Article

Key clinical point: Estrogen therapy with or without the concurrent use of adjuvant aromatase inhibitors (AI) or tamoxifen did not increase the risk for mortality in women with early hormone receptor-positive (HR+) breast cancer (BC).

Major finding: No association was observed between BC mortality risk and receipt of estrogen therapy concurrent with AI, tamoxifen, or both AI and tamoxifen, although estrogen therapy without concurrent AI or tamoxifen was associated with decreased BC mortality risk (adjusted odds ratio 0.61; 95% CI 0.43-0.87).

Study details: Findings are from a population-based nested case-control study including patients with HR+ BC who received local estrogen therapy or AI, tamoxifen, or AI and tamoxifen sequentially, of which 1262 women died due to BC and were matched to 12,620 alive control individuals.

Disclosures: This study was supported by Bröstcancerförbundet, Sweden,and ALF Funding Region Örebro County, Sweden. The authors declared no conflicts of interest.

Source: Sund M et al. Estrogen therapy after breast cancer diagnosis and breast cancer mortality risk. Breast Cancer Res Treat. 2023 (Feb 11). Doi: 10.1007/s10549-023-06871-w

Key clinical point: Estrogen therapy with or without the concurrent use of adjuvant aromatase inhibitors (AI) or tamoxifen did not increase the risk for mortality in women with early hormone receptor-positive (HR+) breast cancer (BC).

Major finding: No association was observed between BC mortality risk and receipt of estrogen therapy concurrent with AI, tamoxifen, or both AI and tamoxifen, although estrogen therapy without concurrent AI or tamoxifen was associated with decreased BC mortality risk (adjusted odds ratio 0.61; 95% CI 0.43-0.87).

Study details: Findings are from a population-based nested case-control study including patients with HR+ BC who received local estrogen therapy or AI, tamoxifen, or AI and tamoxifen sequentially, of which 1262 women died due to BC and were matched to 12,620 alive control individuals.

Disclosures: This study was supported by Bröstcancerförbundet, Sweden,and ALF Funding Region Örebro County, Sweden. The authors declared no conflicts of interest.

Source: Sund M et al. Estrogen therapy after breast cancer diagnosis and breast cancer mortality risk. Breast Cancer Res Treat. 2023 (Feb 11). Doi: 10.1007/s10549-023-06871-w

Key clinical point: Estrogen therapy with or without the concurrent use of adjuvant aromatase inhibitors (AI) or tamoxifen did not increase the risk for mortality in women with early hormone receptor-positive (HR+) breast cancer (BC).

Major finding: No association was observed between BC mortality risk and receipt of estrogen therapy concurrent with AI, tamoxifen, or both AI and tamoxifen, although estrogen therapy without concurrent AI or tamoxifen was associated with decreased BC mortality risk (adjusted odds ratio 0.61; 95% CI 0.43-0.87).

Study details: Findings are from a population-based nested case-control study including patients with HR+ BC who received local estrogen therapy or AI, tamoxifen, or AI and tamoxifen sequentially, of which 1262 women died due to BC and were matched to 12,620 alive control individuals.

Disclosures: This study was supported by Bröstcancerförbundet, Sweden,and ALF Funding Region Örebro County, Sweden. The authors declared no conflicts of interest.

Source: Sund M et al. Estrogen therapy after breast cancer diagnosis and breast cancer mortality risk. Breast Cancer Res Treat. 2023 (Feb 11). Doi: 10.1007/s10549-023-06871-w

Key clinical point: Preoperative magnetic resonance imaging (MRI) of the breast increased mastectomy rates but did not affect the local recurrence and overall survival (OS) rates in patients with breast cancer (BC) who were eligible for breast-conserving surgery (BCS).

Major finding: Among BCS-eligible patients, surgical procedure was changed to mastectomy in 8.3% vs 0.4% of patients in the MRI vs routine radiologic exam group, respectively. There was no difference in local recurrence-free survival (hazard ratio [HR] 0.72; log-rank test P = .7) and OS (HR 1.37; log-rank test P = .8) between both patient populations.

Study details: Findings are from the phase 3 BREAST-MRI study including 524 patients with stage 0-III BC who were eligible for BCS and were randomly assigned to undergo preoperative MRI or radiologic exam routine with mammography and ultrasound.

Disclosures: This publication was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo, Brazil (FAPESP 2018/24224-9). The authors declared no conflicts of interest.

Source: Mota BS et al. Effects of preoperative magnetic resonance image on survival rates and surgical planning in breast cancer conservative surgery: Randomized controlled trial (BREAST-MRI trial). Breast Cancer Res Treat. 2023 (Feb 14). Doi: 10.1007/s10549-023-06884-5

Key clinical point: Preoperative magnetic resonance imaging (MRI) of the breast increased mastectomy rates but did not affect the local recurrence and overall survival (OS) rates in patients with breast cancer (BC) who were eligible for breast-conserving surgery (BCS).

Major finding: Among BCS-eligible patients, surgical procedure was changed to mastectomy in 8.3% vs 0.4% of patients in the MRI vs routine radiologic exam group, respectively. There was no difference in local recurrence-free survival (hazard ratio [HR] 0.72; log-rank test P = .7) and OS (HR 1.37; log-rank test P = .8) between both patient populations.

Study details: Findings are from the phase 3 BREAST-MRI study including 524 patients with stage 0-III BC who were eligible for BCS and were randomly assigned to undergo preoperative MRI or radiologic exam routine with mammography and ultrasound.

Disclosures: This publication was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo, Brazil (FAPESP 2018/24224-9). The authors declared no conflicts of interest.

Source: Mota BS et al. Effects of preoperative magnetic resonance image on survival rates and surgical planning in breast cancer conservative surgery: Randomized controlled trial (BREAST-MRI trial). Breast Cancer Res Treat. 2023 (Feb 14). Doi: 10.1007/s10549-023-06884-5

Key clinical point: Preoperative magnetic resonance imaging (MRI) of the breast increased mastectomy rates but did not affect the local recurrence and overall survival (OS) rates in patients with breast cancer (BC) who were eligible for breast-conserving surgery (BCS).

Major finding: Among BCS-eligible patients, surgical procedure was changed to mastectomy in 8.3% vs 0.4% of patients in the MRI vs routine radiologic exam group, respectively. There was no difference in local recurrence-free survival (hazard ratio [HR] 0.72; log-rank test P = .7) and OS (HR 1.37; log-rank test P = .8) between both patient populations.

Study details: Findings are from the phase 3 BREAST-MRI study including 524 patients with stage 0-III BC who were eligible for BCS and were randomly assigned to undergo preoperative MRI or radiologic exam routine with mammography and ultrasound.

Disclosures: This publication was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo, Brazil (FAPESP 2018/24224-9). The authors declared no conflicts of interest.

Source: Mota BS et al. Effects of preoperative magnetic resonance image on survival rates and surgical planning in breast cancer conservative surgery: Randomized controlled trial (BREAST-MRI trial). Breast Cancer Res Treat. 2023 (Feb 14). Doi: 10.1007/s10549-023-06884-5

Key clinical point: Vaginal laser treatment was not superior in improving sexual function and was less well tolerated than sham laser therapy (SLT) in survivors of breast cancer (BC) with genitourinary syndrome of menopause (GSM) who received treatment with aromatase inhibitors (AI).

Major finding: At 6 months, patients receiving fractional carbon dioxide laser therapy (CLT) and those receiving SLT had similar improvement in the female sexual function index score (P = .15), with the CLT vs SLT group having a significantly lower mean tolerance score (3.3 vs 4.1; P = .007).

Study details: Findings are from the randomized clinical trial LIGHT including 84 patients with BC who were receiving AI for GSM and were randomly assigned to receive a first-line therapy based on nonhormonal moisturizers and vaginal vibrator stimulation with fractional CLT or SLT.

Disclosures: This study was funded by grants from Instituto de Salud Carlos III and the European Union, with various items provided by DEKA, IntherPharma, CumLaude Lab, and BCNatal. The authors declared no conflicts of interest.

Source: Mension E et al. Effect of fractional carbon dioxide vs sham laser on sexual function in survivors of breast cancer receiving aromatase inhibitors for genitourinary syndrome of menopause: The LIGHT randomized clinical trial. JAMA Netw Open. 2023;6(2):e2255697 (Feb 10). Doi: 10.1001/jamanetworkopen.2022.55697

Key clinical point: Vaginal laser treatment was not superior in improving sexual function and was less well tolerated than sham laser therapy (SLT) in survivors of breast cancer (BC) with genitourinary syndrome of menopause (GSM) who received treatment with aromatase inhibitors (AI).

Major finding: At 6 months, patients receiving fractional carbon dioxide laser therapy (CLT) and those receiving SLT had similar improvement in the female sexual function index score (P = .15), with the CLT vs SLT group having a significantly lower mean tolerance score (3.3 vs 4.1; P = .007).

Study details: Findings are from the randomized clinical trial LIGHT including 84 patients with BC who were receiving AI for GSM and were randomly assigned to receive a first-line therapy based on nonhormonal moisturizers and vaginal vibrator stimulation with fractional CLT or SLT.

Disclosures: This study was funded by grants from Instituto de Salud Carlos III and the European Union, with various items provided by DEKA, IntherPharma, CumLaude Lab, and BCNatal. The authors declared no conflicts of interest.

Source: Mension E et al. Effect of fractional carbon dioxide vs sham laser on sexual function in survivors of breast cancer receiving aromatase inhibitors for genitourinary syndrome of menopause: The LIGHT randomized clinical trial. JAMA Netw Open. 2023;6(2):e2255697 (Feb 10). Doi: 10.1001/jamanetworkopen.2022.55697

Key clinical point: Vaginal laser treatment was not superior in improving sexual function and was less well tolerated than sham laser therapy (SLT) in survivors of breast cancer (BC) with genitourinary syndrome of menopause (GSM) who received treatment with aromatase inhibitors (AI).

Major finding: At 6 months, patients receiving fractional carbon dioxide laser therapy (CLT) and those receiving SLT had similar improvement in the female sexual function index score (P = .15), with the CLT vs SLT group having a significantly lower mean tolerance score (3.3 vs 4.1; P = .007).

Study details: Findings are from the randomized clinical trial LIGHT including 84 patients with BC who were receiving AI for GSM and were randomly assigned to receive a first-line therapy based on nonhormonal moisturizers and vaginal vibrator stimulation with fractional CLT or SLT.

Disclosures: This study was funded by grants from Instituto de Salud Carlos III and the European Union, with various items provided by DEKA, IntherPharma, CumLaude Lab, and BCNatal. The authors declared no conflicts of interest.

Source: Mension E et al. Effect of fractional carbon dioxide vs sham laser on sexual function in survivors of breast cancer receiving aromatase inhibitors for genitourinary syndrome of menopause: The LIGHT randomized clinical trial. JAMA Netw Open. 2023;6(2):e2255697 (Feb 10). Doi: 10.1001/jamanetworkopen.2022.55697

Key clinical point: Endocrine therapy (ET) did not have any detrimental effect on cognitive abilities in women aged ≥70 years with early breast cancer (BC).

Major finding: Patients receiving ET had a Mini-Mental State Examination (MMSE) score of 28.1, with mild and severe cognitive impairments observed in 25% and 2% of patients, respectively. The MSME score improved by 0.4 points (P = .013) after 15 months and by 0.5 points (P = .018) after 27 months in patients receiving ET.

Study details: Findings are from the observational CLIMB study including 273 women with stage I-III BC who were ≥70 years old, of which 48% received ET.

Disclosures: This study was funded by the KWF Dutch Cancer Society. The authors declared no conflicts of interest.

Source: Baltussen JC et al. Association between endocrine therapy and cognitive decline in older women with early breast cancer: Findings from the prospective CLIMB study. Eur J Cancer. 2023 (Feb 16). Doi: 10.1016/j.ejca.2023.02.008

Key clinical point: Endocrine therapy (ET) did not have any detrimental effect on cognitive abilities in women aged ≥70 years with early breast cancer (BC).

Major finding: Patients receiving ET had a Mini-Mental State Examination (MMSE) score of 28.1, with mild and severe cognitive impairments observed in 25% and 2% of patients, respectively. The MSME score improved by 0.4 points (P = .013) after 15 months and by 0.5 points (P = .018) after 27 months in patients receiving ET.

Study details: Findings are from the observational CLIMB study including 273 women with stage I-III BC who were ≥70 years old, of which 48% received ET.

Disclosures: This study was funded by the KWF Dutch Cancer Society. The authors declared no conflicts of interest.

Source: Baltussen JC et al. Association between endocrine therapy and cognitive decline in older women with early breast cancer: Findings from the prospective CLIMB study. Eur J Cancer. 2023 (Feb 16). Doi: 10.1016/j.ejca.2023.02.008

Key clinical point: Endocrine therapy (ET) did not have any detrimental effect on cognitive abilities in women aged ≥70 years with early breast cancer (BC).

Major finding: Patients receiving ET had a Mini-Mental State Examination (MMSE) score of 28.1, with mild and severe cognitive impairments observed in 25% and 2% of patients, respectively. The MSME score improved by 0.4 points (P = .013) after 15 months and by 0.5 points (P = .018) after 27 months in patients receiving ET.

Study details: Findings are from the observational CLIMB study including 273 women with stage I-III BC who were ≥70 years old, of which 48% received ET.

Disclosures: This study was funded by the KWF Dutch Cancer Society. The authors declared no conflicts of interest.

Source: Baltussen JC et al. Association between endocrine therapy and cognitive decline in older women with early breast cancer: Findings from the prospective CLIMB study. Eur J Cancer. 2023 (Feb 16). Doi: 10.1016/j.ejca.2023.02.008

Key clinical point: Patients with breast cancer (BC) should be recommended to undergo primary breast surgery within 8 weeks from BC diagnosis for best survival outcomes.

Major finding: Overall survival outcomes were worsened by ≥15% when the interval between BC diagnosis and surgery was ≥9 weeks compared with 0-4 weeks (hazard ratio at 9 weeks 1.15; P < .001).

Study details: Findings are from a case series study including 373,334 female patients with stage I-III BC who underwent primary breast surgery.

Disclosures: This study was supported by grants from the US National Cancer Institute and other sources. LG Wilke declared being the founder of and stock owner in Elucent Medical. BM Hanlon declared receiving grants from the US National Institutes of Health outside the submitted work.

Source: Wiener AA et al. Reexamining time from breast cancer diagnosis to primary breast surgery. JAMA Surg. 2023 (Mar 1). Doi: 10.1001/jamasurg.2022.8388

Key clinical point: Patients with breast cancer (BC) should be recommended to undergo primary breast surgery within 8 weeks from BC diagnosis for best survival outcomes.

Major finding: Overall survival outcomes were worsened by ≥15% when the interval between BC diagnosis and surgery was ≥9 weeks compared with 0-4 weeks (hazard ratio at 9 weeks 1.15; P < .001).

Study details: Findings are from a case series study including 373,334 female patients with stage I-III BC who underwent primary breast surgery.

Disclosures: This study was supported by grants from the US National Cancer Institute and other sources. LG Wilke declared being the founder of and stock owner in Elucent Medical. BM Hanlon declared receiving grants from the US National Institutes of Health outside the submitted work.

Source: Wiener AA et al. Reexamining time from breast cancer diagnosis to primary breast surgery. JAMA Surg. 2023 (Mar 1). Doi: 10.1001/jamasurg.2022.8388

Key clinical point: Patients with breast cancer (BC) should be recommended to undergo primary breast surgery within 8 weeks from BC diagnosis for best survival outcomes.

Major finding: Overall survival outcomes were worsened by ≥15% when the interval between BC diagnosis and surgery was ≥9 weeks compared with 0-4 weeks (hazard ratio at 9 weeks 1.15; P < .001).

Study details: Findings are from a case series study including 373,334 female patients with stage I-III BC who underwent primary breast surgery.

Disclosures: This study was supported by grants from the US National Cancer Institute and other sources. LG Wilke declared being the founder of and stock owner in Elucent Medical. BM Hanlon declared receiving grants from the US National Institutes of Health outside the submitted work.

Source: Wiener AA et al. Reexamining time from breast cancer diagnosis to primary breast surgery. JAMA Surg. 2023 (Mar 1). Doi: 10.1001/jamasurg.2022.8388

Key clinical point: Adjuvant treatment with paclitaxel and trastuzumab demonstrated very good long-term survival outcomes in patients with small, node-negative, human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC).

Major finding: After a median follow-up of 10.8 years, only 31 invasive disease-free survival events occurred, of which six were locoregional ipsilateral recurrences, nine were new contralateral breast cancers, six were distant recurrences, and 10 were all-cause deaths. The 10-year invasive disease-free survival rate was >90% (91.3%; 95% CI 88.3%-94.4%).

Study details: Findings are from the phase 2 APT study including 406 patients with small (≤3 cm), node-negative, HER2+ BC who received adjuvant paclitaxel+trastuzumab for 12 weeks followed by trastuzumab for 40 weeks to complete a full year of trastuzumab treatment.

Disclosures: This study was funded by Genentech. The authors declared receiving consulting or advisory board fees, grant support, payment, or having other ties with several sources.

Source: Tolaney SM et al. Adjuvant paclitaxel and trastuzumab for node-negative, HER2-positive breast cancer: Final 10-year analysis of the open-label, single-arm, phase 2 APT trial. Lancet Oncol. 2023;24(3):273-285 (Feb 27). Doi: 10.1016/S1470-2045(23)00051-7

Key clinical point: Adjuvant treatment with paclitaxel and trastuzumab demonstrated very good long-term survival outcomes in patients with small, node-negative, human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC).

Major finding: After a median follow-up of 10.8 years, only 31 invasive disease-free survival events occurred, of which six were locoregional ipsilateral recurrences, nine were new contralateral breast cancers, six were distant recurrences, and 10 were all-cause deaths. The 10-year invasive disease-free survival rate was >90% (91.3%; 95% CI 88.3%-94.4%).

Study details: Findings are from the phase 2 APT study including 406 patients with small (≤3 cm), node-negative, HER2+ BC who received adjuvant paclitaxel+trastuzumab for 12 weeks followed by trastuzumab for 40 weeks to complete a full year of trastuzumab treatment.

Disclosures: This study was funded by Genentech. The authors declared receiving consulting or advisory board fees, grant support, payment, or having other ties with several sources.

Source: Tolaney SM et al. Adjuvant paclitaxel and trastuzumab for node-negative, HER2-positive breast cancer: Final 10-year analysis of the open-label, single-arm, phase 2 APT trial. Lancet Oncol. 2023;24(3):273-285 (Feb 27). Doi: 10.1016/S1470-2045(23)00051-7

Key clinical point: Adjuvant treatment with paclitaxel and trastuzumab demonstrated very good long-term survival outcomes in patients with small, node-negative, human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC).

Major finding: After a median follow-up of 10.8 years, only 31 invasive disease-free survival events occurred, of which six were locoregional ipsilateral recurrences, nine were new contralateral breast cancers, six were distant recurrences, and 10 were all-cause deaths. The 10-year invasive disease-free survival rate was >90% (91.3%; 95% CI 88.3%-94.4%).

Study details: Findings are from the phase 2 APT study including 406 patients with small (≤3 cm), node-negative, HER2+ BC who received adjuvant paclitaxel+trastuzumab for 12 weeks followed by trastuzumab for 40 weeks to complete a full year of trastuzumab treatment.

Disclosures: This study was funded by Genentech. The authors declared receiving consulting or advisory board fees, grant support, payment, or having other ties with several sources.

Source: Tolaney SM et al. Adjuvant paclitaxel and trastuzumab for node-negative, HER2-positive breast cancer: Final 10-year analysis of the open-label, single-arm, phase 2 APT trial. Lancet Oncol. 2023;24(3):273-285 (Feb 27). Doi: 10.1016/S1470-2045(23)00051-7

Key clinical point: Alisertib demonstrated clinically meaningful antitumor activity both with and without fulvestrant and a tolerable safety profile in patients with endocrine-resistant, human epidermal growth factor receptor 2-negative (ERBB2−) metastatic breast cancer (BC).

Major finding: The objective response rates were 19.6% (90% CI 10.6%-31.7%) and 20.0% (90% CI 10.9%-32.3%) for alisertib and alisertib+fulvestrant, respectively, and the median progression-free survival was approximately 5 months for both treatment arms. The most common grade ≥3 adverse events were neutropenia, leukopenia, and anemia.

Study details: Findings are from the phase 2 TBCRC041 trial including 91 patients with endocrine-resistant, ERBB2− metastatic BC who were previously treated with a cyclin-dependent kinase 4/6 inhibitor and were randomly assigned to receive alisertib alone or alisertib+fulvestrant.

Disclosures: This study was supported by Takeda Oncology. The authors declared receiving funding, fees, or research support or having other ties with several sources, including Takeda Oncology.

Source: Haddad TC et al. Evaluation of alisertib alone or combined with fulvestrant in patients with endocrine-resistant advanced breast cancer: The phase 2 TBCRC041 randomized clinical trial. JAMA Oncol. 2023 (Mar 9). Doi: 10.1001/jamaoncol.2022.7949

Key clinical point: Alisertib demonstrated clinically meaningful antitumor activity both with and without fulvestrant and a tolerable safety profile in patients with endocrine-resistant, human epidermal growth factor receptor 2-negative (ERBB2−) metastatic breast cancer (BC).

Major finding: The objective response rates were 19.6% (90% CI 10.6%-31.7%) and 20.0% (90% CI 10.9%-32.3%) for alisertib and alisertib+fulvestrant, respectively, and the median progression-free survival was approximately 5 months for both treatment arms. The most common grade ≥3 adverse events were neutropenia, leukopenia, and anemia.

Study details: Findings are from the phase 2 TBCRC041 trial including 91 patients with endocrine-resistant, ERBB2− metastatic BC who were previously treated with a cyclin-dependent kinase 4/6 inhibitor and were randomly assigned to receive alisertib alone or alisertib+fulvestrant.

Disclosures: This study was supported by Takeda Oncology. The authors declared receiving funding, fees, or research support or having other ties with several sources, including Takeda Oncology.

Source: Haddad TC et al. Evaluation of alisertib alone or combined with fulvestrant in patients with endocrine-resistant advanced breast cancer: The phase 2 TBCRC041 randomized clinical trial. JAMA Oncol. 2023 (Mar 9). Doi: 10.1001/jamaoncol.2022.7949

Key clinical point: Alisertib demonstrated clinically meaningful antitumor activity both with and without fulvestrant and a tolerable safety profile in patients with endocrine-resistant, human epidermal growth factor receptor 2-negative (ERBB2−) metastatic breast cancer (BC).

Major finding: The objective response rates were 19.6% (90% CI 10.6%-31.7%) and 20.0% (90% CI 10.9%-32.3%) for alisertib and alisertib+fulvestrant, respectively, and the median progression-free survival was approximately 5 months for both treatment arms. The most common grade ≥3 adverse events were neutropenia, leukopenia, and anemia.

Study details: Findings are from the phase 2 TBCRC041 trial including 91 patients with endocrine-resistant, ERBB2− metastatic BC who were previously treated with a cyclin-dependent kinase 4/6 inhibitor and were randomly assigned to receive alisertib alone or alisertib+fulvestrant.

Disclosures: This study was supported by Takeda Oncology. The authors declared receiving funding, fees, or research support or having other ties with several sources, including Takeda Oncology.

Source: Haddad TC et al. Evaluation of alisertib alone or combined with fulvestrant in patients with endocrine-resistant advanced breast cancer: The phase 2 TBCRC041 randomized clinical trial. JAMA Oncol. 2023 (Mar 9). Doi: 10.1001/jamaoncol.2022.7949

Key clinical point: The risk for non-breast second primary cancer (SPC) at many sites was significantly elevated in female breast cancer (BC) survivors, particularly those who were first diagnosed with BC before the age of 50 years.

Major finding: The summary standardized incidence ratio (SIR) for non-breast SPC was estimated to be 1.24 (95% CI 1.14-1.36), with the risk being significantly higher among patients diagnosed with BC before vs after the age of 50 years (SIR 1.59 vs 1.13; P < .001). The risk for non-breast SPC was the highest at the thyroid (SIR 1.89; 95% CI 1.49-2.38), followed by corpus uteri, ovary, kidney, esophagus, skin (melanoma), blood (leukemia), lung, stomach, and bladder.

Study details: Findings are from a meta-analysis of one prospective and 27 retrospective studies.

Disclosures: This study was funded by the CRUK Catalyst Award CanGene-CanVar, UK. The authors declared no conflicts of interest.

Source: Allen I et al. Risks of second non-breast primaries following breast cancer in women: A systematic review and meta-analysis. Breast Cancer Res. 2023;25(1):18 (Feb 10). Doi: 10.1186/s13058-023-01610-x

Key clinical point: The risk for non-breast second primary cancer (SPC) at many sites was significantly elevated in female breast cancer (BC) survivors, particularly those who were first diagnosed with BC before the age of 50 years.

Major finding: The summary standardized incidence ratio (SIR) for non-breast SPC was estimated to be 1.24 (95% CI 1.14-1.36), with the risk being significantly higher among patients diagnosed with BC before vs after the age of 50 years (SIR 1.59 vs 1.13; P < .001). The risk for non-breast SPC was the highest at the thyroid (SIR 1.89; 95% CI 1.49-2.38), followed by corpus uteri, ovary, kidney, esophagus, skin (melanoma), blood (leukemia), lung, stomach, and bladder.

Study details: Findings are from a meta-analysis of one prospective and 27 retrospective studies.

Disclosures: This study was funded by the CRUK Catalyst Award CanGene-CanVar, UK. The authors declared no conflicts of interest.

Source: Allen I et al. Risks of second non-breast primaries following breast cancer in women: A systematic review and meta-analysis. Breast Cancer Res. 2023;25(1):18 (Feb 10). Doi: 10.1186/s13058-023-01610-x

Key clinical point: The risk for non-breast second primary cancer (SPC) at many sites was significantly elevated in female breast cancer (BC) survivors, particularly those who were first diagnosed with BC before the age of 50 years.

Major finding: The summary standardized incidence ratio (SIR) for non-breast SPC was estimated to be 1.24 (95% CI 1.14-1.36), with the risk being significantly higher among patients diagnosed with BC before vs after the age of 50 years (SIR 1.59 vs 1.13; P < .001). The risk for non-breast SPC was the highest at the thyroid (SIR 1.89; 95% CI 1.49-2.38), followed by corpus uteri, ovary, kidney, esophagus, skin (melanoma), blood (leukemia), lung, stomach, and bladder.

Study details: Findings are from a meta-analysis of one prospective and 27 retrospective studies.

Disclosures: This study was funded by the CRUK Catalyst Award CanGene-CanVar, UK. The authors declared no conflicts of interest.

Source: Allen I et al. Risks of second non-breast primaries following breast cancer in women: A systematic review and meta-analysis. Breast Cancer Res. 2023;25(1):18 (Feb 10). Doi: 10.1186/s13058-023-01610-x

Endocrine therapy (ET) has long been the therapeutic backbone for the treatment of HR+/HER2- breast cancer. However, for patients who already have advanced HR+/HER2- disease at the time of diagnosis, studies have shown that addition of a CDK4/6 inhibitor significantly improves outcomes compared with ET alone.

In this ReCAP, Dr Kevin Kalinsky, director of the Glenn Family Breast Center at Winship Cancer Institute in Atlanta, Georgia, examines important considerations in the frontline treatment of HR+/HER2- advanced breast cancer.

First, he reviews the PALOMA-2 data, which looked at the overall survival of the CDK4/6 inhibitor palbociclib plus letrozole. He then compares that data with the overall survival data of other CDK4/5 inhibitors.

Dr Kalinsky then examines the findings of MONALEESA-7, which looked at premenopausal patients with HR+/HER2- advanced breast cancer treated with ET plus or minus ribociclib. In that study population, the combination of ET and ribociclib showed an overall survival advantage.

Finally, he discusses data from the Right Choice trial, which found that patients did better when given hormonal therapy plus a CDK4/6 inhibitor as opposed to doublet chemotherapy.

--

Kevin Kalinsky, MD, Director, Glenn Family Breast Center, Winship Cancer Institute, Atlanta, Georgia

Kevin Kalinsky, MD, has disclosed the following relevant financial relationships:

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Pfizer; Eli Lilly; Novartis ; Eisai; AstraZeneca; Daiichi Sankyo; Puma; 4D Pharma; Oncosec; Immunomedics; Merck; Seattle Genetics

Spouse holds stock in: Grail; Array Biopharma; Pfizer (prior employee)

Endocrine therapy (ET) has long been the therapeutic backbone for the treatment of HR+/HER2- breast cancer. However, for patients who already have advanced HR+/HER2- disease at the time of diagnosis, studies have shown that addition of a CDK4/6 inhibitor significantly improves outcomes compared with ET alone.

In this ReCAP, Dr Kevin Kalinsky, director of the Glenn Family Breast Center at Winship Cancer Institute in Atlanta, Georgia, examines important considerations in the frontline treatment of HR+/HER2- advanced breast cancer.

First, he reviews the PALOMA-2 data, which looked at the overall survival of the CDK4/6 inhibitor palbociclib plus letrozole. He then compares that data with the overall survival data of other CDK4/5 inhibitors.

Dr Kalinsky then examines the findings of MONALEESA-7, which looked at premenopausal patients with HR+/HER2- advanced breast cancer treated with ET plus or minus ribociclib. In that study population, the combination of ET and ribociclib showed an overall survival advantage.

Finally, he discusses data from the Right Choice trial, which found that patients did better when given hormonal therapy plus a CDK4/6 inhibitor as opposed to doublet chemotherapy.

--

Kevin Kalinsky, MD, Director, Glenn Family Breast Center, Winship Cancer Institute, Atlanta, Georgia

Kevin Kalinsky, MD, has disclosed the following relevant financial relationships:

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Pfizer; Eli Lilly; Novartis ; Eisai; AstraZeneca; Daiichi Sankyo; Puma; 4D Pharma; Oncosec; Immunomedics; Merck; Seattle Genetics

Spouse holds stock in: Grail; Array Biopharma; Pfizer (prior employee)

Endocrine therapy (ET) has long been the therapeutic backbone for the treatment of HR+/HER2- breast cancer. However, for patients who already have advanced HR+/HER2- disease at the time of diagnosis, studies have shown that addition of a CDK4/6 inhibitor significantly improves outcomes compared with ET alone.

In this ReCAP, Dr Kevin Kalinsky, director of the Glenn Family Breast Center at Winship Cancer Institute in Atlanta, Georgia, examines important considerations in the frontline treatment of HR+/HER2- advanced breast cancer.

First, he reviews the PALOMA-2 data, which looked at the overall survival of the CDK4/6 inhibitor palbociclib plus letrozole. He then compares that data with the overall survival data of other CDK4/5 inhibitors.

Dr Kalinsky then examines the findings of MONALEESA-7, which looked at premenopausal patients with HR+/HER2- advanced breast cancer treated with ET plus or minus ribociclib. In that study population, the combination of ET and ribociclib showed an overall survival advantage.

Finally, he discusses data from the Right Choice trial, which found that patients did better when given hormonal therapy plus a CDK4/6 inhibitor as opposed to doublet chemotherapy.

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Kevin Kalinsky, MD, Director, Glenn Family Breast Center, Winship Cancer Institute, Atlanta, Georgia

Kevin Kalinsky, MD, has disclosed the following relevant financial relationships:

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Pfizer; Eli Lilly; Novartis ; Eisai; AstraZeneca; Daiichi Sankyo; Puma; 4D Pharma; Oncosec; Immunomedics; Merck; Seattle Genetics

Spouse holds stock in: Grail; Array Biopharma; Pfizer (prior employee)

Key clinical point: Patients with estrogen receptor-negative (ER−) primary breast cancer (BC) have a higher risk of developing secondary BC during the first 5 years after treatment than patients with ER-positive (ER+) primary BC.

Major finding: In women with ER− vs ER+ primary BC, the rates of secondary BCs were higher during the first 5 years of follow-up (16.0/1000 person-years [PY]; 95% CI 14.2-17.9/1000 PY vs 7.8/1000 PY; 95% CI 7.3-8.4/1000 PY) but were similar after 5 years (12.1/1000 PY; 95% CI 9.9-14.7/1000 PY vs 9.3/1000 PY; 95% CI 8.4-10.3/1000 PY).

Study details: Findings are from a study including 36,165 women with stage I-III primary BC who underwent breast‐conserving surgery or mastectomy.

Disclosures: This study was funded by the US National Cancer Institute. Some authors declared receiving grants, personal fees, payments, or travel support from several sources.

Source: Lowry KP et al. Variation in second breast cancer risk after primary invasive cancer by time since primary cancer diagnosis and estrogen receptor status. Cancer. 2023 (Feb 15). Doi: 10.1002/cncr.34679

Key clinical point: Patients with estrogen receptor-negative (ER−) primary breast cancer (BC) have a higher risk of developing secondary BC during the first 5 years after treatment than patients with ER-positive (ER+) primary BC.

Major finding: In women with ER− vs ER+ primary BC, the rates of secondary BCs were higher during the first 5 years of follow-up (16.0/1000 person-years [PY]; 95% CI 14.2-17.9/1000 PY vs 7.8/1000 PY; 95% CI 7.3-8.4/1000 PY) but were similar after 5 years (12.1/1000 PY; 95% CI 9.9-14.7/1000 PY vs 9.3/1000 PY; 95% CI 8.4-10.3/1000 PY).

Study details: Findings are from a study including 36,165 women with stage I-III primary BC who underwent breast‐conserving surgery or mastectomy.

Disclosures: This study was funded by the US National Cancer Institute. Some authors declared receiving grants, personal fees, payments, or travel support from several sources.

Source: Lowry KP et al. Variation in second breast cancer risk after primary invasive cancer by time since primary cancer diagnosis and estrogen receptor status. Cancer. 2023 (Feb 15). Doi: 10.1002/cncr.34679

Key clinical point: Patients with estrogen receptor-negative (ER−) primary breast cancer (BC) have a higher risk of developing secondary BC during the first 5 years after treatment than patients with ER-positive (ER+) primary BC.

Major finding: In women with ER− vs ER+ primary BC, the rates of secondary BCs were higher during the first 5 years of follow-up (16.0/1000 person-years [PY]; 95% CI 14.2-17.9/1000 PY vs 7.8/1000 PY; 95% CI 7.3-8.4/1000 PY) but were similar after 5 years (12.1/1000 PY; 95% CI 9.9-14.7/1000 PY vs 9.3/1000 PY; 95% CI 8.4-10.3/1000 PY).

Study details: Findings are from a study including 36,165 women with stage I-III primary BC who underwent breast‐conserving surgery or mastectomy.

Disclosures: This study was funded by the US National Cancer Institute. Some authors declared receiving grants, personal fees, payments, or travel support from several sources.

Source: Lowry KP et al. Variation in second breast cancer risk after primary invasive cancer by time since primary cancer diagnosis and estrogen receptor status. Cancer. 2023 (Feb 15). Doi: 10.1002/cncr.34679