Breast Cancer Risk and Screening in Transgender Individuals
AbstractPurpose of ReviewThere are over 1.4 million individuals who identify as transgender in the USA, and these individuals are frequently treated with cross-sex hormonal therapy (CSH) to acquire their desired phenotype. Simultaneously, breast cancer is one of the most common cancers in the USA, and there are mixed data on how CSH may influence breast cancer development in transgender individuals. Here, we review the barriers that exist to health access in this population, the current evidence of breast cancer risk in transgender individuals, and breast cancer screening guidelines for both transgender women and men.Recen...
Source: Current Breast Cancer Reports - January 4, 2021 Category: Cancer & Oncology Source Type: research
Model-Based Patterns of Lymphedema Symptomatology: Phenotypic and Biomarker Characterization
This study aimed to identify lymphedema symptom patterns and the association of such patterns with phenotypic characteristics and biomarkers using latent class analysis (LCA). A prospective, descriptive, and repeated-measure design was used to enroll 140 women and collect data.Recent FindingsLCA identified three distinct lymphedema symptom classes at 8 weeks and 12 months post-surgery: low, moderate, and severe symptom classes and associated phenotypic characteristics. Participants were more likely to be in the severe symptom classes at 12 months post-surgery if they had lower education level, cording, an axillary synd...
Source: Current Breast Cancer Reports - November 24, 2020 Category: Cancer & Oncology Source Type: research
Locoregional Management of Inflammatory Breast Cancer
AbstractPurpose of ReviewInflammatory breast cancer (IBC) is a biologically aggressive subtype with a high risk for rapid local progression and early distant metastasis. We review the updated data for optimal locoregional management of IBC, including areas of active controversy.Recent FindingsAdvancements in tri-modality therapies have improved survival among IBC patients in recent years; however, the risk of locoregional and distant recurrence remains high, particularly in triple-negative IBC. Data to support de-escalation of surgery or radiotherapy is limited, and the recommended treatment approach for non-metastatic IBC...
Source: Current Breast Cancer Reports - November 18, 2020 Category: Cancer & Oncology Source Type: research
Addressing Fertility: an Essential Aspect of Comprehensive Care for Young Patients with Breast Cancer
AbstractPurpose of ReviewApproximately 12,000 women between 20 and 39 years of age are diagnosed with invasive breast cancer (BC) annually in the USA. We aim to summarize data regarding the impact of BC treatment on fertility and strategies for fertility preservation in young women with BC.Recent FindingsStandard curative therapies for breast cancer can lead to subfertility, infertility, and primary ovarian insufficiency by their direct gonadotoxic effects and/or by delaying the age at which a woman can attempt pregnancy. Oocyte and embryo cryopreservation are the preferred options for fertility preservation and, if done...
Source: Current Breast Cancer Reports - November 13, 2020 Category: Cancer & Oncology Source Type: research
Impact of Breast Cancer Systemic Therapies on Fertility
AbstractPurpose of ReviewMany young women diagnosed with breast cancer will be confronted with premature ovarian insufficiency and infertility as a consequence of systemic therapies used to treat their cancer. This is a concern for nearly half of young women diagnosed with breast cancer. We will review the impact of breast cancer chemotherapy, endocrine therapy, and immunotherapy on fertility and surrogate markers of fertility.Recent FindingsModern breast cancer treatments continue to have an impact on a woman ’s fertility potential. This risk is reduced as more patients are able to safely eliminate chemotherapy as part ...
Source: Current Breast Cancer Reports - November 10, 2020 Category: Cancer & Oncology Source Type: research
De-Escalation of Local-Regional Therapy for Older Breast Cancer Patients
AbstractPurpose of ReviewOver the past decade, prospective clinical trials and retrospective data have changed clinical guidelines for the treatment of older patients, most notably those patients with early, hormone receptor-positive, clinically node-negative breast cancer. Here is a comprehensive review of the literature supporting de-escalation of local-regional therapy in older patients with breast cancer.Recent FindingsThe de-escalation of treatment in elderly patients includes minimizing surgical interventions and adjuvant radiation therapy. Current Choosing Wisely ® guidelines recommend considering the omission of s...
Source: Current Breast Cancer Reports - November 9, 2020 Category: Cancer & Oncology Source Type: research
Regional Nodal Recurrence after Treatment for Breast Cancer
AbstractPurpose of ReviewRegional nodal recurrence (RNR) after breast cancer treatment is historically rare but associated with worse survival outcomes. The management of primary breast cancer has changed significantly, with less completion axillary dissection (ALND) and increased use of genomic testing, neoadjuvant therapy, and regional nodal irradiation. This review examines the incidence, risk factors, presentation, treatment, and prognosis of RNR in the context of modern breast cancer treatment.Recent FindingsThe rate of RNR recurrence is low (< 3%) in modern studies. Tumor biology and nodal burden play an import...
Source: Current Breast Cancer Reports - November 6, 2020 Category: Cancer & Oncology Source Type: research
Impact and Timing of Breast Cancer Radiation Therapy and Fertility Preservation
In conclusion, the impact that breast radiation appears to have on fertility is low and, in our opinion, should not result in patients choosing mastectomy over breast conservation therapy due to fears of infertility. However, further studies specifying the patients receiving breast radiation and requiring fertility preservation methods are warranted to help reassure patients and their providers. (Source: Current Breast Cancer Reports)
Source: Current Breast Cancer Reports - November 5, 2020 Category: Cancer & Oncology Source Type: research
Ovarian Tissue Cryopreservation and Novel Bioengineering Approaches for Fertility Preservation
AbstractPurpose of ReviewBreast cancer patients who cannot delay treatment or for whom hormone stimulation and egg retrieval are contraindicated require alternative methods of fertility preservation prior to gonadotoxic treatment. Ovarian tissue cryopreservation is an alternative approach that may offer patients the opportunity to preserve fertility and carry biologically related children later in life. Various experimental approaches are being explored to obtain mature gametes from cryopreserved and thawed ovarian tissue for fertilization and implantation using biomimetic tissue culture in vitro. Here, we review the most ...
Source: Current Breast Cancer Reports - November 4, 2020 Category: Cancer & Oncology Source Type: research
Oocyte Donation, Gestational Carriers, and Adoption for Breast Cancer Survivors
AbstractPurpose of ReviewThe purpose of this review is to describe and compare the use of oocyte donation, gestational carriers, and adoption for family building specifically in women with a history of breast cancer.Recent FindingsOocyte donation is an effective and safe option for women whose exposure to gonadotoxic cancer therapy has resulted in primary ovarian insufficiency, or for women with a familial cancer syndrome who are concerned about genetic risk to their offspring. A gestational carrier may also be considered —with or without oocyte donation—depending on the patient’s acceptance of ovarian stimulation an...
Source: Current Breast Cancer Reports - November 3, 2020 Category: Cancer & Oncology Source Type: research
New Frontiers in Hypofractionation for Regional Nodal Irradiation in Breast Cancer
AbstractPurpose of ReviewIn recent years, there have been a number of small, yet notable practice changes in the delivery of postmastectomy radiation therapy (PMRT) in breast cancer patients. Herein, we describe the role of PMRT and its evolving delivery with hypofractionated regimens.Recent FindingsThe UK START trials and whole-breast hypofractionation studies established the safety and effectiveness of accelerated radiotherapy. This has inspired further investigations of similar principles in patients with reconstruction, acute and late toxicities associated with hypofractionated regimens, socioeconomic benefit, and evol...
Source: Current Breast Cancer Reports - October 27, 2020 Category: Cancer & Oncology Source Type: research
Leveraging Neoadjuvant Chemotherapy to Minimize the Burden of Axillary Surgery: a Review of Current Strategies and Surgical Techniques
AbstractPurpose of ReviewAxillary nodal disease is significantly less likely in both clinically node-negative (cN0) and node-positive (cN+) breast cancer patients after neoadjuvant chemotherapy (NAC). There have thus been significant efforts to “de-escalate” axillary surgery in this setting. This review discusses modern axillary surgical paradigms and techniques after NAC.Recent FindingsIn cN0 patients, the accuracy and feasibility of sentinel lymph node biopsy (SLNB) after NAC is well-established, with prospective evidence supporting its oncologic safety. SLNB is also acceptable in select cN+ patients when certain cri...
Source: Current Breast Cancer Reports - October 24, 2020 Category: Cancer & Oncology Source Type: research
Breast Cancer-Related Lymphedema: a Review of Risk Factors, Radiation Therapy Contribution, and Management Strategies
AbstractPurpose of ReviewIn recent years, breast cancer-related lymphedema (BCRL), which affects one in five patients treated for breast cancer (BC), has garnered increasing interest by clinicians and researchers as BC survival rates improve and survivorship issues become increasingly imperative. This review represents an overview of the literature for BCRL risk factors, such as radiation therapy (RT), screening, and treatment.Recent FindingsRisk factors with strong evidence include axillary surgery, regional lymph node radiation, elevated body mass index, cellulitis, and subclinical edema. Neoadjuvant and taxane-based che...
Source: Current Breast Cancer Reports - October 24, 2020 Category: Cancer & Oncology Source Type: research
Accelerated Partial Breast Irradiation (APBI): Where Are We Now?
AbstractPurpose of ReviewAccelerated partial breast irradiation (APBI) is an alternative approach to breast conserving therapy (BCT) where radiation (RT) is delivered over a shorter period of time compared with whole breast irradiation (WBI), resulting in improved patient convenience and cost savings. APBI can be delivered using brachytherapy, intraoperative RT, or conformal external beam radiation therapy (EBRT) techniques. In this review, the authors appraise the latest modern randomized controlled trials (RCTs) of APBI and discuss the application of the data to clinical practice.Recent FindingsThe OCOG-RAPID and NSABP B...
Source: Current Breast Cancer Reports - October 18, 2020 Category: Cancer & Oncology Source Type: research
Hypofractionated Whole Breast Radiotherapy and Boost in Early-Stage Breast Cancer
AbstractPurpose of ReviewTo review postlumpectomy whole breast irradiation (WBI) in early-stage breast cancer with regard to the use of hypofractionation and a tumor bed boost.Recent FindingsHypofractionation is currently standard practice for most cases of postlumpectomy WBI. A boost is recommended for women at increased risk for local recurrence due to clinical or pathologic risk factors. A sequential boost is currently standard practice for WBI with either conventional or hypofractionated radiation. Phase I –II trials of hypofractionation and concurrent boost have shown comparably low risks for local recurrence and ac...
Source: Current Breast Cancer Reports - October 16, 2020 Category: Cancer & Oncology Source Type: research
