October 21, 2008
Expert review calls LHRH agonists “acceptable” for early breast cancer
LHRH agonists probably reduce the risk of recurrence and increase survival in premenopausal women with early breast cancer, whether used alone or in combination with tamoxifen. They’re an “acceptable alternative” to ovarian ablation or radiotherapy, concludes a systematic review from the Cochrane Collaboration.
They appear to reduce recurrence and mortality when used in combination with adjuvant chemotherapy. But evidence to date is too weak to draw strong conclusions, say the authors.
Perhaps results will be stronger when studies are done with the aid of genotyping.
Premenopausal women taking goserelin lose bone mass, but this is preventable with zoledronic acid, according to new results from an Austrian trial.
Research/Reviews
Why did it take so monopolize on endocrine factors in treating breast cancer (compared to HER-2, for instance)? Authors from Johns Hopkins’ Kimmel Center ponder the question in a recent review found in this category.
Clinical Trials
Use this article category to find current clinical trials testing tamoxifen or goserelin for breast cancer in premenopausal women.
No Comments » | 
Breast, Cancer, Women | Tagged: early breast cancer, goserelin, LHRH agonists, tamoxifen | 
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Posted by smnewsletters
October 7, 2008
New test tells who can avoid adjuvant therapy for ER+ breast cancer
A newly published profile of postoperative clinical and biological markers accurately identifies those women with estrogen receptor-positive breast cancer who would benefit from post-operative adjuvant therapy and those who would not. The report from an international team appears in the current Journal of the National Cancer Institute.
They developed the profile using 60-month followup outcomes from the P024 neoadjuvant chemotherapy trial of letrozole and tamoxifen. They validated it by analyzing data from the IMPACT trial of anastrozole and tamoxifen.
The authors call their panel of indicators the preoperative endocrine prognostic index (PEPI). It includes:
* pathological tumor size
* node status
* level of the cell-cycle marker antigen Ki67, and
* postoperative ER status.
Only last month an editorial in Journal of Clinical Oncology trumpeted a report of another prognostic panel for estrogen receptor-positive breast cancer.
As new tests proliferate, you can use SearchMedica to keep track of them.
Failing to report and assess estrogen-receptor subsets can have a dramatic effect on the results of clinical trials testing adjuvant therapy, according to a report in the latest JCO. The authors urge that every trial should include this information going forward.
Related searches
P024
Ki67
Research/Reviews
Turn to this category for a quick look at recent studies of ER+ breast cancer.
CME
Look here for recent accredited CME courses on the topic.
No Comments » | 
Breast, Cancer | Tagged: Breast, estrogen receptor, tamoxifen | 
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Posted by smnewsletters
August 26, 2008
Substantial recurrence risk shown to follow systemic breast cancer therapy
MD Anderson researchers found a 20% recurrence risk 10 years after breast cancer patients were declared disease-free following five years of adjuvant treatment. Results of the retrospective registry study appear in the August Journal of the National Cancer Institute.
No guidelines address this situation for premenopausal women. But the range of risk would justify adjuvant or neoadjuvant therapy at the time of diagnosis, according to the authors.
Predictors of late recurrence include:
* Hormone-positive tumors not treated with endocrine therapy
* Higher stage
Very recently the same team reported on the prognostic significance of Her2 status in inflammatory breast cancer.
Practical Articles/News
The query “breast cancer anxiety” in this article category delivers a recent review of psychological factors that predict emotional distress in breast cancer patients.
Research/Reviews
Two recent reports in this article category correlate receptor subtype with location of tumor recurrence in breast cancer.
No Comments » | 
Breast, Cancer, Women | Tagged: adjuvant therapy, Breast, her-2, neoadjuvant therapy | 
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Posted by smnewsletters
July 22, 2008
Beyond biopsy: Experimental blood test monitors NSCLC treatment
The Harvard/Mass General researchers who came up with a blood test that can monitor lung-cancer treatment have published their report in the New England Journal of Medicine.
The test uses a microchip that filters tumor cells bearing the carcinoma-specific epithelial cell adhesion molecule (EpCAM), and then scans them for EGFR mutations. In a 23-patient study, the noninvasive method genotyped tumor cells with 96% sensitivity. Presence of the drug-resistance mutation T790M, detectable in about 40% of patients, correlated with reductions in progression-free survival.
Detecting the evolution of resistance to receptor-targeted drugs would obviously avoid wasting time and money, not to mention human suffering, says an editorial. But whether the method will evolve into a clinically useful test remains to be seen.
Start with SearchMedica, and you can move quickly and easily to find relevant information on topics related to your original query.
Related Searches
EpCAM
T790M
Research Reviews
What’s the latest progress to monitor treatment by assaying circulating tumor cells in breast cancer?
CME
Remind yourself about EGFR mutations in lung cancer with an online course.
No Comments » | Breast, Cancer, Lung | Tagged: Breast, blood tests, lung cancer, lung biopsy | Permalink
Posted by smnewsletters
March 18, 2008
How many breast cancer patients (and MDs) ignore the greater risks?
The odds are about 50:50 that a breast cancer survivor over 60 will die as a result of something else – most likely heart disease or osteoporosis – according to a new report in the Journal of the National Cancer Institute. It calls for greater attention to these women’s other medical problems.
Another study in the same issue finds that women diagnosed with ductal carcinoma in situ (DCIS) radically overestimated their risk of progression to cancer or metastasis. They also showed “notable declines” in general health, vitality, and mental health during the 18 months after diagnosis.
A companion editorial to this study (look for the link at the bottom of the abstract) tentatively suggests a trial of “watchful waiting” for DCIS—rather than knee-jerk mastectomy. If it works for prostate cancer, then why not for this pre-malignant condition?
These articles aren’t full of advice about how to help patients who fret about their condition. But there are ideas elsewhere on SearchMedica.
Clinical Trials
Find the new trial mentioned in the DCIS editorial that is testing brief hormonal therapy before surgery. Researchers are looking for changes in tumor volume, with a goal of finding nonsurgical means to avert progression.
Patient Education
Find something worth sending home with a patient who will be thinking a long time about her diagnosis of early breast cancer.
No Comments » | Breast, Cancer, Mood Disorder, Women | Tagged: Breast, DCIS, heart disease, mastectomy, osteoporosis | Permalink
Posted by smnewsletters
December 12, 2007
A report in JNCI unveils a model of breast-cancer risk assessment created specifically for African-American women. Based in part on data from the Women’s Contraceptive and Reproductive Experience (CARE) study, the new CARE model shows that 30% of African-American women should have qualified for the STAR trial of breast cancer prevention. That protocol used the standard NCI Breast Cancer Risk Assessment Tool (BRCAT), which judged only 15% eligible.
The new tool is not recommended for women who have BRCA mutations or a history of breast cancer.
Last July, Howard University researchers reported that a modified version of the BCRAT (or Gail model) was even worse at predicting risk in this population than the original Gail model itself.
A meta-analysis in JCO last year revealed that African-Americans have poorer outcomes from breast cancer treatment irrespective of socioeconomic factors. Risk counseling based on erroneous assessment must be among the reasons.
See what else you can find in the categories that sort your results by document type:
Clinical Trials for Patients
Learn more about the CARE study assessing breast cancer risk among white and African American women.
Practical Articles and News
Locate the Gail model itself on the National Cancer Institute website. (The new CARE model isn’t there yet. The NCI says it will be there shortly.)
No Comments » | Breast | Tagged: african american, brca, brcat, care model, clinical trials, gail model, nci, star trial | Permalink
Posted by Cranky Aged Mama
September 27, 2007
In approving Evista (raloxifene) for breast cancer prevention, the FDA offers a wonderful choice to women with osteoporosis and a high risk of breast cancer. For others (and their doctors) it may be a challenge to sort out the risks and benefits.
To refresh your memory: In June 2006, results from the STAR trial showed that raloxifene prevented most breast cancer with fewer side effects than tamoxifen, while reducing the risk of fracture. But tamoxifen scored better against noninvasive breast cancers.
Two months ago, the RUTH trial linked raloxifene to an increased risk of fatal stroke.
Results Organized by Category:
Clinical Trials for Patients
For sisters of breast cancer patients, a new clinical trial examining risk factors may provide a sense of contributing to a solution.
Patient Education Materials
Quickly find reliable information about raloxifene side effects to give a concerned patient.
No Comments » | Breast | Tagged: FDA, raloxifene | Permalink
Posted by Cranky Aged Mama
May 31, 2007
A new report from the National Cancer Institute notes a nationwide decline in mammography utilization between 2000 and 2005 in statistics from the National Health Interview Survey. This raises the unhappy possibility that the reported reduction in the incidence of breast cancer in recent years may be nothing more than observer error.
There were significant drops in mammography use among women in the highest risk group (those aged between 50 and 64) and among educated white women with health insurance—one group that has traditionally had regular mammograms.
Only last month, other experts were proposing that the recent decline in breast cancer rates was due to reduced use of hormone replacement therapy.
Refine you search with clinically useful categories:
Practice Guidelines
Remind yourself about what the guidelines are for mammography screening in primary care.
Practical Articles and News
What are the most effective ways to encourage your patients to get mammograms on schedule?
No Comments » | Breast | Tagged: mammography, screening | Permalink
Posted by Cranky Aged Mama
