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

Polygenic Risk Scores in Breast Cancer
AbstractPurpose of ReviewBreast cancer is a complex disease that is fueled by genetic as well as non-genetic factors. As data risk estimates become better, stratifying a woman ’s risk for breast cancer can lead to better prevention strategies. The purpose of this review is to introduce the polygenic risk score (PRS) and shed light on its clinical applications as well as shortcomings in the field of breast cancer prevention.Recent FindingsA PRS combines relevant single-nucleotide polypeptides (SNPs) and generates an estimated risk of a specific cancer. It has the ability of questioning the whole genome and incorporati...
Source: Current Breast Cancer Reports - August 13, 2019 Category: Cancer & Oncology Source Type: research

Breast Cancer Screening for Women at Average Risk
AbstractPurpose of ReviewThe purpose of this review is to examine the most recent data and guidelines regarding screening for breast cancer in average risk women.Recent FindingsThe differing recommendations for screening reflect differences in value judgements between the benefits (decreased cancer-related death and morbidity) and the harms (potential for overdiagnosis, false positives, false negatives, anxiety, and cost of care) of breast cancer screening.SummaryThere are multiple organizations with recommendations for breast cancer screening in women at average risk. All organizations recommend mammography to screen for ...
Source: Current Breast Cancer Reports - July 25, 2019 Category: Cancer & Oncology Source Type: research

Promoting Breast Cancer Awareness and Clinical Breast Examination in the LMIC: Experiences from Tajikistan, Pakistan and Kenya
AbstractPurpose of ReviewBreast cancer is the most common cancer and a leading cause of cancer death among women living in low- and middle-income countries (LMIC) despite declining mortality in high-income countries. The rising morbidity and mortality from breast cancer is fueled by a number of factors including late presentation, poor access to medical care, and less than optimal diagnostic and therapeutic capabilities. Reducing the breast cancer burden in LMICs will require improving early detection and overcoming barriers to accessing the health system as well as making diagnosis and treatment more affordable. While Nor...
Source: Current Breast Cancer Reports - July 25, 2019 Category: Cancer & Oncology Source Type: research

Mammographic Density: Intersection of Advocacy, Science, and Clinical Practice
AbstractPurpose of ReviewHere we aim to review the association between mammographic density, collagen structure, and breast cancer risk.Recent FindingsWhile mammographic density is a strong predictor of breast cancer risk in populations, studies by Boyd show that mammographic density does not predict breast cancer risk in individuals. Mammographic density is affected by age, parity, menopausal status, race/ethnicity, and body mass index (BMI). New studies normalize mammographic density to BMI and this may provide a more accurate way to compare mammographic density in women of diverse race and ethnicity. Preclinical and tis...
Source: Current Breast Cancer Reports - July 24, 2019 Category: Cancer & Oncology Source Type: research

Ductal Carcinoma In Situ Management: All or Nothing, or Something in between?
AbstractPurpose of ReviewStandard treatment for ductal carcinoma in situ (DCIS) is similar to that of invasive carcinoma. However, there is significant controversy regarding the true clinical implications of DCIS, and thus, the best management strategy. The aim of this review is to highlight relevant biology, diagnostic considerations, treatment options, and recent clinical trials.Recent FindingsOutcomes are generally excellent with low recurrence rates and exceptional disease-specific survival. Outcomes can be predicted using various prognostic indicators and/or nomograms to guide treatment decisions. Ongoing clinical tri...
Source: Current Breast Cancer Reports - July 19, 2019 Category: Cancer & Oncology Source Type: research

How Did We Get There? The Progression from Ductal Carcinoma In Situ to Invasive Ductal Carcinoma
AbstractPurpose of ReviewDuctal carcinoma in situ (DCIS) is a non-obligate precursor of invasive breast cancer. Despite numerous studies investigating the progression from in situ to invasive disease, there is still controversy as to the mechanisms by which a DCIS comes to become an invasive cancer. Here, we reviewed the state-of-the-art of the pathologic and molecular characterization of DCIS.Recent FindingsDCIS displays intra-lesion genetic heterogeneity. Single-cell sequencing studies have demonstrated that progression from DCIS to invasive breast cancer is a complex phenomenon, which can vary from lesion to lesion. Whi...
Source: Current Breast Cancer Reports - July 16, 2019 Category: Cancer & Oncology Source Type: research

Breast Atypia as a Biomarker of Risk
AbstractPurpose of ReviewProvide a summary of available evidence on breast atypia as a biomarker of risk.Recent FindingsWith an increase in independent studies on atypical hyperplasia (AH), knowledge has advanced recently regarding its subsequent associated breast cancer risk. For women with AH, absolute risk can be estimated generally as ~  1% per year, and a greater extent of disease appears to further increase risk. Although both breasts are at increased risk, the risk is higher for the ipsilateral breast. In women with AH, a family history of breast cancer does not confer significantly increased risk. Risk is si...
Source: Current Breast Cancer Reports - July 13, 2019 Category: Cancer & Oncology Source Type: research

Breast Cancer Treatment in Resource Constrained Countries: a Zimbabwean Perspective
AbstractPurpose of ReviewBreast cancer is becoming a significant burden to the healthcare system in Zimbabwe. The financial toxicity of breast cancer treatment is a significant problem for patients even in the developed world. This review looks at the management of breast cancer patients in Zimbabwe relating it to the other developed nations.Recent FindingsDespite the tremendous progress made by science in the care of women with breast cancer over the past few decades, most of the women in Zimbabwe are yet to benefit from this progress. There is poor access to modern screening methods, quality chemotherapy drugs and reliab...
Source: Current Breast Cancer Reports - July 13, 2019 Category: Cancer & Oncology Source Type: research

Oncoplastic Breast-Conserving Surgery in Low- and Middle-Income Countries : Training Surgeons and Bridging the Gap
AbstractPurpose of ReviewBreast cancer treatment in low- and middle-income countries involves a series of limitations. On the other hand, oncoplastic surgery has been well established in these countries as an alternative to mastectomy, offering oncologic safety while preserving the natural contours of the female breast. The aim of this review is to discuss recent studies and analyses involving oncoplastic surgery in low- and middle-income countries.Recent FindingsAlthough major differences remain between low- and high-income countries with respect to science, this same pattern is not reflected in oncoplastic surgery. This ...
Source: Current Breast Cancer Reports - June 29, 2019 Category: Cancer & Oncology Source Type: research

Screening Modalities for Women at Intermediate and High Risk for Breast Cancer
AbstractPurpose of ReviewBreast cancer screening is critically important to detect malignancy at an early stage. Annual mammography remains the gold standard as the imaging modality for patients with an average breast cancer risk. However, women with increased breast cancer risk benefit from supplemental screening using additional imaging modalities. This review summarizes the current recommendations within this patient population.Recent FindingsAnalysis from ACRIN 6666 demonstrated that the cancer detection rate of ultrasound is comparable to mammography with an increased amount of invasive and node-negative cancers detec...
Source: Current Breast Cancer Reports - June 29, 2019 Category: Cancer & Oncology Source Type: research

Late Presentation of Breast Cancer in Lower- and Middle-Income Countries
AbstractPurpose of ReviewBreast cancer incidence and mortality in low- and medium-income countries has increased and is predicted to rise. Late presentation, associated with poor prognosis, is unfortunately common to most of these countries. This review discusses recent studies and offers recommendations to address pertinent issues raised.Recent FindingsLate presentation continues to prevail in many LMICs, worse in sub-Saharan Africa. Socioeconomic and demographic factors play a significant role. The fear of mastectomy is a prominent cause of reluctance to seek treatment. Increasing awareness, clinical breast examination a...
Source: Current Breast Cancer Reports - June 20, 2019 Category: Cancer & Oncology Source Type: research

Breast Cancer Management Among Refugees and Forcibly Displaced Populations: a Call to Action
AbstractPurpose of ReviewThe prevalence of breast cancer is rising among refugees and displaced populations worldwide, and late-stage diagnosis has contributed to poor health outcomes in these populations. With a specific focus on the Middle East and Lebanon in particular, we discuss the challenges associated with breast cancer prevention and treatment among refugees and displaced populations and highlight priorities for urgent and needed action.Recent FindingsIn the Middle East, a complex interplay of social, cultural, economic, and political factors results in delayed diagnosis and treatment of breast cancer among displa...
Source: Current Breast Cancer Reports - June 20, 2019 Category: Cancer & Oncology Source Type: research

Correction to: Ablative Treatment of Breast Cancer; Are We There Yet?
The original version of this article unfortunately contained a mistake in the article title. The captured title was “Local-Regional Evaluation and Therapy (D Euhus, Section Editor)” instead of “Ablative Treatment of Breast Cancer; Are We There Yet?” (Source: Current Breast Cancer Reports)
Source: Current Breast Cancer Reports - June 18, 2019 Category: Cancer & Oncology Source Type: research

Role of Liquid Biopsy in Clinical Decision-Making for Breast Cancer
AbstractPurpose of ReviewLiquid biopsies are easily obtainable, non-invasive, longitudinal snapshots that can be used to measure micrometastatic disease burden, monitor disease progression, and provide genomic assessments of primary tumor/metastatic lesions. To date, most published studies have focused on circulating tumor cells (CTCs) and cell-free circulating tumor DNA (ctDNA); however, the liquid biopsy field is expanding exponentially and new blood components are currently under investigation.Recent FindingsCTCs and ctDNA remain the most extensively studied liquid biopsy components to date. Several additional blood-bas...
Source: Current Breast Cancer Reports - May 1, 2019 Category: Cancer & Oncology Source Type: research

Surgical Therapy for Women with Multiple Synchronous Ipsilateral Breast Cancer (MIBC): Current Evidence to Guide Clinical Practice
AbstractPurpose of ReviewBased on retrospective, historic data, surgeons have long recommended mastectomy as the surgical approach for women with multiple ipsilateral synchronous (multifocal or multi-centric) breast cancer (MIBC). In the modern era, however, local recurrence rates have significantly decreased due to improved imaging techniques and earlier detection through breast cancer screening, more accurate delivery of radiation, and the advent of targeted systemic therapies. Given the significant non-surgical advancements in the field of breast cancer care, the role of maximally invasive surgery in improving breast ca...
Source: Current Breast Cancer Reports - May 1, 2019 Category: Cancer & Oncology Source Type: research

Diffusion-Weighted Magnetic Resonance Imaging of the Breast: an Accurate Method for Measuring Early Response to Neoadjuvant Chemotherapy?
This article aims to review the literature regarding the accuracy of DWI in predicting patients who will respond to neoadjuvant chemotherapy at an early stage within their treatment pathway.Recent FindingsThe initial search yielded 11,171 articles. After careful review, 19 of these articles were found to adhere to the inclusion criteria. Despite the varied research methods and data analysis across the studies, 16 out of 19 of these studies (84%) demonstrated DWI to be an accurate predictor of neoadjuvant chemotherapy response.SummaryThese results are promising; however, further multi-centre studies with larger sample sizes...
Source: Current Breast Cancer Reports - April 29, 2019 Category: Cancer & Oncology Source Type: research

Practical Perspectives Regarding Patient Selection and Technical Considerations in Oncoplastic Surgery
AbstractPurpose of ReviewOncoplastic surgery is a form of breast conservation surgery that involves volume displacement and replacement techniques to reconstruct the breast after a partial mastectomy. We aimed to report our clinical experiences with support from the literature as to the optimal application of oncoplastic surgery with regard to patient and disease selection and presentation, and discuss common technical considerations.Recent FindingsBased on clinical experience and recent literature, oncoplastic surgery has several oncologic and reconstructive strengths including a decreased positive margin rate, high patie...
Source: Current Breast Cancer Reports - April 26, 2019 Category: Cancer & Oncology Source Type: research

Ablative Treatment of Breast Cancer; Are We There Yet?
AbstractPurpose of ReviewBreast cancer treatment has evolved through continuous integration of technological advances and changes in our understanding of tumor biology. Radical mastectomy was the best operation for the technology and beliefs of its time. Advances in technology, the acknowledgement that care is best delivered through a multi-modal approach, and continued investigation have resulted in less disfiguring procedures. Ablative therapy for the treatment of breast cancer is the natural continuation of this trend.Recent FindingsData from breast cancer ablation trials utilizing various energy forms have been favorab...
Source: Current Breast Cancer Reports - April 25, 2019 Category: Cancer & Oncology Source Type: research

Local-Regional Evaluation and Therapy (D Euhus, Section Editor)
AbstractPurpose of ReviewBreast cancer treatment has evolved through continuous integration of technological advances and changes in our understanding of tumor biology. Radical mastectomy was the best operation for the technology and beliefs of its time. Advances in technology, the acknowledgement that care is best delivered through a multi-modal approach, and continued investigation have resulted in less disfiguring procedures. Ablative therapy for the treatment of breast cancer is the natural continuation of this trend.Recent FindingsData from breast cancer ablation trials utilizing various energy forms have been favorab...
Source: Current Breast Cancer Reports - April 25, 2019 Category: Cancer & Oncology Source Type: research

Management of B3 Lesions —Practical Issues
AbstractPurpose of the ReviewBreast lesions of uncertain malignant potential (B3) are a heterogeneous group of diagnostic entities that can be associated with atypia. These are associated with in situ or invasive malignancy in 20 –30% of cases. The management of those lesions has been both controversial and challenging for the multidisciplinary teams.Recent FindingsThis is an up-to-date review of the current International Consensus on the management of B3 lesions with emphasis on the practical considerations.SummaryThrough multidisciplinary management pathways, the vast majority of B3 lesions should be managed by vac...
Source: Current Breast Cancer Reports - April 25, 2019 Category: Cancer & Oncology Source Type: research

Interval Cancers and Duty of Candour, a UK Perspective
AbstractPurpose of ReviewInterval cancers are defined as a cancer presenting in the interval following a negative screen. Interval cancers are important because they reduce confidence in the screening programme and have relatively worse prognostic features than screen-detected cancers. This review will look at the rates of interval cancers in the UK Breast screening programme and other population-based breast screening programmes in Europe. It will discuss the latest UK classification and look at factors affecting interval cancer rates. It will examine the pathological features of interval cancers and their mortality impac...
Source: Current Breast Cancer Reports - March 18, 2019 Category: Cancer & Oncology Source Type: research

Diagnosing and Managing the Malignant Axilla in Breast Cancer
AbstractPurpose of ReviewThe management of the malignant axilla remains a controversial topic. Although many issues have been resolved with the results of randomised controlled trials, there are still areas where evidence is lacking. This review will focus on the current diagnostic methods used to detect lymph node (LN) metastases as well as the impact of volume of LN disease on the choice of axillary management. The roles of surgical excision, radiotherapy and systemic therapy as treatment modalities for LN metastases will also be explored with particular emphasis on the use of neo-adjuvant chemotherapy (NACT). Lastly, ne...
Source: Current Breast Cancer Reports - February 11, 2019 Category: Cancer & Oncology Source Type: research

Is Ultrafast or Abbreviated Breast MRI Ready for Prime Time?
AbstractPurpose of ReviewBreast MRI has been recognized as the most sensitive modality for breast cancer screening. Its use is, however, restricted due to the high costs of the MRI scan itself, the limited availability of MRI scanners and the long reading times. In this review, the use of shorter MRI protocols for screening is discussed.Recent FindingsShortened scan protocols have been proposed to reduce both the actual patient handling time and the time to evaluate the scan. So far, these “abbreviated” scan protocols have shown similar sensitivity and only marginally lower specificity as the common scan protoc...
Source: Current Breast Cancer Reports - January 21, 2019 Category: Cancer & Oncology Source Type: research

The Role of Deep Learning in Breast Screening
AbstractPurpose of ReviewTo review research on deep learning models and their potential application within breast screening.Recent FindingsThe greatest issue in breast screening is a workforce crisis across the UK, much of Europe and even Japan. Traditional computer-aided detection (CAD) for mammography decision-support could not reach the level of an independent reader. Deep learning (DL) outperforms CAD and is close to surpassing human performance. DL is already capable of decision support and density assessment for 2D full-field digital mammography (FFDM), and is on the cusp of providing consistent, accurate and interpr...
Source: Current Breast Cancer Reports - January 19, 2019 Category: Cancer & Oncology Source Type: research

Multimodality Imaging of Breast Parenchymal Density and Correlation with Risk Assessment
AbstractPurpose of ReviewBreast density, or the amount of fibroglandular tissue in the breast, has become a recognized and independent marker for breast cancer risk. Public awareness of breast density as a possible risk factor for breast cancer has resulted in legislation for risk stratification purposes in many US states. This review will provide a comprehensive overview of the currently available imaging modalities for qualitative and quantitative breast density assessment and the current evidence on breast density and breast cancer risk assessment.Recent FindingsTo date, breast density assessment is mainly performed wit...
Source: Current Breast Cancer Reports - January 17, 2019 Category: Cancer & Oncology Source Type: research

Use of Multigene Prognostic Indices to Guide Clinical Decision-Making Regarding Adjuvant Systemic Therapy
AbstractPurpose of ReviewSeveral multigene assays have been developed to guide adjuvant therapy decisions for early-stage invasive breast cancer, including the 21-gene recurrence score, 70-gene assay, EndoPredict, PAM50 Risk of Recurrence, and Breast Cancer Index.Recent FindingsEach assay has varying levels of evidence to support the analytical validity, clinical validity, and clinical utility in providing prognostic information complementary to conventional clinical characteristics. While each test is able to identify patients at low risk of distant recurrence, understanding the differences in development and studies used...
Source: Current Breast Cancer Reports - November 19, 2018 Category: Cancer & Oncology Source Type: research

Novel Agents for the Management of Endocrine Resistant Breast Cancer
AbstractPurpose of ReviewMost women with hormone receptor (HR)-positive, HER2-negative (HR+/HER2 −) breast cancer will ultimately develop endocrine-resistant disease, either primary or acquired. This review will discuss the proposed mechanisms underlying endocrine resistance and key advances in the treatment of endocrine-resistant breast cancer.Recent FindingsEstrogen receptor 1 mutations (ESR1) occur in the majority of patients with HR+/HER2 − metastatic breast cancer after prolonged exposure to aromatase inhibitors. Data from the SoFEA trial showed that patients had improved progression-free survival (PFS) af...
Source: Current Breast Cancer Reports - November 15, 2018 Category: Cancer & Oncology Source Type: research

Optimizing HER2-Directed Therapy in Early-Stage Breast Cancer
AbstractPurpose of ReviewHER2-positive early breast cancer has been revolutionized by the development of HER2-directed therapy, which has significantly reduced breast cancer recurrence risk and improved overall survival. Here, we review the available treatment options for this patient population and discuss how we might individualize therapy in the future to optimize the balance of efficacy and toxicity.Recent FindingsThe addition of pertuzumab to a trastuzumab-based adjuvant regimen improves pathologic complete response rates and invasive disease-free survival (DFS). Addition of neratinib for patients with high-risk disea...
Source: Current Breast Cancer Reports - November 6, 2018 Category: Cancer & Oncology Source Type: research

Bone-Modifying Agents in Early-Stage and Advanced Breast Cancer
AbstractPurpose of ReviewBone-modifying agents have an important role in the treatment of patients with bone mineral density loss, early-stage breast cancer to reduce risk of recurrence, and metastatic breast cancer with bone involvement. Here we review mechanisms of action of these agents and clinical indications for their use.Recent FindingsThe meta-analysis undertaken by the Early Breast Cancer Trialists ’ Collaborative Group showed that the use of bisphosphonates was associated with a decreased risk of breast cancer recurrence.SummaryThe effect of bisphosphonates and receptor activator of nuclear factor kappa-B l...
Source: Current Breast Cancer Reports - October 25, 2018 Category: Cancer & Oncology Source Type: research

Non-hormonal Chemoprevention
AbstractPurpose of reviewPotential strategies for prevention of breast cancer include lifestyle modification, preventive therapies (i.e., chemoprevention), and surgical prevention. Several therapies (such as selective estrogen response modifiers and aromatase inhibitors) have been shown to prevent breast cancer. However, tolerability and toxicity limit use and these therapies only prevent estrogen receptor –positive (ER) disease. There is emerging data regarding prevention properties of several non-hormonal agents. These agents generally have lower toxicities and seem to be effective for reduction of both ER+ and ER&...
Source: Current Breast Cancer Reports - October 23, 2018 Category: Cancer & Oncology Source Type: research

Phased Implementation as a Strategy for Stepwise, Sustainable Improvement in Breast Healthcare in Low-Resource Settings
(Source: Current Breast Cancer Reports)
Source: Current Breast Cancer Reports - October 20, 2018 Category: Cancer & Oncology Source Type: research

Updates on Targeted Therapy for Triple-Negative Breast Cancer (TNBC)
AbstractPurpose of ReviewWe will provide a brief update of the most recent advances in targeted therapies for triple-negative breast cancer (TNBC) to help guide the practicing oncologist faced with the dilemma of how to treat this complex disease.Recent FindingsThe current standard of care remains chemotherapy, with recent data supporting the use of platinum agents and poly(ADP-ribose) polymerases (PARP) inhibitors. Immune checkpoint inhibitor trials have also shown efficacy.SummaryTNBCs are grouped together, yet there is an extraordinary amount of diversity amongst these cancers, which have distinct molecular subtypes tha...
Source: Current Breast Cancer Reports - October 6, 2018 Category: Cancer & Oncology Source Type: research

Updates on Molecular Classification of Triple Negative Breast Cancer
AbstractPurpose of ReviewClinical management of triple negative breast cancer (TNBC) is challenging as patients have heterogeneous responses to systemic therapy, and there is no established therapeutic target. Gene expression profiling and genomic sequencing analysis are among the first steps in understanding the biology of TNBC. In this paper, we review the molecular classification of TNBC and discuss the implications for systemic therapy.Recent FindingsClonal and mutational spectrum analyses of TNBC show that it is highly heterogeneous with a diverse mutational pattern and can be clustered into different subtypes includi...
Source: Current Breast Cancer Reports - September 24, 2018 Category: Cancer & Oncology Source Type: research

Breast Cancer Disparities Among Women in Underserved Communities in the USA
AbstractPurpose of ReviewBreast cancer disparities that exist between high-income countries (HIC) and low- and middle-income countries (LMICs) are also reflected within population subgroups throughout the United States (US). Here we examine three case studies of US populations “left behind” in breast cancer outcomes/equity.Recent FindingsAfrican Americans in Chicago, non-Latina White women in Appalachia, and Latinas in the Yakima Valley of Washington State all experience a myriad of factors that contribute to lower rates of breast cancer detection and appropriate treatment as well as poorer survival. These fact...
Source: Current Breast Cancer Reports - September 1, 2018 Category: Cancer & Oncology Source Type: research

Breast Cancer Disparities Among Women in Low- and Middle-Income Countries
AbstractPurpose of ReviewThe burden of breast cancer in low-income and middle-income countries transitioning to higher levels of human development is a public health crisis, set to increase dramatically in the coming decades. This paper provides an overview of the burden in human and economic terms, a summary of the costs, and cost-effective analyses for breast cancer interventions and suggests a way forward through research to better inform national, regional, and global policies for breast cancer control.Recent FindingsInequitable access to effective health services for breast cancer is striking between and within countr...
Source: Current Breast Cancer Reports - September 1, 2018 Category: Cancer & Oncology Source Type: research

Palliative Care in the Caribbean Through the Lens of Women with Breast Cancer: Challenges and Opportunities
AbstractBackgroundAcross the Caribbean, too many women are presenting with advanced breast cancer and dying with little or no access to palliative care. No comprehensive assessment of current capacity to deliver palliative care in the region exists, largely due to limited data. We assess the challenges in delivering palliative care for breast cancer patients in the Caribbean, highlighting the needs and experiences of low-income women through emblematic patient narratives.Recent FindingsThere is an urgent need to improve access to palliative care and pain relief throughout the region. Challenges include insufficient healthc...
Source: Current Breast Cancer Reports - September 1, 2018 Category: Cancer & Oncology Source Type: research

Early Diagnosis of Breast Cancer in the Absence of Population-Based Mammographic Screening in Asia
AbstractPurpose of ReviewAsia is made up of mainly low- and middle-income countries, where the majority of breast cancer presents as late-stage disease where survival is poor even with treatment. We review methods of early diagnosis of breast cancer in countries where population-based mammographic screening is not feasible.Recent findingsWhile there is insufficient evidence that breast self-examination and clinical breast examination (CBE) lead to a reduction in breast cancer mortality, recent trials have shown that screening with CBE successfully reduces stage at diagnosis, which may translate to improved breast cancer su...
Source: Current Breast Cancer Reports - September 1, 2018 Category: Cancer & Oncology Source Type: research

Risk and Prevention for Highly Penetrant Genes
AbstractPurpose of ReviewApproximately 10% of breast cancer cases are attributed to a hereditary predisposition. Here, we review the risks and management options for highly penetrant genes includingBRCA1/2,TP53,PTEN,CDH1,STK11, andPALB2 which confer a 5 to greater than 10-fold increased risk of breast cancer, and an increased risk of other cancers.Recent FindingsRisk-reducing salpingo-oophorectomy (RRSO) reduces mortality inBRCA1/2 carriers. Other management strategies are tailored to the hereditary cancer syndrome in question and include more intensive screening with imaging and serologic studies, risk-reducing surgeries ...
Source: Current Breast Cancer Reports - September 1, 2018 Category: Cancer & Oncology Source Type: research

Access to Affordable Breast Cancer Care in Eastern Europe
AbstractPurpose of ReviewThe majority of Central and Eastern European (CEE) countries report inferior breast cancer survival rates compared with Western European countries. We review limitations in access to screening programs, surgery, radiotherapy, pathology, palliative care, and antineoplastic medicines as potential explanations for these disparities.Recent FindingsMost CEE countries do not have the quality and quantity of radiotherapy needed to adequately service the population. Surgical services are widely accessible, but sentinel node biopsy is not universally available. There are important limitations for CEE patien...
Source: Current Breast Cancer Reports - September 1, 2018 Category: Cancer & Oncology Source Type: research

Management of Lobular Neoplasia
AbstractPurpose of ReviewLobular neoplasia (LN) is a well-established risk factor and non-obligate precursor for breast cancer. The clinical breast cancer risk assessment and management for these patients can be challenging.Recent FindingsNumerous studies have confirmed that LN is a risk factor and non-obligate precursor for breast cancer. The molecular profile of LCIS is similar to invasive lobular carcinoma. Surgical excision is generally recommended after core biopsy, but there may be a subset of patients with LN who may be observed without surgery. The significant increase in breast cancer risk associated with this dis...
Source: Current Breast Cancer Reports - September 1, 2018 Category: Cancer & Oncology Source Type: research

Moderate-Penetrance Predisposition to Breast Cancer
AbstractPurpose of ReviewResearch over the past 25  years has revealed much about the architecture of predisposition to breast and ovarian cancer. There is now a general understanding that there are three broad categories of germline variation that may increase risk. First, there are the “high-penetrance” genes associated with a relative risk f or cancer of greater than 5 and demonstrating an autosomal dominant pattern of inheritance. At the other end of the spectrum are “low-penetrance” common variants. These variants are associated with minor increases in risk (commonly less than a relative r...
Source: Current Breast Cancer Reports - September 1, 2018 Category: Cancer & Oncology Source Type: research

The Role of Quality Measures in Improving Breast Cancer Care in Low-Income Countries
AbstractPurpose of ReviewMeasurement of the quality of cancer care is foundational to quality improvement, and widely pursued in high-income countries. However, cancer care quality measurement has not yet been systematically attempted in low-income countries (LICs). We aimed to describe key considerations in developing quality measures for breast cancer care in LICs, and explore challenges and next steps.Recent FindingsThere are no published reports of systematically developed quality measures from LICs, and few reports of care quality. However, existing resource-stratified treatment guidelines can help facilitate measure ...
Source: Current Breast Cancer Reports - September 1, 2018 Category: Cancer & Oncology Source Type: research

Factors Contributing to Late-Stage Breast Cancer Presentation in sub-Saharan Africa
AbstractPurpose of ReviewLate stage at breast cancer diagnosis is a major contributor to poor survival from breast cancer in many sub-Saharan African countries. Using Ugandan as an example, we discuss barriers along the journey to diagnosis and highlight areas where improvements are needed.Recent FindingsIn Uganda, the majority of breast cancer patients noticed symptoms of their cancer for at least 9  months prior to diagnosis, which is typical of many African countries. For most women, the health provider delay is extensive, owing to barriers related to cost, transport, stigma, provider knowledge, and difficult-to-na...
Source: Current Breast Cancer Reports - September 1, 2018 Category: Cancer & Oncology Source Type: research

Lifestyle Interventions for Breast Cancer Prevention
AbstractPurpose of ReviewOne in eight women in the USA will develop breast cancer in her lifetime. Despite established efficacy, the use of pharmacotherapy for breast cancer prevention is limited by concerns over toxicities that may negatively influence quality of life. Additional interventions for breast cancer prevention are needed.Recent FindingsThere is emerging evidence from observational studies that obesity, physical inactivity, sedentary behavior, and dietary patterns are associated with breast cancer risk. Randomized trials are necessary to provide unbiased efficacy estimates of lifestyle changes on breast cancer ...
Source: Current Breast Cancer Reports - September 1, 2018 Category: Cancer & Oncology Source Type: research