source: International Journal of Cancer - Category: Cancer & Oncology Authors: Tags: Research Article Source Type: research
Introduction: Breast-conserving surgery (BCS) with adjuvant whole breast radiation therapy (WBRT) is the standard treatment for a majority of early breast cancer patients. No predictive biomarkers for RT are in use and most patients are cured by surgery alone, and are thus over-treated. Further, some patients suffer a relapse despite WBRT, and may have benefited from mastectomy or more aggressive postoperative treatment. Gene expression tests can be used to predict risk of distant recurrence and effect of adjuvant systemic therapy, and can reveal the intrinsic subtype of the tumor. A surrogate method of determining intrins...
Source: Cancer Research - Category: Cancer & Oncology Authors: Tags: Poster Session Abstracts Source Type: research
Introduction: Breast-conserving surgery (BCS) with adjuvant whole breast radiation therapy (WBRT) is the standard treatment for a majority of early breast cancer patients. No predictive biomarkers for RT are in use and most patients are cured by surgery alone, and are thus over-treated. Further, some patients suffer a relapse despite WBRT, and may have benefited from mastectomy or more aggressive postoperative treatment. Gene expression tests can be used to predict risk of distant recurrence and effect of adjuvant systemic therapy, and can reveal the intrinsic subtype of the tumor. A surrogate method of determining intrins...
Source: Cancer Research - Category: Cancer & Oncology Authors: Tags: Poster Session Abstracts Source Type: research
CONCLUSION: Inverting the sequence protocol for BC, requiring both CT and RT, allows more IBR without diminishing pCR and should therefore be considered as an acceptable therapeutic option. PMID: 28033508 [PubMed - as supplied by publisher]
Source: Breast - Category: Cancer & Oncology Authors: Tags: Breast Source Type: research
In 2005, the EBCTCG meta-analysis demonstrated for the first time that RT after either breast-conserving surgery (BCS) or mastectomy not only reduced local-regional recurrence (LRR), but also improved long-term survival. At the time, they (erroneously) postulated that for every 4 LRR's avoid at 5 years, there was an additional survivor at 15 years. The EBCTCG subsequently adopted 'any first recurrence' as the primary endpoint for the effect of RT based on 1 – RT's established systemic effect in reducing both local and distant recurrence, 2 – that time to LRR is not strictly valid, and 3 – that the ratio b...
Source: Cancer Research - Category: Cancer & Oncology Authors: Tags: Invited Speaker Abstracts Source Type: research
Indications for nipple sparing mastectomyJean-Yves Petit (EIO - Milan) Benefit of the nipple areola complex (NAC) conservation has been shown (1,). To reduce the risk of local recurrences (LR), inclusion criteria and/or add localized radiation therapy have been proposed. The LR rate in patients receiving NSM is comparable with the rate in modified radical or skin-sparing mastectomies(2) Same conclusions have been raised in a study of one thousand NSM in Milan(3). LR were observed in 3 to 6% of patients at 5 years, consistent with traditional mastectomy. Today, the quality of the surgery allows for a more radical glandular ...
Source: Cancer Research - Category: Cancer & Oncology Authors: Tags: Invited Speaker Abstracts Source Type: research
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