Wednesday, December 14, 2011 (Last Updated: 12/15/2011)
The annual San Antonio Breast Cancer Symposium was held from Dec. 6 to 10 and attracted approximately 8,000 participants from around the world, including medical oncologists, radiation oncologists, researchers, and other health care professionals. The conference highlighted recent advances in the risk, diagnosis, treatment, and prevention of breast cancer, with presentations focusing on emerging treatments in hard-to-treat patient populations, including patients with metastatic breast cancer.
Dawn Hershman, M.D., of the Columbia University Medical Center in New York City, and colleagues found that fewer than 25 percent of women undergo breast reconstruction surgery after mastectomy.
"One of the factors that was shown to influence undergoing breast reconstruction after mastectomy was commercial insurance status. We found that patients with commercial insurance were more likely to get breast reconstruction after mastectomy as compared to patients without insurance or with Medicare or Medicaid. In addition, the influence of having commercial insurance on immediate reconstruction rates increased between 2000 and 2010," Hershman said.
The investigators also found that patients who had mastectomies done in rural hospitals, smaller hospitals, and at hospitals with a lower volume of mastectomies had a decreased likelihood of undergoing immediate breast reconstruction after mastectomy.
"While it is true that some women may choose not to undergo postmastectomy reconstruction, and some women may not be candidates, the associations we see suggest that access and finances have an independent influence on immediate reconstruction rates," Hershman said.
In a prospective, randomized, double-blind, phase 3 study, Alexander H.G. Paterson, M.D., of the University of Calgary in Canada, and colleagues found that clodronate only modestly reduced the incidence of distant metastases in postmenopausal women with breast cancer. However, the bisphosphonate was associated with limited adverse events.
The investigators randomized 3,311 patients with stage I, II, or III breast cancer to receive three years of clodronate or an oral placebo three times a day, with patients also undergoing surgery (lumpectomies or mastectomies) and receiving radiation therapy and chemotherapy or hormonal therapy. The investigators found that 286 patients who received clodronate and 312 who received placebo experienced disease events (defined as any cancer or death), indicating a 9 percent relative reduction of events in the clodronate group as compared with the placebo group.
"This reduction was smaller than had been hoped for and was not statistically significant," Paterson said in a statement.
Additionally, in those who received clodronate, the investigators found a 16 percent relative reduction in mortality as well as a relative reduction of 23 percent in the occurrence of skeletal metastases and a relative reduction of 26 percent in the occurrence of nonskeletal metastases.
"Although clodronate appeared more favorable for all end points, only the comparisons of the distant metastasis-free interval and nonskeletal metastasis-free interval were statistically significant and favorable for the clodronate patients," Paterson said in a statement.
The results of the study also suggest that clodronate may be more effective in patients aged 50 years or older when diagnosed with breast cancer and for women with estrogen receptor/progesterone receptor-positive nodes.
In the German Adjuvant Intergroup Node Positive study, Volker Möbus, Ph.D., of the Klinikum Frankfurt Hochst GmbH, and colleagues found that ibandronate did not improve disease-free survival in patients with breast cancer.
The investigators randomized 3,023 patients with breast cancer to two different chemotherapy regimens and then further assigned them to 50 milligrams of oral ibandronate or observation. The investigators found no significant difference in disease-free survival between those who received ibandronate versus those who underwent observation.
"So far, clinical trials of adjuvant bisphosphonates in early breast cancer have shown variable results, independent from their application (oral compared with intravenous)," Möbus said in a statement.
SABCS: Starch Intake Tied to Breast Cancer Recurrence
FRIDAY, Dec. 9 (HealthDay News) -- Higher carbohydrate intake, particularly starch, is linked to increased breast cancer recurrence risk, according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 6 to 10.
SABCS: BRCA1/2 Mutations Up Risk of Contralateral Breast Cancer
THURSDAY, Dec. 8 (HealthDay News) -- Women who have had unilateral breast cancer and carry BRCA1/2 genetic mutations have a higher risk of developing contralateral breast cancer (CBC), according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 6 to 10.
SABCS: Post-Mastectomy Reconstruction Factors ID'd
THURSDAY, Dec. 8 (HealthDay News) -- A minority of women with breast cancer undergo breast reconstruction after mastectomy, with higher rates seen in younger women (below 50 years) and those with commercial insurance, according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 6 to 10.
SABCS: Breast Cancer Survival Up With Everolimus + Exemestane
THURSDAY, Dec. 8 (HealthDay News) -- Everolimus plus exemestane improves progression-free survival (PFS) for postmenopausal women with hormone-receptor (HR)-positive breast cancer; and pertuzumab plus trastuzumab plus docetaxel improves PFS in human epidermal growth factor receptor type 2 (HER2)-positive metastatic breast cancer, according to two studies published online Dec. 7 in the New England Journal of Medicine to coincide with presentation at the annual San Antonio Breast Cancer Symposium, held from Dec. 6 to 10.
SABCS: Adjuvant Bevacizumab Ups Progression-Free Survival
THURSDAY, Dec. 8 (HealthDay News) -- For patients with human epidermal growth factor receptor 2 (HER2)-positive, locally recurrent/metastatic breast cancer (LR/mBC), the addition of bevacizumab (BEV) to trastazumab (H) and docetaxel (DOC) is associated with an increase in progression-free survival (PFS), according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 6 to 10.
SABCS: Long-Term Benefits for Zoledronic Acid in Breast Cancer
WEDNESDAY, Dec. 7 (HealthDay News) -- In the long-term, adjuvant zoledronic acid (ZOL) is associated with a significant reduction in disease-free survival (DFS) events and death in premenopausal women with endocrine-receptor positive early-stage breast cancer; and for postmenopausal women with hormone receptor-positive early breast cancer, immediate treatment with ZOL is associated with a reduced risk of DFS events, according to two studies presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 6 to 10.
SABCS: Dyslipidemia, Obesity After 60 Tied to Breast CA Risk
WEDNESDAY, Dec. 7 (HealthDay News) -- For women, having diabetes, being obese after age 60, or having abnormally low blood lipid levels are all associated with an increased breast cancer risk, according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 6 to 10.
SABCS: Whole Breast Radiation Beats Partial Brachytherapy
WEDNESDAY, Dec. 7 (HealthDay News) -- Accelerated partial breast brachytherapy (APBI-brachy), in older women with invasive breast cancer treated with conservative surgery, is less effective and more toxic than whole breast irradiation (WBI), according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 6 to 10.
Hematology & Oncology
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