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 28, 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 25, 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 24, 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 24, 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 vacuum-...
Source: Current Breast Cancer Reports - April 24, 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 17, 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 protocols, whi...
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) after taki...
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 ligan...
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− d...
Source: Current Breast Cancer Reports - October 23, 2018 Category: Cancer & Oncology Source Type: research
