Postmastectomy Radiation Modalities (Protons, Chest Wall Boost, Skin Bolus, Fractionation, and Timing) and Breast Reconstruction Complications: The Role of Radiation Oncologist
AbstractPurpose of ReviewIntegrating postmastectomy radiotherapy (PMRT) and breast reconstruction remains a multidisciplinary clinical challenge. While PMRT improves tumor outcomes in patients with locally advanced breast cancers, it increases breast reconstruction complications. Therefore, understanding the nuances of different surgical and PMRT techniques and their dynamic interaction is crucial to overcome such challenge.Recent FindingsIntroduction of new reconstruction techniques including single-stage implant reconstruction, different types of surgical mesh and pre-pectoral implants placement, allowed different approa...
Source: Current Breast Cancer Reports - August 5, 2023 Category: Cancer & Oncology Source Type: research
Regional Nodal Irradiation and Post-Mastectomy Radiation Therapy After Up-Front Surgery
AbstractPurpose of ReviewThis review serves to summarize available data impacting treatment decisions for the use of post-mastectomy radiation (PMRT) and regional nodal irradiation (RNI).Recent FindingsIn the last decade, there have been ongoing shifts in breast cancer management, including changes in the type and sequencing of systemic therapy tailored to receptor subtype and molecular profiling, changes to the surgical management of the regional nodes, and improvements in radiation treatment planning and delivery technology. In this chapter, we will consider historic and modern indications for PMRT and RNI after up-front...
Source: Current Breast Cancer Reports - August 4, 2023 Category: Cancer & Oncology Source Type: research
The Relevant Work of Breast Cancer Patient Associations in the Search for Quality Access to Care and Guarantee of Rights in Brazil
AbstractPurpose of ReviewBreast cancer care is a challenge of many proportions in Brazil ’s public health system (Unified Health System (SUS)). These bottlenecks are often the target of advocacy work by patient associations, whose advocacy effort is the focus of analysis of this review article.Recent FindingsSince the 1990s, social movements have occupied institutionalized spaces of social participation. The SUS, in turn, has several structural problems that often hinder navigation of cancer patients, resulting in long waiting times and poor outcomes.SummaryCancer advocacy in Brazil has been a crucial component to help i...
Source: Current Breast Cancer Reports - July 28, 2023 Category: Cancer & Oncology Source Type: research
Practical Approach to Establishing a Lymphedema Screening Program: Tips and Tricks
AbstractPurpose of ReviewBreast cancer-related lymphedema (BCRL)
affects approximately 1 in 5 women diagnosed with breast cancer. Improvements in overall survival cultivate a focus on breast cancer survivorship and quality of life. While personalized cancer care has allowed us to optimize oncologic outcomes and minimize treatment-related morbidity, treatments rendered for cancer cure continue to place our patients at risk for BCRL.Recent FindingsAlthough there is no definitive cure for BCRL, prospective screening has demonstrated lower rates of BCRL and lower rates of progression to late-stage disease. Prevention of la...
Source: Current Breast Cancer Reports - July 24, 2023 Category: Cancer & Oncology Source Type: research
Radiation Management of DCIS and Elimination of RT in Low-risk Disease
This study summarizes the management and outcomes of ductal carcinoma in situ (DCIS). It will review recent literature including data supporting the use of a radiation boost, partial breast irradiation, endocrine therapy, HER2 therapy, genomic assays, and omission of radiation or surgery.Recent FindingsEvidence suggests there are a cohort of patients who may benefit from either tumor bed boost, partial breast irradiation, or omission of radiation.SummaryThe management for DCIS is continuously evolving in order to identify patients who have higher risk features that necessitate aggressive treatment and those with more favor...
Source: Current Breast Cancer Reports - July 19, 2023 Category: Cancer & Oncology Source Type: research
Management of Local –Regional Recurrence of Breast Cancer
AbstractPurpose of ReviewLocoregional recurrence (LRR) of breast cancer represents a heterogenous spectrum of disease. Treatment strategies are tailored to each patient and are impacted by multiple factors. The intent of this review is to discuss recent studies and modern management of isolated LRR.Recent FindingsFor selected patients with small ipsilateral breast tumor recurrences, partial-breast irradiation following repeat breast-conserving surgery may be appropriate with acceptable rates of toxicities and promising local control. Over the past decade, numerous systemic therapies for the neoadjuvant or adjuvant treatmen...
Source: Current Breast Cancer Reports - July 15, 2023 Category: Cancer & Oncology Source Type: research
Optimizing the Treatment for Pregnancy-Associated Breast Cancer: a Case Example and Review of the Literature
AbstractPurpose of ReviewBreast cancer is the most common malignancy affecting women throughout the world, and accounts for 30% of new cancer diagnoses in women with overall lifetime risk hovering around 1/9. Pregnancy-associated breast cancer (PABC) is defined as breast cancer diagnosed during pregnancy or within 12 months of delivery. While accounting for up to 7% of cancers in women younger than 45, incidence is variable, with a higher preponderance among those with positive family history or a deleterious BRCA mutation. In this review, we provide a comprehensive overview of the epidemiology, diagnosis, and treatment pa...
Source: Current Breast Cancer Reports - July 12, 2023 Category: Cancer & Oncology Source Type: research
Partial Breast Radiation
AbstractPurpose of ReviewFollowing breast-conserving surgery, adjuvant radiation has traditionally been delivered using whole breast irradiation (WBI). Over the past several decades, multiple studies have evaluated the role of smaller target volumes for adjuvant radiation therapy delivered with partial breast irradiation (PBI) or intraoperative radiation therapy (IORT) techniques. The intent of this review is to provide an update on the role of PBI and IORT given recently published studies.Recent FindingsMultiple randomized trials evaluating PBI have been published with mature outcomes, demonstrating comparable rates of lo...
Source: Current Breast Cancer Reports - July 5, 2023 Category: Cancer & Oncology Source Type: research
Fractionation Approaches in Whole Breast RT
AbstractPurpose of ReviewTo review the current approaches to fractionation from phase III prospective randomized trials for postlumpectomy whole breast radiation therapy (WBRT) for early-stage breast cancer.Recent FindingsModerate hypofractionation (M-WBRT) given Monday through Friday over 3 –4 weeks is now standard practice for almost all patients needing postlumpectomy WBRT. The use of M-WBRT is being expanded to include regional node irradiation (RNI) and may be further shortened by a tumor bed boost that is concurrent rather than sequential to avoid extra days of treatment. And f or selected patients, there is now a...
Source: Current Breast Cancer Reports - July 3, 2023 Category: Cancer & Oncology Source Type: research
Exploiting Therapeutic Vulnerabilities in Triple-Negative Breast Cancer: Successes, Challenges, and Opportunities
AbstractPurpose of ReviewTriple-negative breast cancer (TNBC) is notoriously difficult to treat. Recent technological advances have led to the identification of novel targets and new approaches to treat this devastating disease. The aim of this review is to highlight therapeutic vulnerabilities of TNBC and discuss novel therapeutic strategies.Recent FindingsInterrogating the inherent heterogeneity and rich cellular and transcriptional diversity within TNBC has led to the discovery of vulnerabilities and actionable targets for therapeutic development. Characterization of the tumor immune environment, discovery of novel mole...
Source: Current Breast Cancer Reports - June 29, 2023 Category: Cancer & Oncology Source Type: research
Current Recommendations and Role of Breast Conservation Surgery for Multifocal or Multicentric Breast Cancer
AbstractPurpose of ReviewWith improvements in imaging, breast cancers are diagnosed at earlier stages and increasingly, with additional findings of multifocal or multicentric disease. The aim of this review is to challenge existing paradigms that these scenarios can only be addressed with a mastectomy.Recent FindingsTraditionally, multifocal or multicentric breast cancers have been addressed with a total mastectomy. Partial mastectomies have been attempted with the tacit understanding between patient and physician that the intervening tissue between cancer foci may contain cancer, and the safest oncologic decision would be...
Source: Current Breast Cancer Reports - June 24, 2023 Category: Cancer & Oncology Source Type: research
Metastatic Triple-Negative Breast Cancer
This article is a review of the latest key literature in the management of metastatic TNBC and offers a glimpse of ongoing drug development.Recent FindingsRecent paradigm-shifting trials led to the incorporation of immune checkpoint inhibitors with chemotherapy in the frontline setting for TNBC with positive PDL1-expression. Novel antibody –drug conjugates with new targets (Trop2, HER2) now offer additional treatment options for metastatic TNBC.SummaryThere have been significant strides in understanding the tumor-immune microenvironment and molecular vulnerabilities in TNBC. As the treatment of metastatic TNBC evolves ra...
Source: Current Breast Cancer Reports - June 17, 2023 Category: Cancer & Oncology Source Type: research
The Future of Lymphedema: Potential Therapeutic Targets for Treatment
AbstractPurpose of ReviewThis review aims to summarize the current knowledge regarding the pharmacological interventions studied in both experimental and clinical trials for secondary lymphedema.Recent FindingsLymphedema is a progressive disease that results in tissue swelling, pain, and functional disability. The most common cause of secondary lymphedema in developed countries is an iatrogenic injury to the lymphatic system during cancer treatment. Despite its high incidence and severe sequelae, lymphedema is usually treated with palliative options such as compression and physical therapy. However, recent studies on the p...
Source: Current Breast Cancer Reports - June 1, 2023 Category: Cancer & Oncology Source Type: research
Breast-to-Brain Metastasis: from Microenvironment to Plasticity
This article will focus on the dynamic intercellular communication between metastatic cancer cells, the tumor microenvironment, and neighboring brain cells to breach the brain ’s defenses and promote tumor progression.Recent FindingsRecent advances have further elucidated how tumor cells traverse through the blood –brain barrier and implicated the blood–cerebrospinal fluid barrier as a potential entry point. Tumor cells once within the brain milieu utilize factors secreted by and dynamically reprogram neurons, glial cells, and infiltrating leukocytes for their own colonization and survival.SummaryCurrent research has...
Source: Current Breast Cancer Reports - May 24, 2023 Category: Cancer & Oncology Source Type: research
Clinical Applications for Liquid Biopsy Assessment of Minimal Residual Disease in Breast Cancer
AbstractPurpose of ReviewWe review current techniques and applications for minimal residual disease (MRD) detection in patients without detectable metastasis using circulating tumor cells (CTC) and circulating tumor DNA (ctDNA) in breast cancer. We discuss the evidence for MRD detection in predicting patient outcomes and how these assays could be used to guide treatment decisions.Recent FindingsCurrent research has demonstrated that MRD detection through liquid biopsy techniques predicts patient outcomes. Increasingly, studies are showing MRD detection can be used to develop personalized treatment strategies based on the p...
Source: Current Breast Cancer Reports - May 12, 2023 Category: Cancer & Oncology Source Type: research
