Do Women with Breast Cancer –related Lymphoedema Need to Wear Compression While Exercising?: Results from a Systematic Review and Meta-analysis
AbstractPurpose of ReviewTo undertake a systematic review and meta-analysis to evaluate the effects of wearing compression versus no compression during a single bout of exercise, and during an exercise intervention, for those with breast cancer-related lymphoedema (BCRL). A multiple database search was undertaken to identify eligible randomised controlled trials (RCTs) and non-RCTs involving those with BCRL. The primary outcome variable was lymphoedema and pooled statistics were calculated using standardised mean differences (SMDs) within or between compression and no compression groups.Recent FindingsSix eligible studies ...
Source: Current Breast Cancer Reports - July 20, 2020 Category: Cancer & Oncology Source Type: research

Surgical Approaches to the Prevention and Management of Breast Cancer –Related Lymphedema
AbstractPurpose of ReviewUpper extremity lymphedema is a much-feared complication of breast cancer treatment leading to significant impairments in patients ’ quality of life. The mainstay of treatment for this debilitating chronic disease has been non-surgical modalities, namely complete decongestive therapies. Surgical treatment of lymphedema has emerged as an option for patients who have exhausted these conservative measures and consists of both ph ysiologic procedures (vascularized lymph node transplant and lymphovenous bypass) which aim to reduce the burden of lymphatic fluid and reductive procedures to remove ex...
Source: Current Breast Cancer Reports - July 18, 2020 Category: Cancer & Oncology Source Type: research

Return-to-Work and Breast Cancer Survivorship Care
AbstractPurpose of ReviewThis commentary addresses the current needs of breast cancer survivorship care focusing on return-to-work and management of chronic treatment effects, such as lymphedema.Recent FindingsCurrent literature reported a reduced work engagement and work ability among breast cancer survivors and those who developed treatment-related lymphedema. The return-to-work experience was highly individualized and built on the interactions among the survivor, the lymphedema disease processes, their work activities, and a broad array of contextual factors. Both lymphedema and its management negatively influenced wome...
Source: Current Breast Cancer Reports - June 22, 2020 Category: Cancer & Oncology Source Type: research

Breast Cancer Health Disparities in Hispanics/Latinas
AbstractPurpose of ReviewBreast cancer incidence and mortality rates are lower in some Hispanic/Latino subpopulations compared with non-Hispanic White women. However, studies suggest that the risk of breast cancer –specific mortality is higher in USA Hispanics/Latinas. In this review we summarized current knowledge on factors associated with breast cancer incidence and risk of mortality in women of Hispanic/Latino origin.Recent FindingsAssociative studies have proposed a multiplicity of factors likely contributing to differences in breast cancer incidence and survival between population groups, including socioeconomi...
Source: Current Breast Cancer Reports - May 28, 2020 Category: Cancer & Oncology Source Type: research

Large Datasets for Disparities Research in Breast Cancer
AbstractPurpose of ReviewBreast cancer disparities affect how different populations are impacted by breast cancer incidence, mortality, and survival. We provide an overview of large datasets that scientists can use to study disparities in breast cancer outcomes.Recent FindingsMany large datasets are accessible to disparities researchers with a project plan and little or no cost. Yet only two datasets have been significantly used in breast cancer disparities publications. Other datasets combine administrative claim, molecular, electronic health record, patient reported, imaging, and clinical trial data in a way that could b...
Source: Current Breast Cancer Reports - May 26, 2020 Category: Cancer & Oncology Source Type: research

Panel Testing for Hereditary Breast Cancer: More or Less?
AbstractPurpose of ReviewPanel testing is increasingly being offered to patients. Currently, women may be offered a panel of up to 80 genes. Oncologists are tasked with understanding the indications for this testing as well as the potential implications. In this review, we outline which patients should undergo genetic testing for hereditary breast cancer, when this testing should be performed, and which genes should be tested for.Recent FindingsOur understanding of hereditary breast cancer has drastically changed with the advent of next generation sequencing (NGS), and many additional genes have been associated with increa...
Source: Current Breast Cancer Reports - May 20, 2020 Category: Cancer & Oncology Source Type: research

Disparities in Genetic Testing and Care Among Black Women with Hereditary Breast Cancer
AbstractPurpose of ReviewDespite a steady improvement in breast cancer survival rates over the past several decades, mortality disparities remain among Black women, who have a 42% higher death rate compared to non-Hispanic white (NHW) women. Hereditary breast cancer (HBC) accounts for 5 –10% of all breast cancer cases, the majority of which are due to theBRCA1 andBRCA2 (BRCA) genes. Despite the availability ofBRCA testing for over 25  years, there remain disproportionately lower rates of genetic testing among Blacks compared to NHW due to a multitude of factors. The intent of this review is to discuss racial dis...
Source: Current Breast Cancer Reports - May 19, 2020 Category: Cancer & Oncology Source Type: research

The Role of Artificial Intelligence in Understanding and Addressing Disparities in Breast Cancer Outcomes
AbstractPurpose of ReviewThe goal of our paper is to explore the role of AI in understanding health disparities in cancer care and its potential role in resolving them.Recent FindingsMultiple studies have shown that with the recent advances in AI, its integration in cancer care has the potential to impact earlier diagnosis and improve clinical decision making. While AI risks to further widen health disparities, some studies suggest that it represents an excellent opportunity for resolving them.SummaryWith active engagement, incorporating AI in breast cancer care represents an excellent opportunity for elucidating and resol...
Source: Current Breast Cancer Reports - May 18, 2020 Category: Cancer & Oncology Source Type: research

Breast Reconstruction Disparities in the United States and Internationally
AbstractPurpose of ReviewWomen electing to undergo breast reconstruction following mastectomy have increased in frequency. Classically studied healthcare disparities have an influence on whether women undergo reconstruction. This review evaluates these domains, globally, while exploring why they exist.Recent FindingsIn the USA, women who are young, white, with higher income and education level, private insurance, and those treated at private or academic hospitals are most likely to undergo reconstruction. Women of a minority race or ethnicity, lower socioeconomic group, early education status, and with public or no insuran...
Source: Current Breast Cancer Reports - May 15, 2020 Category: Cancer & Oncology Source Type: research

Integrating Biology and Access to Care in Addressing Breast Cancer Disparities: 25 Years ’ Research Experience in the Carolina Breast Cancer Study
AbstractPurpose of ReviewTo review research on breast cancer mortality disparities, emphasizing research conducted in the Carolina Breast Cancer Study, with a focus on challenges and opportunities for integration of tumor biology and access characteristics across the cancer care continuum.Recent FindingsBlack women experience higher mortality following breast cancer diagnosis, despite lower incidence compared to white women. Biological factors, such as stage at diagnosis and breast cancer subtypes, play a role in these disparities. Simultaneously, social, behavioral, environmental, and access to care factors are important....
Source: Current Breast Cancer Reports - May 14, 2020 Category: Cancer & Oncology Source Type: research

Impact of Genetic Ancestry on Treatment Toxicity and Racial Disparities in Breast Cancer
AbstractPurpose of ReviewRacial disparities in breast cancer are multifactorial and include inferior outcomes and increased rates of serious toxicity in African Americans. The purpose of this review is to evaluate the contribution of race, genetic ancestry, and genomic biomarkers to treatment toxicity and to demonstrate the impact of toxicity on racial disparities.Recent FindingsTaxane-induced peripheral neuropathy (TIPN) and congestive heart failure (CHF) are potentially irreversible and life-altering toxicities of curative chemotherapy for breast cancer. Analysis of genetic ancestry, rather than self-reported race, in a ...
Source: Current Breast Cancer Reports - May 12, 2020 Category: Cancer & Oncology Source Type: research

Ductal Carcinoma In Situ (DCIS): the Importance of Patient-Reported Outcomes (PRO)
AbstractPurpose of ReviewPatient reported outcomes (PROs) are an optimal method for assessing quality of life (QOL), including physical and psychosocial health. This review summarizes PROs frequently assessed in the setting of a DCIS diagnosis.Recent FindingsHealth-related QOL has generally been found to be modestly affected in women with DCIS and similar to women with invasive breast cancer. Several studies reported a substantial negative impact on sexual health and body image, including some differences based on surgery type. Some patients experience pain after treatment, although many physical symptoms resolve. The prev...
Source: Current Breast Cancer Reports - April 20, 2020 Category: Cancer & Oncology Source Type: research

Implications of BRCA Germline Mutations on Breast Cancer Medical Treatment
AbstractPurpose of ReviewDetection of BRCA germline mutations (gBRCAm) impacts breast cancer medical treatment —according to differential sensitivity to cytotoxic chemotherapy and the activity of PARP inhibitors—and not only familial prevention. Guidelines for genetic testing—initially mainly based on familial history, age, and triple negative breast cancer (TNBC) subtype—currently are expanding in o rder to offer new therapeutic options.Recent FindingsIn the early setting, gBRCAm patients present a similar outcome as the non-carrier population with standard neoadjuvant chemotherapy, and the role of...
Source: Current Breast Cancer Reports - April 6, 2020 Category: Cancer & Oncology Source Type: research

Breast Self-Examination: the Case for a Second Look
AbstractPurpose of ReviewBreast Self-Examination (BSE) remains controversial despite the 2009 United States Preventive Service Task Force (USPSTF) recommendation against teaching of BSE. The USPSTF recommendations were based on results from the Shanghai Study, a high-quality randomized trial of BSE in 266,064 Chinese factory workers from 1989 to 1991; women instructed in BSE did not have a significant difference in mortality versus uninstructed controls. Regardless of the outcome of the Shanghai Study, the practice of BSE in the US over the past 25  years has been associated with a marked reduction in the size of brea...
Source: Current Breast Cancer Reports - February 26, 2020 Category: Cancer & Oncology Source Type: research

Treatment of Ductal Carcinoma In Situ: Considerations for Tailoring Therapy in the Contemporary Era
AbstractPurpose of ReviewStandard options for the treatment of ductal carcinoma in situ (DCIS) include breast-conserving surgery (BCS) alone; BCS with radiotherapy or endocrine therapy, or both; and mastectomy. Survival is excellent with all options, but rates of local recurrence (LR) vary, as do quality-of-life measures. Here, we discuss treatment outcomes, risk factors for LR, and tools for risk estimation.Recent FindingsAfter BCS, radiotherapy reduces the risk of LR by half, and endocrine therapy reduces the risk by a third. Young age, inadequate margins, and greater volume of disease are associated with higher risk of ...
Source: Current Breast Cancer Reports - February 24, 2020 Category: Cancer & Oncology Source Type: research

Ductal Carcinoma In Situ —Pathological Considerations
AbstractPurpose of ReviewMammographic screening and radiological surveillance for local management has led to an exponential increase in diagnosis of ductal carcinoma in situ (DCIS) with limited impact on breast cancer specific mortality. Since definitive diagnosis of DCIS requires histopathological examination increase in radiological surveillance has resulted in significant increase in breast biopsies. Pathological characteristics of DCIS include grade, necrosis, size, anatomy, margins of excision, estrogen, and progesterone receptor status, and these features are useful for both prognostication and prediction.Recent Fin...
Source: Current Breast Cancer Reports - February 20, 2020 Category: Cancer & Oncology Source Type: research

DCIS: Radiation Considerations
AbstractPurpose of ReviewDuctal carcinoma in situ (DCIS) is commonly treated with radiotherapy as a part of breast-conserving therapy, though increasingly the use of routine radiation treatment is being questioned. The intent of this review is to summarize studies on the role of radiotherapy for DCIS, with an emphasis on more recent trials.Recent FindingsWhile older randomized clinical trials have established a local control benefit for adjuvant radiotherapy following breast-conserving surgery in all patients including those with low-risk DCIS, these and subsequent studies have failed to demonstrate any survival benefit. G...
Source: Current Breast Cancer Reports - February 18, 2020 Category: Cancer & Oncology Source Type: research

Treatment from within: Ductal Carcinoma as an Opportunity to Harness the Immune System
AbstractPurpose of ReviewBreast Ductal Carcinoma in Situ (DCIS) is an increasingly common diagnosis and already accounts for ~20% of screen-detected breast cancers. A subset of patients with DCIS will experience disease recurrence and some will die from breast cancer. Tailored strategies for treatment are lacking at this time. Human Epidermal Growth Factor Receptor 2 (HER2) is a tumor associated antigen that is shown to correlate with poorer outcomes among patients with early breast cancer, including DCIS. Significant interactions between the humoral and cellular branches of the immune system were observed in tumorigenesis...
Source: Current Breast Cancer Reports - February 17, 2020 Category: Cancer & Oncology Source Type: research

Risk Management for BRCA1/BRCA2 Mutation Carriers Without and With Breast Cancer
AbstractPurpose of ReviewWe review the management for unaffectedBRCA1/2 mutation carriers and the local management of early-stage breast cancer.Recent FindingsFor unaffectedBRCA1/2 mutation carriers, surveillance includes annual magnetic resonance imaging (MRI) and mammogram (MG). Novel imaging modalities, including abbreviated protocol MRI, ultrafast/accelerated MRI, and contrast-enhanced digital mammography are being investigated. Risk-reducing mastectomy (RRM) should be considered, and nipple-areolar sparing mastectomy (NSM) is now an option. Additionally, risk-reducing salpingo-oophorectomy (RRSO) is strongly recommend...
Source: Current Breast Cancer Reports - February 17, 2020 Category: Cancer & Oncology Source Type: research

Health Disparities in Germline Genetic Testing for Cancer Susceptibility
AbstractPurpose of ReviewDespite advances in testing for heritable cancer susceptibility gene mutations, health disparities persist. We review racial/ethnic and socioeconomic factors that affect access to genetic counseling and testing, which may influence the validity of results among diverse populations and the clinical utility of genetic testing.Recent FindingsDifferential access to genetic testing among racial/ethnic minorities including Hispanics and blacks compared with whites drives disparities in the clinical validity of results: specifically, variants of unknown significance (VUS) are notably more prevalent in min...
Source: Current Breast Cancer Reports - February 12, 2020 Category: Cancer & Oncology Source Type: research

Prophylactic Mastectomy and Breast Reconstruction in Patients at High Risk for Breast Cancer
AbstractPurpose of ReviewThis paper summarizes key issues pertinent to oncologic and surgical outcomes of risk-reducing mastectomy and reconstruction.Recent FindingsAmong BRCA 1/2 mutation carriers who present with initial breast cancer, risk-reducing mastectomy in patients who are young at time of initial breast cancer diagnosis have the greatest absolute reduction in contralateral breast cancer risk associated with contralateral risk-reducing mastectomy. Although retrospective studies are suggestive of a survival advantage conferred by risk-reducing mastectomy in BRCA ½ carriers, additional research in the contemp...
Source: Current Breast Cancer Reports - February 6, 2020 Category: Cancer & Oncology Source Type: research

Lobular Neoplasia
AbstractPurpose of ReviewToday, the term lobular neoplasia (LN) incorporates atypical lobular hyperplasia (ALH), classical lobular carcinoma in situ (C-LCIS) and nonclassical lobular carcinoma in situ (NC-LCIS). These neoplastic lesions are thought of as risk indicators and non-obligate precursors of invasive breast cancer. This review highlights the current literature and up-to-date treatment recommendations for ALH, C-LCIS, and NC-LCIS.Recent FindingsCurrently, NC-LCIS requires surgical excision to rule out a concurrent carcinoma; but a core biopsy diagnosis of ALH or C-LCIS can be safely managed with close clinical and ...
Source: Current Breast Cancer Reports - January 17, 2020 Category: Cancer & Oncology Source Type: research

Fertility Counseling and Preservation in Breast Cancer
AbstractPurpose of ReviewYoung women represent a minority of breast cancer patients for which fertility, family planning, and pregnancy represent unique vulnerabilities. This review intends to discuss recent published evidence regarding treatment-related infertility, fertility counseling, and preservation.Recent FindingsFertility concerns are common among young women with breast cancer and may negatively affect treatment decisions. Data is available to aid providers in approximating odds of post-treatment amenorrhea and infertility. Multiple fertility preservation techniques are available. While embryo preservation is most...
Source: Current Breast Cancer Reports - January 14, 2020 Category: Cancer & Oncology Source Type: research

Variant of Uncertain Significance-Related Uncertainty in Breast Cancer Genomics
AbstractPurpose of ReviewThis paper considers the psychosocial implications of variant of uncertain significance (VUS)-derived uncertainty from the perspective of patients and providers and identifies potential uncertainty management strategies that can improve VUS-related clinical care.Recent FindingsBased on the analysis of current research evidence around VUS-related medical management as well as provider and patient experiences of VUS-related uncertainty, we conclude that uncertainty around this new type of medical information is pervasive. Uncertainty appraisal varies across different contextual and situational factor...
Source: Current Breast Cancer Reports - January 14, 2020 Category: Cancer & Oncology Source Type: research

Correction to: A Radiation Oncologist ’s Guide to Axillary Management in Breast Cancer: a Walk Through the Trials
The original version of this article unfortunately contained a mistake. (Source: Current Breast Cancer Reports)
Source: Current Breast Cancer Reports - January 11, 2020 Category: Cancer & Oncology Source Type: research

Multimodality Imaging of Ductal Carcinoma In Situ
AbstractPurpose of ReviewWe aim to review the appearance of ductal carcinoma in situ (DCIS) across the spectrum of imaging modalities used in common clinical practice.Recent FindingsChanges in technology and clinical breast cancer screening patterns have impacted the imaging evaluation of DCIS. DCIS classically presents as asymptomatic calcifications in women undergoing screening mammography. The replacement of traditional 2D mammography with digital breast tomosynthesis has changed the typical appearance of screen-detected DCIS. Ultrasound is traditionally utilized to detect DCIS in women with clinical symptoms, but effor...
Source: Current Breast Cancer Reports - January 8, 2020 Category: Cancer & Oncology Source Type: research

A Clinical Algorithm for Breast Cancer Patients: Exploring Reconstructive Options after Radiation
AbstractPurpose of ReviewAs radiation therapy is used as an adjuvant treatment in an increasing number of women during the management of breast cancer, radiation therapy and its well-known adverse effects pose additional challenges for breast reconstruction. The purpose of this review is to examine recent data on outcomes of various breast reconstruction methods in the setting of radiation therapy and help surgeons and oncologists as well as patients with their decision-making process.Recent FindingsBreast reconstruction methods can be categorized into autologous-, implant-, and tissue expander/implant-based, each with its...
Source: Current Breast Cancer Reports - December 5, 2019 Category: Cancer & Oncology Source Type: research

Gut Microbiome and Breast Cancer in the Era of Cancer Immunotherapy
AbstractPurpose of ReviewImmune checkpoint inhibitors (ICIs) are an emerging therapy in breast cancer, but not all patients will have benefit with these medications. It has been proposed that certain gut microbes may play a role in protecting the host against inappropriate inflammation and modulating the immune response. Here, we review the current evidence on the association of the gut microbiome, antitumor immunity, and response to immunotherapy and discuss open questions, ongoing trials, and future directions for modulating the gut microbiome as part of breast cancer treatment.Recent FindingsSeveral groups have showed t...
Source: Current Breast Cancer Reports - December 5, 2019 Category: Cancer & Oncology Source Type: research

Current Considerations of Breast Implant –Associated Anaplastic Large Cell Lymphoma in Breast Surgery: a Systematic Review
AbstractPurpose of ReviewA systematic review of three databases (PubMed, Scopus, and Google Scholar) was conducted to appraise the current evidence behind the diagnosis and management of breast implant –associated anaplastic large cell lymphoma (BIA-ALCL). The goal is to help patients make informed decisions regarding reconstruction after breast cancer treatment by educating physicians on the nuances of diagnosis and treatment of BIA-ALCL.Recent FindingsFollowing recent statements by the FDA, BIA-ALCL has recently garnered the attention of both patients and plastic surgeons. To date, BIA-ALCL has been almost exclusiv...
Source: Current Breast Cancer Reports - December 2, 2019 Category: Cancer & Oncology Source Type: research

Recent Developments in HER2-Directed Therapy in Breast Cancer
AbstractPurpose of ReviewThis review will discuss recent important trials for the treatment of HER2-positive breast cancer, emphasize ongoing areas of development, and highlight areas of unmet need.Recent FindingsAdvances for early-stage treatment have been driven by key clinical trials with pertuzumab, neratinib, and TDM-1. In the adjuvant setting, dual HER2 targeting with trastuzumab and pertuzumab has demonstrated modest improvement in disease-free survival. Neratinib also showed modest benefit in the extended adjuvant setting after prior trastuzumab. Finally, for patients who did not achieve pathologic complete respons...
Source: Current Breast Cancer Reports - November 28, 2019 Category: Cancer & Oncology Source Type: research

The Diagnostic Approach to Lymphedema: a Review of Current Modalities and Future Developments
The objective of this review is to discuss current modalities and devices as well as highlight promising advancements intended to aid in diagnosing secondary lymp hedema in breast cancer patients.Recent FindingsImaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) can offer high resolution of the lymphatics but are expensive and time-consuming. Single photon emission computed tomography (SPECT) is an alternative that reveals organ function as opposed to organ structure. Other imaging methods, such as color duplex ultrasound (CDU), laser scanner 3D (LS3D), and dual-energy X-ray absorptiome...
Source: Current Breast Cancer Reports - November 25, 2019 Category: Cancer & Oncology Source Type: research

PD-L1 Testing in Patients with Breast Cancer: Controversies and Current Practice
AbstractPurpose of ReviewAtezolizumab has emerged as a novel treatment in patients with triple-negative breast cancer showing unprecedented survival gain. This breakthrough benefit is exclusively observed in PD-L1-positive patients, but PD-L1 positivity still lacks a reliable definition. In this review, we discuss the current data on PD-L1 testing and its impact on the treatment of patients.Recent FindingsThe VENTANA SP142 assay was used in the trial that led to the approval of atezolizumab in the first-line setting. However, recent data show that this assay appears to be less sensitive to detect PD-L1 expression compared ...
Source: Current Breast Cancer Reports - November 25, 2019 Category: Cancer & Oncology Source Type: research

Busting the Contralateral Prophylactic Mastectomy Myth: Incidence of Follow-up Imaging and Biopsy After Risk-Reductive Breast Surgery
AbstractPurpose of ReviewContralateral prophylactic mastectomy (CPM) at the time of unilateral breast cancer surgery is increasing, though still controversial in BRCA( −) patients. We review the relevant literature regarding CPM and specifically abnormal imaging/biopsies in patients following unilateral mastectomy (UM) versus CPM and present results from our own retrospective chart review.Recent FindingsA large cohort study by van la Parra et al. examined the incidence/risk of breast biopsy at follow-up, finding the 5-year estimated biopsy rate to be the lowest for UM compared to breast-conserving surgery. Our retros...
Source: Current Breast Cancer Reports - November 25, 2019 Category: Cancer & Oncology Source Type: research

Updates in Genetic Testing Guidelines for Breast Cancer Susceptibility Genes: a Change in the Paradigm
AbstractPurpose of ReviewUp to 10% of all breast cancers are associated with inherited germline mutations. Genetic testing guidelines for hereditary breast cancer susceptibility have changed significantly since their inception in the late 1990s. The purpose of this review is to discuss the changes in technology that have improved our ability to efficiently detect germline mutations, introduce the recent paradigm change towards population-based testing currently supported by the American Society of Breast Surgeons, and highlight the challenges that expansion of testing parameters presents.Recent FindingsNext-generation sequ...
Source: Current Breast Cancer Reports - November 23, 2019 Category: Cancer & Oncology Source Type: research

Combination Immunotherapy Strategies in Breast Cancer
We describe current and emerging combination approaches which may improve patient outcomes in metastatic breast cancer. (Source: Current Breast Cancer Reports)
Source: Current Breast Cancer Reports - November 22, 2019 Category: Cancer & Oncology Source Type: research

Hot Topic: Should all Women with Breast Cancer Undergo Genetic Testing?
AbstractPurpose of ReviewPanel testing for germline mutations in cancer patients has advanced rapidly in recent years. In breast cancer, these advances have raised questions about the indications for testing, with some groups advocating testing of all patients with breast cancer.Recent FindingsStudies uniformly demonstrate that expanded scope of genetic testing will result in identification of more women with germline mutations. However, many challenges remain in interpretation of such broad panel testing, including limited information about the risks of second cancers conferred by most of these germline mutations and the ...
Source: Current Breast Cancer Reports - November 21, 2019 Category: Cancer & Oncology Source Type: research

I-SPY 2: a Neoadjuvant Adaptive Clinical Trial Designed to Improve Outcomes in High-Risk Breast Cancer
AbstractPurpose of ReviewThe I-SPY 2 trial is an adaptive clinical trial platform designed to improve outcomes in high-risk breast cancer patients by testing new drugs in the neoadjuvant setting. The intent of this review is to discuss background, study structure, innovation, and outcomes of the I-SPY 2 trial.Recent FindingsI-SPY 2 evaluates new agents combined with standard therapy with pathologic complete response (pCR) as the primary endpoint. I-SPY-2 uses clinical biomarkers to classify breast cancer into 10 subtypes, with Bayesian adaptive randomization to allow individualized patient assignment to therapy arms to max...
Source: Current Breast Cancer Reports - November 20, 2019 Category: Cancer & Oncology Source Type: research

Immunotherapy in Triple-Negative Breast Cancer: Present and Future
AbstractPurpose of ReviewImmunotherapy is emerging as an effective treatment option for metastatic triple-negative breast cancer. In this review, we summarize clinical data of immunotherapy in triple-negative breast cancer and comment on future directions in the field.Recent FindingsIMpassion130 was a phase III trial that demonstrated progression-free survival benefit, and potentially overall survival benefit, of first-line chemotherapy (nab-paclitaxel) plus anti-programmed death ligand 1 (PD-L1) atezolizumab, among PD-L1-positive metastatic triple-negative breast cancers. Studies are ongoing to evaluate other combination ...
Source: Current Breast Cancer Reports - November 20, 2019 Category: Cancer & Oncology Source Type: research

The Promise of Immunotherapy for Breast Cancer Brain Metastases
AbstractPurpose of ReviewThe goal of our review is to describe the rationale for immunotherapy in the treatment of breast cancer brain metastases (BCBM), the current landscape of clinical trials for this disease process, and possible future directions based on anticipated results.Recent FindingsImmune checkpoint inhibition has shown efficacy in the treatment of several solid tumor brain metastases (i.e., melanoma and non-small cell lung cancer), but data specific to BCBM is relatively sparse. Preclinical studies in BCBM have illustrated a lower immune content in the brain microenvironment measured by tumor-infiltrating lym...
Source: Current Breast Cancer Reports - November 20, 2019 Category: Cancer & Oncology Source Type: research

Inflammatory Breast Cancer: Diagnostic, Molecular and Therapeutic Considerations
AbstractPurpose of ReviewInflammatory breast cancer (IBC) is an aggressive type of breast cancer with poor prognosis. Treatment for non-metastatic disease is neoadjuvant chemotherapy followed by mastectomy and radiation. IBC diagnosis is primarily a clinical diagnosis, which can lead to misdiagnosis and delayed management. In addition, there are no molecular criteria for diagnosis or therapeutic regimens developed specifically for IBC. We aimed to discuss recent developments in IBC, including diagnosis, molecular mechanisms, and treatment.Recent FindingsRecently, the Union for International Cancer Control (UICC) and the Am...
Source: Current Breast Cancer Reports - November 15, 2019 Category: Cancer & Oncology Source Type: research

Immunotherapy for HER2-Positive Breast Cancer: Changing the Paradigm
AbstractPurpose of ReviewTo summarize and discuss the available evidence and ongoing efforts in order to establish the efficacy and safety of immunotherapeutic approaches in HER2-positive breast cancer.Recent FindingsThe introduction into the clinic of anti-HER2 –targeted therapies more than 15 years ago resulted in a substantial improvement in the outcome of patients with HER2-overexpressing breast cancer. However, only patients with the highest levels of HER2 expression will potentially benefit from these therapies and, unfortunately, many patients prog ress or relapse after optimal treatment. As metastatic breast ...
Source: Current Breast Cancer Reports - November 13, 2019 Category: Cancer & Oncology Source Type: research

Biomarker Predictors for Immunotherapy Benefit in Breast: Beyond PD-L1
AbstractPurpose of ReviewImmune checkpoint blockade (ICB) has changed the clinical course of multiple cancer types and durable responses have now been observed in breast cancer (BC) patients. Most data suggest that, compared to other subtypes, triple-negative BC (TNBC) patients are more responsive to ICB, and anti-PD-L1 therapy is now approved in PD-L1+ metastatic TNBC, in combination with chemotherapy.Recent FindingsNearly 40% of PD-L1+ TNBC patients did not respond to this combination. Thus, additional biomarkers appear to be necessary to more precisely identify potential responders. A comprehensive analysis of the breas...
Source: Current Breast Cancer Reports - November 11, 2019 Category: Cancer & Oncology Source Type: research

Preoperative Radiotherapy Trials to Facilitate Immediate Breast Reconstruction after Mastectomy
AbstractPurpose of ReviewPostmastectomy radiotherapy (PMRT) is often a component of treatment algorithms for locally advanced or node-positive breast cancer. Breast reconstruction may be delayed or not performed due to negative effects of PMRT on the reconstruction. Administering radiotherapy in the preoperative setting allows for immediate breast reconstruction (IBR) to be performed in patients who have indications for PMRT and desire IBR. This review summarizes the current literature on this new concept.Recent FindingsMost prospective treatment protocols included neoadjuvant systemic therapy followed by radiotherapy (RT)...
Source: Current Breast Cancer Reports - November 7, 2019 Category: Cancer & Oncology Source Type: research

Update on Breast Implant-Associated Anaplastic Large Cell Lymphoma
AbstractPurpose of ReviewThe US Food and Drug Administration issued a recall of textured breast implants in July 2019 secondary to their association with anaplastic large cell lymphoma. This brief review serves to summarize what is actually known about breast implant associated anaplastic large cell lymphoma.Recent FindingsSince the FDA ’s first preliminary report in 2011, there have been a reported worldwide total of 573 breast implant associated anaplastic large cell lymphoma (BIA-ALCL) cases, including 33 deaths. In addition to halting the implantation of textured implants, the July recall served to increase aware...
Source: Current Breast Cancer Reports - November 7, 2019 Category: Cancer & Oncology Source Type: research

A Radiation Oncologist ’s Guide to Axillary Management in Breast Cancer: a Walk Through the Trials
AbstractPurpose of ReviewThe axilla is the most common site for breast cancer nodal metastases. Aggressive management includes axillary lymph node dissection (ALND), radiotherapy, and systemic therapy, but carries the risks of lymphedema and “overtreatment”. We review the clinical trials that led to de-escalation of axillary management and their nuances that are often overlooked.Recent FindingsWith the rise of sentinel lymph node biopsy, several trials conclude that ALND can be omitted in specific populations. However, the subtleties in those trials, such as the role of chemotherapy and radiotherapy, have yet t...
Source: Current Breast Cancer Reports - September 14, 2019 Category: Cancer & Oncology Source Type: research

Report from the Front: a Glimpse at Breast Cancer Research in Low- and Middle-Income Countries
AbstractPurpose of ReviewBreast cancer is increasingly more prevalent in low- and middle-income countries (LMICs) and its biology in these populations may differ from that in more affluent countries. Research in these settings is limited by both societal factors and the lack of resources. Our intent is to review the parameters that limit more extensive research activities in LMICs and potentially investigate options for improvement.FindingsLMIC governments have limited infrastructure to support appropriate research and the physicians are overburdened by clinical work. Even the patients fail to see the value of research in ...
Source: Current Breast Cancer Reports - September 2, 2019 Category: Cancer & Oncology Source Type: research

Combining Radiation Therapy with Immune Checkpoint Blockadein Breast Cancer
AbstractPurpose of ReviewImmune checkpoint blockade (ICB) is an emerging therapy in breast cancer. Its optimal integration with radiation therapy (RT) for breast cancer remains to be established. Herein, we review the current evidence on combining ICB and RT in breast cancer and discuss the challenges, open questions, ongoing trials, and future directions for use of this treatment combination.Recent FindingsEarly trials of ICB in breast cancer show evidence of a modest response, limited due to the low baseline immunogenicity of most breast cancers. RT, as a potent stimulator of the immune system, has been used in combinati...
Source: Current Breast Cancer Reports - August 30, 2019 Category: Cancer & Oncology Source Type: research

Bridging the Gap in Training and Clinical Practice in Sub-Saharan Africa
AbstractPurpose of ReviewAs medical knowledge and innovation reaches new heights, there is a growing gap in medical advancements between low- and middle-income countries (LMICs) and high-income countries (HICs). The former has lack of basic health care and preventive or diagnostic services for early cancer while the latter has access to novel diagnostic and therapeutic modalities.Recent FindingsKey to overcoming this disparity is finding ways to bridge this divide across distances and continental divides through innovative technology and sharing of knowledge by committed individuals and through public private partnerships....
Source: Current Breast Cancer Reports - August 19, 2019 Category: Cancer & Oncology Source Type: research

Partial-Breast Irradiation: Review of Modern Trials
AbstractPurpose of ReviewFollowing partial mastectomy, whole-breast irradiation (WBI), delivered over 3 to 6  weeks, has been the standard adjuvant radiation approach for early-stage breast cancer. A growing body of literature over the past decade has suggested that irradiation of the partial breast, including the tumor bed plus a margin, may be a suitable alternative for appropriately selected patients. The use of partial breast irradiation (PBI) has been studied in multiple prospective randomized trials, now with up to 10 years of follow-up, establishing similar safety and efficacy compared with WBI. Advantages...
Source: Current Breast Cancer Reports - August 19, 2019 Category: Cancer & Oncology Source Type: research

Pathology Meets Biology: the New Era of Breast Cancer Staging
AbstractPurpose of ReviewBreast cancer is now recognized to be a very heterogeneous disease. This complexity was recently reflected in the newest American Joint Committee on Cancer (AJCC) breast cancer staging, implemented in 2018. Although it seems very daunting, the new staging is based on both the anatomical extent of the disease and the prognostic factors such as hormonal and HER2 status, grade of the tumor, and genomic assays providing information regarding risk of recurrence. The purpose of this review is to illustrate the reasoning for the change in previous, solely an anatomically based breast cancer staging system...
Source: Current Breast Cancer Reports - August 16, 2019 Category: Cancer & Oncology Source Type: research