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Evidence-Based Strategies to Minimize the Likelihood of Axillary Lymph Node Dissection in Clinically Node-Positive Patients Following Neoadjuvant Chemotherapy
Surg Oncol Clin N Am. 2023 Oct;32(4):693-703. doi: 10.1016/j.soc.2023.05.003. Epub 2023 Jun 9.ABSTRACTDe-escalation of axillary management after neoadjuvant chemotherapy in clinically node-positive patients is feasible. The current literature shows this may be accomplished by sentinel lymph node biopsy (SLNB) with the use of dual tracer and removal of at least 2 sentinel lymph nodes, or by targeted axillary dissection (TAD). The accuracy of TAD has been consistently shown as better than that of SLNB. However, these techniques should only be offered to select patients without extensive axillary disease, understanding that l...
Source: Clinical Breast Cancer - September 15, 2023 Category: Cancer & Oncology Authors: Ashley A Woodfin Abigail S Caudle Source Type: research
Is Axillary Staging Obsolete in Early Breast Cancer?
This article reviews the incidence of nodal metastases in early-stage breast cancer and the need for axillary staging to maintain local control in the axilla or to determine the need for adjuvant systemic therapy across the spectrum of patients with breast cancer, and reviews clinical trials addressing this question. At present, sentinel lymph node biopsy should be omitted in women age ≥70 years with cT1-2 N0, HR+/HER2- cancers. The importance of nodal status in selecting patients for radiotherapy remains the main reason for axillary staging in younger postmenopausal women with cT1-2N0, HR+/HER2- cancers.PMID:37714636 | ...
Source: Clinical Breast Cancer - September 15, 2023 Category: Cancer & Oncology Authors: Monica Morrow Source Type: research
How to Navigate the Treatment Spectrum from Multimodality Therapy to Observation Alone for ductal carcinoma in situ
Surg Oncol Clin N Am. 2023 Oct;32(4):663-673. doi: 10.1016/j.soc.2023.05.011. Epub 2023 Jun 15.ABSTRACTDCIS detection has increased dramatically since the introduction of screening mammography. Current guidance concordant care recommends surgical intervention for all patients with DCIS, followed by radiation and/or endocrine therapy for some. Adjuvant therapies after surgical excision have reduced recurrence rates but not breast cancer mortality. Given the lack of evidence of current treatment regimens and the morbidity associated with these treatments, there is concern that DCIS is over-treated. Active surveillance may be...
Source: Clinical Breast Cancer - September 15, 2023 Category: Cancer & Oncology Authors: Sydney M Record Eun-Sil Shelley Hwang Akiko Chiba Source Type: research
Individualizing Breast Cancer Risk Assessment in Clinical Practice
Surg Oncol Clin N Am. 2023 Oct;32(4):647-661. doi: 10.1016/j.soc.2023.05.013. Epub 2023 Jul 6.ABSTRACTMultiple tools exist to assess a patient's breast cancer risk. The choice of risk model depends on the patient's risk factors and how the calculation will impact care. High-risk patients-those with a lifetime breast cancer risk of ≥20%-are, for instance, eligible for supplemental screening with breast magnetic resonance imaging. Those with an elevated short-term breast cancer risk (frequently defined as a 5-year risk ≥1.66%) should be offered endocrine prophylaxis. High-risk patients should also receive guidance on mod...
Source: Clinical Breast Cancer - September 15, 2023 Category: Cancer & Oncology Authors: Amy E Cyr Kaitlyn Kennard Source Type: research
Breast Cancer Risk Reduction: Current Status and Emerging Trends to Increase Efficacy and Reduce Toxicity of Preventive Medication
Surg Oncol Clin N Am. 2023 Oct;32(4):631-646. doi: 10.1016/j.soc.2023.05.001. Epub 2023 Jun 15.ABSTRACTThe primary prevention of breast cancer is a worthwhile goal for which the efficacy of antiestrogens is well established. However, implementation has been problematic related to low prioritization by providers and the reluctance of high-risk women to experience medication side effects. Emerging solutions include improved risk estimation through the use of polygenic risk scores and the application of radiomics to screening mammograms; and optimization of medication dose to limit toxicity. The identification of agents to pr...
Source: Clinical Breast Cancer - September 15, 2023 Category: Cancer & Oncology Authors: Seema Ahsan Khan Source Type: research
Prognostic model of ER-positive, HER2-negative breast cancer predicted by clinically relevant indicators
CONCLUSION: To generate nomograms that predicted DFS and OS, independent predictors of DFS in ER-positive/HER2-negative breast cancer patients were chosen. The nomograms successfully stratified patients into prognostic categories and worked well in both internal validation and external validation.PMID:37713046 | DOI:10.1007/s12094-023-03316-0
Source: Clinical Breast Cancer - September 15, 2023 Category: Cancer & Oncology Authors: Xinming Song Pintian Wang Ruiling Feng Mandika Chetry E Li Xiaohua Wu Zewa Liu Shasha Liao Jing Lin Source Type: research
Machine learning- and WGCNA-mediated double analysis based on genes associated with disulfidptosis, cuproptosis and ferroptosis for the construction and validation of the prognostic model for breast cancer
CONCLUSION: Multiplex analysis based on DRGs, CRGs and FRGs correlated strongly with BC, providing new insights for developing clinical prognostic tools and designing immunotherapy regimens for BC patients.PMID:37712959 | DOI:10.1007/s00432-023-05378-7
Source: Clinical Breast Cancer - September 15, 2023 Category: Cancer & Oncology Authors: Lijun Xu Shanshan Wang Dan Zhang Yunxi Wu Jiali Shan Huixia Zhu Chongyu Wang Qingqing Wang Source Type: research
The value of radiomics model based on ultrasound image features in the differentiation between minimal breast cancer and small benign breast masses
CONCLUSION: The radiomics model based on ultrasound image features has a satisfied predictive ability for small breast masses, and is expected to become a potential tool for the diagnosis of MBC, and it is a zero cost (in terms of patient participation and imaging time).PMID:37712556 | DOI:10.1002/jcu.23556
Source: Clinical Breast Cancer - September 15, 2023 Category: Cancer & Oncology Authors: Shuyi Lyu Meiwu Zhang Baisong Zhang Jiazhen Zhu Libo Gao Yuqin Qiu Liu Yang Yan Zhang Source Type: research
Antibody-drug conjugates in breast cancer: overcoming resistance and boosting immune response
J Clin Invest. 2023 Sep 15;133(18):e172156. doi: 10.1172/JCI172156.ABSTRACTAntibody-drug conjugates (ADCs) have emerged as a revolutionary therapeutic class, combining the precise targeting ability of monoclonal antibodies with the potent cytotoxic effects of chemotherapeutics. Notably, ADCs have rapidly advanced in the field of breast cancer treatment. This innovative approach holds promise for strengthening the immune system through antibody-mediated cellular toxicity, tumor-specific immunity, and adaptive immune responses. However, the development of upfront and acquired resistance poses substantial challenges in maximi...
Source: Clinical Breast Cancer - September 15, 2023 Category: Cancer & Oncology Authors: Hannah L Chang Blake Schwettmann Heather L McArthur Isaac S Chan Source Type: research
Correction: Andrographolide inhibits breast cancer through suppressing COX-2 expression and angiogenesis via inactivation of p300 signaling and VEGF pathway
J Exp Clin Cancer Res. 2023 Sep 16;42(1):241. doi: 10.1186/s13046-023-02818-7.NO ABSTRACTPMID:37715266 | PMC:PMC10504694 | DOI:10.1186/s13046-023-02818-7
Source: Clinical Genitourinary Cancer - September 15, 2023 Category: Cancer & Oncology Authors: Yulin Peng Yan Wang Ning Tang Dongdong Sun Yulong Lan Zhenlong Yu Xinyu Zhao Lei Feng Baojing Zhang Lingling Jin Fabiao Yu Xiaochi Ma Chuanzhu Lv Source Type: research
Low interobserver agreement among subspecialised breast pathologists in evaluating HER2-low breast cancer
CONCLUSIONS: Subspecialised breast pathologists have suboptimal agreement for immunohistochemical evaluation of HLBC using the modified Ki-67 methodology. An urgent need remains for a new assay/algorithm to reliably evaluate HLBC.PMID:37714693 | DOI:10.1136/jcp-2023-209055
Source: Clinical Genitourinary Cancer - September 15, 2023 Category: Cancer & Oncology Authors: Gulisa Turashvili Yuan Gao Di Andy Ai Abdulwahab M Ewaz Sandra Gjorgova Gjeorgjievski Qun Wang Thi T A Nguyen Chao Zhang Xiaoxian Li Source Type: research
Personalizing Breast Cancer Care
Surg Oncol Clin N Am. 2023 Oct;32(4):xv-xvi. doi: 10.1016/j.soc.2023.06.001. Epub 2023 Jun 21.NO ABSTRACTPMID:37714647 | DOI:10.1016/j.soc.2023.06.001
Source: Clinical Genitourinary Cancer - September 15, 2023 Category: Cancer & Oncology Authors: Melissa Pilewskie Source Type: research
Lasting Impacts of the COVID-19 Pandemic on Breast Cancer Diagnosis and Treatment in the United States
Surg Oncol Clin N Am. 2023 Oct;32(4):811-819. doi: 10.1016/j.soc.2023.05.010. Epub 2023 May 10.ABSTRACTThe COVID-19 pandemic was an unprecedented time that placed unique challenges on the screening and treatment of breast cancer in the United States. Collaboration among medical disciplines and societies provided guidelines and strategies to mitigate the exposure of patients and medical providers to the virus and provide optimal care. We discuss the changes that the pandemic had on the multidisciplinary management of breast cancer.PMID:37714645 | PMC:PMC10169575 | DOI:10.1016/j.soc.2023.05.010
Source: Clinical Genitourinary Cancer - September 15, 2023 Category: Cancer & Oncology Authors: Jenna L Sturz Judy C Boughey Source Type: research
Addressing Inequalities in Breast Cancer Care Delivery
Surg Oncol Clin N Am. 2023 Oct;32(4):799-810. doi: 10.1016/j.soc.2023.05.009. Epub 2023 Jun 16.ABSTRACTBreast cancer treatment, timeliness of care, and clinical outcomes are inferior for patients of Black race and Hispanic ethnicity, and the origin of these inequities is multifactorial. Owing to aggregate reporting of data in the United States for patients of Asian, Native Hawaiian, and Pacific Islander ancestry, disparities within and across these groups are difficult to appreciate. In large part due to low prevalence, male breast cancer remains understudied, and treatment algorithms are primarily extrapolated from resear...
Source: Clinical Genitourinary Cancer - September 15, 2023 Category: Cancer & Oncology Authors: Leisha C Elmore Oluwadamilola M Fayanju Source Type: research
