Breast Cancer

October is National Breast Cancer Awareness Month, a good time to briefly reflect on what cancer "awareness" means to the oncology community and to the growing number of breast cancer survivors nationwide

As half of all breast cancers occur in patients beyond the age of 65 and a quarter beyond the age of 75, a significant number of patients with metastatic breast cancer are elderly. New hormonal therapies, such as aromatase inhibitors, appear to have favorably improved the survival of these patients. Side effects such as osteoporosis or cognitive issues appear manageable. Information specific to elderly patients has recently emerged in the field of chemotherapy for metastatic breast cancer. This article reviews data on anthracyclines, taxanes, capecitabine (Xeloda), gemcitabine (Gemzar), trastuzumab (Herceptin), and bevacizumab (Avastin). For most patients in this setting, sequential single-agent chemotherapy appears at this time to be the preferred course of treatment.

Individualized cognitive therapy (CT) is effective in reducing depression in women with metastatic breast cancer

Postmenopausal women who take anastrozole (Arimidex) for 5 years as adjuvant therapy for breast cancer experience a 6% to 8% reduction in bone mineral density (BMD) in the lumbar spine and hip

Clinical trials may be running out of volunteers, according to a report at the American Society of Clinical Oncology 2006 meeting

The bone loss associated with adjuvant exemestane (Aromasin) therapy for breast cancer tends to be greater in women who have suboptimal levels of vitamin D

Although most American adults can identify mammography, the Pap test, and colonoscopy as cancer screening tests, they are generally ill informed about the age at which screening should begin and how often they should undergo the examinations.

Combining the investigational aromatase inhibitor atamestane with the estrogen-blocker toremifene (Fareston) in an attempt to achieve "complete estrogen blockade" did not improve time to progression (TTP) in patients with advanced breast cancer, compared with aromatase inhibitor monotherapy with letrozole (Femara).

In 2001, a grandmother with breast cancer inspired Anthony Leanna, then 10 years old, to start the Heavenly Hats Foundation, a nonprofit corporation that provides free headwear to cancer patients nationwide.

When used as first-line therapy for metastatic HER2-positive breast cancer, docetaxel (Taxotere) plus trastuzumab (Herceptin) (TH) has similar efficacy to docetaxel, carboplatin, and trastuzumab (TCH), but the toxicity profiles differ, finds a randomized phase III trial presented at the 42nd Annual Meeting of the American Society of Clinical Oncology

Postmenopausal women who are receiving tamoxifen as adjuvant therapy for early-stage breast cancer have a reduced risk of relapse and death if they switch to the aromatase inhibitor exemestane (Aromasin) after several years

Five-year follow-up data from the STAR (Study of Tamoxifen and Raloxifene) trial show that the drugs are similarly effective for preventing invasive breast cancer in postmenopausal women at high risk for the disease, that raloxifene (Evista) was somewhat less effective at preventing noninvasive breast cancer, and that raloxifene is associated with a 30% lower risk of thromboembolic events than tamoxifen.

Capecitabine (Xeloda)/paclitaxel (XP) is at least as efficacious as epirubicin (Ellence)/paclitaxel (EP) as first-line therapy for metastatic breast cancer, data from a randomized, multicenter phase III trial show

Adding docetaxel (Taxotere) to anthracycline-based adjuvant chemotherapy reduces the risk of relapse, new primaries, and death among women with node-positive breast cancer, first data from the BIG 2-98 trial show.

Johns Hopkins scientists have found that a method they developed to screen body fluids for certain kinds of cells and some of their genetic blueprint is twice as accurate at spotting breast cancer cells as a pathologist's view with a microscope.

Women most at risk for developing breast cancer were the least likely to realize it according to a recent national survey conducted by Harris Interactive.

At the 42nd American Society of Clinical Oncology (ASCO) annual meeting in Atlanta, Eli Lilly and Co announced results of a phase II trial evaluating its thoracic cancer drug pemetrexed (Alimta) in first-line treatment of metastatic breast cancer.

Low blood levels of vitamin D may worsen the bone loss associated with exemestane (Aromasin), an aromatase inhibitor commonly given to postmenopausal women with breast cancer

YM BioSciences Inc announced that treatment has been started in its phase II trial combining tesmilifene with docetaxel (Taxotere).

Weight gain, particularly after menopause, is associated with an increased risk of breast cancer in women

The aromatase inhibitors (AIs) anastrozole (Arimidex), letrozole (Femara), and exemestane (Aromasin) are significantly more effective than the selective estrogen-receptor modulator (SERM) tamoxifen in preventing recurrence in estrogen receptor-positive early breast cancer. Aromatase inhibitors are likely to replace SERMs as first-line adjuvant therapy for many patients. However, AIs are associated with significantly more osteoporotic fractures and greater bone mineral loss. As antiresorptive agents, oral and intravenous bisphosphonates such as alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva), pamidronate (Aredia), and zoledronic acid (Zometa) have efficacy in preventing postmenopausal osteoporosis, cancer treatment-related bone loss, or skeletal complications of metastatic disease. Clinical practice guidelines recommend baseline and annual follow-up bone density monitoring for all patients initiating AI therapy. Bisphosphonate therapy should be prescribed for patients with osteoporosis (T score < -2.5) and considered on an individual basis for those with osteopenia (T score < -1). Modifiable lifestyle behaviors including adequate calcium and vitamin D intake, weight-bearing exercise, and smoking cessation should be addressed. Adverse events associated with bisphosphonates include gastrointestinal toxicity, renal toxicity, and osteonecrosis of the jaw. These safety concerns should be balanced with the potential of bisphosphonates to minimize or prevent the debilitating effects of AI-associated bone loss in patients with early, hormone receptor-positive breast cancer.

Tamoxifen as a breast cancer prevention drug has little impact on overall mortality rates for most "high-risk" women, according to a new study.

Researchers from Florida Atlantic University, the Center for Breast Care at the Women's Center at Boca Raton Community Hospital, and MeVis, the Center for Diagnostic Systems and Visualization at the University of Breman, Germany, have developed new techniques to aid clinicians in the diagnosis and treatment of breast cancer.

Dr. Maitland DeLand, a radiation oncologist at LSU School of Medicine, New Orleans, and president of OncoLogics, Inc, in Lafayette, La, has found that following radiotherapy for breast cancer, exposing women to low-energy nonthermal light-emitting diode (LED) photomodulation can significantly reduce painful, treatment-interrupting skin reactions.

The aromatase inhibitors (AIs) anastrozole (Arimidex), letrozole (Femara), and exemestane (Aromasin) are significantly more effective than the selective estrogen-receptor modulator (SERM) tamoxifen in preventing recurrence in estrogen receptor-positive early breast cancer. Aromatase inhibitors are likely to replace SERMs as first-line adjuvant therapy for many patients. However, AIs are associated with significantly more osteoporotic fractures and greater bone mineral loss. As antiresorptive agents, oral and intravenous bisphosphonates such as alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva), pamidronate (Aredia), and zoledronic acid (Zometa) have efficacy in preventing postmenopausal osteoporosis, cancer treatment-related bone loss, or skeletal complications of metastatic disease. Clinical practice guidelines recommend baseline and annual follow-up bone density monitoring for all patients initiating AI therapy. Bisphosphonate therapy should be prescribed for patients with osteoporosis (T score < -2.5) and considered on an individual basis for those with osteopenia (T score < -1). Modifiable lifestyle behaviors including adequate calcium and vitamin D intake, weight-bearing exercise, and smoking cessation should be addressed. Adverse events associated with bisphosphonates include gastrointestinal toxicity, renal toxicity, and osteonecrosis of the jaw. These safety concerns should be balanced with the potential of bisphosphonates to minimize or prevent the debilitating effects of AI-associated bone loss in patients with early, hormone receptor-positive breast cancer.