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 contemporary ...
Source: Current Breast Cancer Reports - February 5, 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 16, 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 13, 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 13, 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 10, 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 7, 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 4, 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 4, 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 exclusively ...
Source: Current Breast Cancer Reports - December 1, 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 27, 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 24, 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 24, 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 retrospect...
Source: Current Breast Cancer Reports - November 24, 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 22, 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 21, 2019 Category: Cancer & Oncology Source Type: research
