case report - Granulosa cell tumor of the ovary after long-term use of tamoxifen and toremifene - Journal of Obstetrics and Gynaecology Research

Granulosa cell tumor of the ovary after long-term use of tamoxifen and toremifene - Tanaka - 2012 - Journal of Obstetrics and Gynaecology Research

Abstract

The relation between the use of tamoxifen and gynecologic tumors has been documented. In this case, a 58-year-old postmenopausal woman had been treated with tamoxifen for 5 years followed by toremifene for 1.5 years due to the presence of stage II estrogen receptor-positive breast cancer. The patient was found to have a stage Ic granulosa cell tumor of the ovary despite undergoing annual gynecologic examinations. This report presents a case of granulosa cell tumor of the ovary after the long-term use of tamoxifen and toremifene

Inflammatory Breast Cancer: What We Know and What We Need to Learn

Inflammatory Breast Cancer: What We Know and What We Need to Learn:

Abstract

Purpose. We review the current status of multidisciplinary care for patients with inflammatory breast cancer (IBC) and discuss what further research is needed to advance the care of patients with this disease.
Design. We performed a comprehensive review of the English-language literature on IBC through computerized literature searches.
Results. Significant advances in imaging, including digital mammography, high-resolution ultrasonography with Doppler capabilities, magnetic resonance imaging, and positron emission tomography–computed tomography, have improved the diagnosis and staging of IBC. There are currently no established molecular criteria for distinguishing IBC from noninflammatory breast cancer. Such criteria would be helpful for the diagnosis and development of novel targeted therapies. Combinations of neoadjuvant systemic chemotherapy, surgery, and radiation therapy have led to an improved prognosis; however, the overall 5-year survival rate for patients with IBC remains very low (~30%). Sentinel lymph node biopsy and skin-sparing mastectomy are not recommended for patients with IBC.
Conclusion. Optimal management of IBC requires close coordination among medical, surgical, and radiation oncologists, as well as radiologists and pathologists. There is a need to identify molecular changes that define the pathogenesis of IBC to enable eradication of IBC with the use of IBC-specific targeted therapies.

paywalled: Body size and breast cancer prognosis in relation to hormone receptor and menopausal status: a meta-analysis

Body size and breast cancer prognosis in relation to hormone receptor and menopausal status: a meta-analysis.

Abstract

Obesity is associated with poor survival after breast cancer diagnosis in individual studies and meta-analyses. Evidence regarding associations of obesity with breast cancer-specific survival (BCSS) and overall survival (OS) in relation to hormone receptor status, or BCSS in relation to menopausal status has not been evaluated in a previous meta-analysis. ............ These findings led us to conclude that there is no evidence showing that the association of obesity with breast cancer outcome differs by hormone receptor or menopausal status. This has implications for studies of weight loss interventions in the adjuvant BC setting.

paywalled: Conjugated equine oestrogen and breast cancer incidence and mortality in postmenopausal women with hysterectomy: extended follow-up of the Women's Health Initiative randomised placebo-controlled trial : The Lancet Oncology

Conjugated equine oestrogen and breast cancer incidence and mortality in postmenopausal women with hysterectomy: extended follow-up of the Women's Health Initiative randomised placebo-controlled trial : The Lancet Oncology

 Interpretation

Our findings provide reassurance for women with hysterectomy seeking relief of climacteric symptoms in terms of the effects of oestrogen use for about 5 years on breast cancer incidence and mortality. However, our data do not support use of oestrogen for breast cancer risk reduction because any noted benefit probably does not apply to populations at increased risk of such cancer.

Commentary: Oestrogen and breast cancer: results from the WHI trial : The Lancet Oncology

Oestrogen and breast cancer: results from the WHI trial : The Lancet Oncology

"In The Lancet Oncology, the Women's Health Initiative (WHI) investigators report1 that receipt of conjugated equine oestrogen for a median of 5·9 years reduced the risk of invasive breast cancer by 23% compared with placebo (151 cases in 5310 women who received oestrogen vs 199 cases in 5429 controls; p=0·02). Women who did develop breast cancer after receipt of oestrogen had significantly reduced breast cancer-specific mortality (six deaths in the oestrogen group vs 16 deaths in controls; p=0·03) and all-cause mortality (30 deaths vs 50 deaths; p=0·04). This preventive effect occurred at all ages and continued beyond the period of oestrogen use, a carryover effect also noted in prevention trials of tamoxifen.2 ....Although modest, the WHI results are significant and raise important questions about their disparity with many observational studies and the mechanism of reported benefit with oestrogen therapy......

paywalled: Intrapleural paclitaxel for malignant pleural effusion from ovarian and breast cancer: a phase II study with pharmacokinetic analysis.

Intrapleural paclitaxel for malig... [Cancer Chemother Pharmacol. 2012] - PubMed - NCBI
 

Intrapleural paclitaxel for malignant pleural effusion from ovarian and breast cancer: a phase II study with pharmacokinetic analysis.

Abstract

INTRODUCTION:

Malignant pleural effusion (MPE) is a frequent complication in many types of tumors diminishing the patient's ability to perform activities. Despite various studies on talc treatment, some doubts about its safety and effectiveness remain, so the search for a more ideal intrapleural agent continues. We analyzed the effectiveness and safety of intrapleural paclitaxel in ovarian and breast cancer patients.

CONCLUSION:

Intrapleural paclitaxel is a safe and effective palliative treatment for MPE from breast and ovarian cancers and may be integrated with systemic chemotherapy.

paywalled: Coffee intake and breast cancer risk in the NIH-AARP diet and health study cohort - Gierach - 2011 - International Journal of Cancer - Wiley Online Library

Coffee intake and breast cancer risk in the NIH-AARP diet and health study cohort  - International Journal of Cancer 

"These findings from a large prospective cohort do not support a role of coffee intake in breast carcinogenesis."

Correspondence: Bevacizumab in Neoadjuvant Treatment for Breast Cancer — NEJM

Blogger's Note:  correspondence/author's reply/references; while this is specific to Avastin/breast cancer,  future trial protocols may take note

Bevacizumab in Neoadjuvant Treatment for Breast Cancer — NEJM

paywalled: Predisposition gene identification in common cancers by exome sequencing: insights from familial breast cancer.

Predisposition gene identification in common cancers by exome sequencing: insights from familial breast cancer.

Breast Cancer Res Treat. 2012 Apr 18;

Abstract
The genetic component of breast cancer predisposition remains largely unexplained. Candidate gene case-control resequencing has identified predisposition genes characterised by rare, protein truncating mutations that confer moderate risks of disease. In theory, exome sequencing should yield additional genes of this class. Here, we explore the feasibility and design considerations of this approach. We performed exome sequencing in 50 individuals with familial breast cancer, applying frequency and protein function filters to identify variants most likely to be pathogenic. We identified 867,378 variants that passed the call quality filters of which 1,296 variants passed the frequency and protein truncation filters. The median number of validated, rare, protein truncating variants was 10 in individuals with, and without, mutations in known genes. The functional candidacy of mutated genes was similar in both groups. Without prior knowledge, the known genes would not have been recognisable as breast cancer predisposition genes. Everyone carries multiple rare mutations that are plausibly related to disease. Exome sequencing in common conditions will therefore require intelligent sample and variant prioritisation strategies in large case-control studies to deliver robust genetic evidence of disease association.

paywalled: Breast cancer metastasising to the pelvis and abdomen: what the gynaecologist needs to know - 2012 - BJOG: An International Journal of Obstetrics & Gynaecology - Wiley Online Library

Breast cancer metastasising to the pelvis and abdomen: what the gynaecologist needs to know - Moore - 2012 - BJOG: An International Journal of Obstetrics & Gynaecology - Wiley Online Library

A small proportion of breast cancers metastasize within the peritoneal cavity. With increasing breast cancer incidence rates, gynaecologists and oncologists will encounter such women more frequently. Most women with intraperitoneal breast cancer are premenopausal. Although data are limited and are likely to be subject to selection bias, the median survival of women undergoing resection appears superior to those not undergoing surgery. Furthermore, survival is broadly similar to that for women undergoing advanced ovarian cancer surgery, particularly when tumour debulking is optimal. Obtaining data via randomised trials is unlikely to be feasible and therefore we recommend prospective data collection via the establishment of an international intraperitoneal breast cancer patient registry. For individual women where survival is anticipated to be more than a few months, we suggest considering referral to a gynaecological oncology team for discussion of surgical options.

Dying mom makes breast cancer video, begs the FDA to have a heart - She The People - The Washington Post (writer/ovarian cancer survivor: Donna Trussell)

Dying mom makes breast cancer video, begs the FDA to have a heart - She The People - The Washington Post

abstract: Prospective Study of 2-[18F]Fluorodeoxyglucose Positron Emission Tomography in the Assessment of Regional Nodal Spread of Disease in Patients With Breast Cancer: An Ontario Clinical Oncology Group Study

Prospective Study of 2-[18F]Fluorodeoxyglucose Positron Emission Tomography in the Assessment of Regional Nodal Spread of Disease in Patients With Breast Cancer: An Ontario Clinical Oncology Group Study

 Purpose 2-[¹⁸F]fluorodeoxyglucose (FDG) positron emission tomography (PET) is potentially useful in assessing lymph nodes and detecting distant metastases in women with primary breast cancer.


Conclusion
FDG-PET is not sufficiently sensitive to detect positive axillary lymph nodes, nor is it sufficiently specific to appropriately identify distant metastases. However, the very high positive predictive value (96%) suggests that PET when positive is indicative of disease in axillary nodes, which may influence surgical care.

Medscape: New Map of Breast Cancer Identifies 10 Disease Subtypes

Blogger's Note: references Oncotype DX and MammaPrint

New Map of Breast Cancer Identifies 10 Disease Subtypes

abstract: Researchers find discordance between standard human epidermal growth factor receptor 2 (HER2) testing and HER2 status reported on Oncotype DX - CA: A Cancer Journal for Clinicians

Researchers find discordance between standard human epidermal growth factor receptor 2 (HER2) testing and HER2 status reported on Oncotype DX -  2012 - CA: A Cancer Journal for Clinicians

open access: (journal) Cancer - Supplement: A Prospective Surveillance Model for Rehabilitation for Women With Breast Cancer - 15 April 2012

Blogger's Note: no mention of genetics? (ovarian cancer risk/BRCA.......)?

Cancer - Volume 118, Issue Supplement 8 - 15 April 2012 - Wiley Online Library

1. Prospective evaluation of physical rehabilitation needs in breast cancer survivors : A call to action (pages 2187–2190)
2. A prospective surveillance model for rehabilitation for women with breast cancer (pages 2191–2200)
3. Integrating a prospective surveillance model for rehabilitation into breast cancer survivorship care (pages 2201–2206)
4. Patient perspectives on breast cancer treatment side effects and the prospective surveillance model for physical rehabilitation for women with breast cancer (pages 2207–2216)
5. Prevalence of breast cancer treatment sequelae over 6 years of follow-up : The Pulling Through Study
6. A prospective model of care for breast cancer rehabilitation: Postoperative and postreconstructive issues (pages 2226–2236)
7. Upper-body morbidity after breast cancer : Incidence and evidence for evaluation, prevention, and management within a prospective surveillance model of care (pages 2237–2249)
8. A prospective surveillance model for physical rehabilitation of women with breast cancer : Chemotherapy-induced peripheral neuropathy (pages 2250–2260)
9. Cancer-related fatigue : Implications for breast cancer survivors
10. Prospective surveillance and management of cardiac toxicity and health in breast cancer survivors (pages 2270–2276)
11. Weight management and its role in breast cancer rehabilitation (pages 2277–2287)
12. A prospective model of care for breast cancer rehabilitation: Bone health and arthralgias (pages 2288–2299)
13. A prospective model of care for breast cancer rehabilitation: Function (pages 2300–2311)
14. Clinical practice guidelines for breast cancer rehabilitation : Syntheses of guideline recommendations and qualitative appraisals
15. Cost considerations regarding the prospective surveillance model for breast cancer survivors (pages 2325–2330)
16. Stakeholder perspectives on dissemination and implementation of a prospective surveillance model of rehabilitation for breast cancer treatment (pages 2331–2334)

Long-term Use of Estrogen Hormone Therapy Linked to Higher Risk for Breast Cancer « AACR News

Long-term Use of Estrogen Hormone Therapy Linked to Higher Risk for Breast Cancer « AACR News

• Risk increased as the duration of hormone therapy use increased.
• Death rate from breast cancer did not increase with hormone therapy use.

Commentary: Aromatase inhibitors and musculoskeletal adverse events : The Lancet Oncology

Aromatase inhibitors and musculoskeletal adverse events : The Lancet Oncology

".........Because symptom collection is so variable between trials, researchers could look for correlations between changes in patient-reported quality of life and breast-cancer outcomes. Nevertheless, if clinical research confirms a link between emergent symptoms or changes in quality of life and breast-cancer outcomes, further pharmacogenomic and pharmacogenetic studies could help to elucidate the mechanisms. Although confirmation of the association between emergent symptoms with aromatase inhibitors and risk of breast-cancer recurrence would help to guide clinical advice, based on current evidence clinicians should not use the onset of musculoskeletal symptoms to infer which patient will, or will not, benefit from adjuvant treatment with aromatase inhibitors."

Clinical Oncology News - Zoledronic Acid Debate in Breast Cancer Continues

Clinical Oncology News - Zoledronic Acid Debate in Breast Cancer Continues

San Antonio—Long-term results of the ABCSG-12 trial and subanalyses of two recently presented Phase III trials provide further evidence that bisphosphonates can improve survival in breast cancer patients with low estrogen levels. The results of the studies, presented at the recent San Antonio Breast Cancer Symposium (SABCS), have convinced some doctors of the low estrogen hypothesis, but for others the water is still very murky.....


Weighing the Evidence
In recent years, some oncologists have been prescribing bisphosphonates off-label to treat breast cancer, and the new studies may sway more doctors to do so.
“The anticancer effects of adjuvant zoledronic acid are now well established in endocrine-responsive patients,” said Dr. Gnant.
Dr. Paterson added that “inhibition of osteoclast function with bisphosphonates has an effect on cancer growth in older women, and little effect in premenopausal women.”
For other doctors, however, the jury is still out. “Subanalyses are suspect,” said Dr. Vogl. “This is interesting, but we need to study it some more. But if they study it some more, Novartis will have lost its patent protection by the time that study comes out. Novartis has some interest in it [being approved] now.”

Dr. Paterson is a consultant for GlaxoSmithKline, Amgen, Roche and Nicomed and has received a grant for a clinical trial involving denosumab. Dr. Gnant disclosed relationships with AstraZeneca, Novartis, Pfizer, Sanofi, Roche, Schering and Amgen. Dr. Möbus disclosed relationships with Amgen, Novartis and Roche. Dr. de Boer disclosed a relationship with Novartis. Drs. Ingle and Dr. Vogl have no relevant disclosures.

UK - Quality of Life and Experience of Care in Women With Metastatic Breast Cancer: A Cross-Sectional Survey

Blogger's Comment: read prior post on 'symptom clusters'

Journal of Pain and Symptom Management - Quality of Life and Experience of Care in Women With Metastatic Breast Cancer: A Cross-Sectional Survey

Conclusion

Despite improvements in treatment and survival of women with metastatic breast cancer, this group reports high symptom burden and dissatisfaction with elements of their care, indicating that alternative models of service delivery should be explored.

Postmenopausal hormone therapy and ductal carcinoma in situ: A population-based case–control study

Postmenopausal hormone therapy and ductal carcinoma in situ: A population-based case–control study: Publication year: 2012

Source:Cancer Epidemiology

Background and aim:

The relationship between hormone therapy (HT) and invasive breast cancer has been extensively investigated, but the relationship between HT and in situ breast cancer has received relatively little attention. We examined the relationship between HT and ductal carcinoma in situ (DCIS) among postmenopausal women who participated in a population-based case–control study in Connecticut, USA.

Methods: 

This analysis included 1179 post-menopausal women (603 controls and 576 cases), who comprised a subset of a population-based case–control study that included all incident cases of breast carcinoma in situ (BCIS) in Connecticut and frequency-matched controls by 5-year age intervals.

Results: 

We found no association between DCIS and ever use of any HT (adjusted odds ratio (OR)=0.85, 95% confidence interval (CI): 0.65–1.11); of estrogen alone (adjusted OR=0.93; 95% CI: 0.68–1.29) or of estrogen and progesterone (adjusted OR=0.75; 95% CI: 0.52–1.08). There was also no association between DCIS and current use of these hormones. In addition, estimated risk of DCIS did not increase with duration of use of these preparations. Conclusions: These results add to a small literature that remains inconclusive. To determine whether HT poses risk of in situ breast cancer, larger studies with greater power and precise control of important covariates (e.g., mammography screening) are needed, as are meta-analyses of available data.