Breast Cancer

One has to be living off the grid to not be bombarded with direct-to-consumer (DTC) pharmaceutical advertising. Since 1997, when the Food and Drug Administration eased restrictions on this prohibition and allowed pharmaceutical companies to promote prescription-only medications to the public, there has been a deluge of ads in magazines, on the Internet, and, most annoying, on commercial television.

These television ads are quite formulaic:

We are initially introduced to a number of highly functioning patients (typically actors) who are engaged in rewarding pursuits. A voiceover narration then presents the pharmaceutical to be promoted, suggesting (not so subtly) to consumers that taking the advertised drug will improve one’s disease outlook or quality of life such that they too, just like the actors in the minidrama, can lead such highly productive lives.

The potential best-case scenarios of these new treatments may be stated. There then follows a litany of side effects – some of them life threatening – warnings, and contraindications. We’re again treated to another 5 or 10 seconds of patients leading “the good life,” and almost all of the ads end with the narrator concluding: “Ask your doctor (sometimes ‘provider’) if _____ is right for you.”

Big pharma spends nearly $10 billion on DTC advertising, with television ads accounting for the vast majority of these dollars. Is this type of advertising appropriate? Or even ethical?

Americans spend more money on their prescriptions than do citizens of any other highly developed nation. I have personally heard from patients who get their prescriptions from other countries, where they are more affordable. These patients will also cut their pills in half or take a medication every other day instead of every day, to economize on drug costs.

Another “trick” they use to save money – and I have heard pharmacists and pharmaceutical reps themselves recommend this – is to ask for a higher dose of a medication, usually double, and then use a pill cutter to divide a tablet in half, thus making their prescription last twice as long. Why do Americans have to resort to such “workarounds”?

Many of the medications advertised are for relatively rare conditions, such as thyroid eye disease or myasthenia gravis (which affects up to about 60,000 patients in the United States). Why not spend these advertising dollars on programs to make drugs taken by the millions of Americans with common conditions (for example, hypertension, diabetes, heart failure) more affordable?

Very often the television ads contain medical jargon, such as: “If you have the EGFR mutation, or if your cancer is HER2 negative ...”

Do most patients truly understand what these terms mean? And what happens when a patient’s physician doesn’t prescribe a medication that a patient has seen on TV and asks for, or when the physician believes that a generic (nonadvertised) medication might work just as well? This creates conflict and potential discord, adversely affecting the doctor-patient relationship.

An oncologist colleague related to me that he often has to spend time correcting patients’ misperceptions of potential miracle cures offered by these ads, and that several patients have left his practice because he would not prescribe a drug they saw advertised.

Further, while these ads urge patients to try expensive “newest and latest” treatments, pharmacy benefit plans are working with health care insurance conglomerates to reduce costs of pharmaceuticals.

How does this juxtaposition of opposing forces make any sense?

It is time for us to put an end to DTC advertising, at least on television. It will require legislative action by our federal government to end this practice (legal, by the way, only in the United States and New Zealand), and hence the willingness of our politicians to get behind legislation to do so.

Just as a law was passed to prohibit tobacco advertising on television, so should a law be passed to regulate DTC pharmaceutical advertising.

The time to end DTC advertising has come!
 

Lloyd Alterman, MD, is a retired physician and chairman of the New Jersey Universal Healthcare Coalition. He disclosed having no relevant financial relationships.

A version of this article first appeared on Medscape.com.

One has to be living off the grid to not be bombarded with direct-to-consumer (DTC) pharmaceutical advertising. Since 1997, when the Food and Drug Administration eased restrictions on this prohibition and allowed pharmaceutical companies to promote prescription-only medications to the public, there has been a deluge of ads in magazines, on the Internet, and, most annoying, on commercial television.

These television ads are quite formulaic:

We are initially introduced to a number of highly functioning patients (typically actors) who are engaged in rewarding pursuits. A voiceover narration then presents the pharmaceutical to be promoted, suggesting (not so subtly) to consumers that taking the advertised drug will improve one’s disease outlook or quality of life such that they too, just like the actors in the minidrama, can lead such highly productive lives.

The potential best-case scenarios of these new treatments may be stated. There then follows a litany of side effects – some of them life threatening – warnings, and contraindications. We’re again treated to another 5 or 10 seconds of patients leading “the good life,” and almost all of the ads end with the narrator concluding: “Ask your doctor (sometimes ‘provider’) if _____ is right for you.”

Big pharma spends nearly $10 billion on DTC advertising, with television ads accounting for the vast majority of these dollars. Is this type of advertising appropriate? Or even ethical?

Americans spend more money on their prescriptions than do citizens of any other highly developed nation. I have personally heard from patients who get their prescriptions from other countries, where they are more affordable. These patients will also cut their pills in half or take a medication every other day instead of every day, to economize on drug costs.

Another “trick” they use to save money – and I have heard pharmacists and pharmaceutical reps themselves recommend this – is to ask for a higher dose of a medication, usually double, and then use a pill cutter to divide a tablet in half, thus making their prescription last twice as long. Why do Americans have to resort to such “workarounds”?

Many of the medications advertised are for relatively rare conditions, such as thyroid eye disease or myasthenia gravis (which affects up to about 60,000 patients in the United States). Why not spend these advertising dollars on programs to make drugs taken by the millions of Americans with common conditions (for example, hypertension, diabetes, heart failure) more affordable?

Very often the television ads contain medical jargon, such as: “If you have the EGFR mutation, or if your cancer is HER2 negative ...”

Do most patients truly understand what these terms mean? And what happens when a patient’s physician doesn’t prescribe a medication that a patient has seen on TV and asks for, or when the physician believes that a generic (nonadvertised) medication might work just as well? This creates conflict and potential discord, adversely affecting the doctor-patient relationship.

An oncologist colleague related to me that he often has to spend time correcting patients’ misperceptions of potential miracle cures offered by these ads, and that several patients have left his practice because he would not prescribe a drug they saw advertised.

Further, while these ads urge patients to try expensive “newest and latest” treatments, pharmacy benefit plans are working with health care insurance conglomerates to reduce costs of pharmaceuticals.

How does this juxtaposition of opposing forces make any sense?

It is time for us to put an end to DTC advertising, at least on television. It will require legislative action by our federal government to end this practice (legal, by the way, only in the United States and New Zealand), and hence the willingness of our politicians to get behind legislation to do so.

Just as a law was passed to prohibit tobacco advertising on television, so should a law be passed to regulate DTC pharmaceutical advertising.

The time to end DTC advertising has come!
 

Lloyd Alterman, MD, is a retired physician and chairman of the New Jersey Universal Healthcare Coalition. He disclosed having no relevant financial relationships.

A version of this article first appeared on Medscape.com.

One has to be living off the grid to not be bombarded with direct-to-consumer (DTC) pharmaceutical advertising. Since 1997, when the Food and Drug Administration eased restrictions on this prohibition and allowed pharmaceutical companies to promote prescription-only medications to the public, there has been a deluge of ads in magazines, on the Internet, and, most annoying, on commercial television.

These television ads are quite formulaic:

We are initially introduced to a number of highly functioning patients (typically actors) who are engaged in rewarding pursuits. A voiceover narration then presents the pharmaceutical to be promoted, suggesting (not so subtly) to consumers that taking the advertised drug will improve one’s disease outlook or quality of life such that they too, just like the actors in the minidrama, can lead such highly productive lives.

The potential best-case scenarios of these new treatments may be stated. There then follows a litany of side effects – some of them life threatening – warnings, and contraindications. We’re again treated to another 5 or 10 seconds of patients leading “the good life,” and almost all of the ads end with the narrator concluding: “Ask your doctor (sometimes ‘provider’) if _____ is right for you.”

Big pharma spends nearly $10 billion on DTC advertising, with television ads accounting for the vast majority of these dollars. Is this type of advertising appropriate? Or even ethical?

Americans spend more money on their prescriptions than do citizens of any other highly developed nation. I have personally heard from patients who get their prescriptions from other countries, where they are more affordable. These patients will also cut their pills in half or take a medication every other day instead of every day, to economize on drug costs.

Another “trick” they use to save money – and I have heard pharmacists and pharmaceutical reps themselves recommend this – is to ask for a higher dose of a medication, usually double, and then use a pill cutter to divide a tablet in half, thus making their prescription last twice as long. Why do Americans have to resort to such “workarounds”?

Many of the medications advertised are for relatively rare conditions, such as thyroid eye disease or myasthenia gravis (which affects up to about 60,000 patients in the United States). Why not spend these advertising dollars on programs to make drugs taken by the millions of Americans with common conditions (for example, hypertension, diabetes, heart failure) more affordable?

Very often the television ads contain medical jargon, such as: “If you have the EGFR mutation, or if your cancer is HER2 negative ...”

Do most patients truly understand what these terms mean? And what happens when a patient’s physician doesn’t prescribe a medication that a patient has seen on TV and asks for, or when the physician believes that a generic (nonadvertised) medication might work just as well? This creates conflict and potential discord, adversely affecting the doctor-patient relationship.

An oncologist colleague related to me that he often has to spend time correcting patients’ misperceptions of potential miracle cures offered by these ads, and that several patients have left his practice because he would not prescribe a drug they saw advertised.

Further, while these ads urge patients to try expensive “newest and latest” treatments, pharmacy benefit plans are working with health care insurance conglomerates to reduce costs of pharmaceuticals.

How does this juxtaposition of opposing forces make any sense?

It is time for us to put an end to DTC advertising, at least on television. It will require legislative action by our federal government to end this practice (legal, by the way, only in the United States and New Zealand), and hence the willingness of our politicians to get behind legislation to do so.

Just as a law was passed to prohibit tobacco advertising on television, so should a law be passed to regulate DTC pharmaceutical advertising.

The time to end DTC advertising has come!
 

Lloyd Alterman, MD, is a retired physician and chairman of the New Jersey Universal Healthcare Coalition. He disclosed having no relevant financial relationships.

A version of this article first appeared on Medscape.com.

As the number of female veterans continues to grow, the US Department of Veterans Affairs (VA) is adjusting by focusing more on breast/gynecological cancer and referring fewer cases to outside clinicians.

The VA’s effort reflects the reality that female veterans from the wars in Afghanistan and Iraq are approaching the ages—50s, 60s, and 70s—when cancer diagnoses become more common, said Sarah Colonna, MD, national medical director of breast oncology for VA's Breast and Gynecologic Oncology System of Excellence and an oncologist at the Huntsman Cancer Institute and Wahlen VA Medical Center in Salt Lake City, Utah. “This is preparation for the change that we know is coming.”

In response, the Association of VA Hematology/Oncology (AVAHO) is devoting a regional meeting in Tampa, Florida (July 29, 2023) to improving survivorship for patients with women’s cancers. “This meeting is designed to educate both cancer experts and primary care providers on the care of women who have already gone through breast and gynecological cancer treatment,” Colonna explained.

Adherence Challenges

Colonna will speak in a session about the importance of adherence to endocrine therapy. “When we prescribe endocrine therapy for breast cancer, we usually ask women to stay on it for 5 to 10 years, and sometimes that’s hard for them,” she said. “I’ll talk about tips and tricks to help women stay on endocrine therapy for the long haul because we know that is linked to better survival.”

Between two-thirds and three-quarters of women with breast cancer are advised to stay on endocrine drugs, she said, but the medications can be difficult to tolerate due to adverse effects such as hot flashes and sleep disturbances.

In addition, patients are often anxious about the medications. “Women are very leery of anything that changes or makes their hormones different,” Colonna noted. “They feel like it’s messing with something that is natural for them.”

Colonna urges colleagues to focus on their “soft skills,” the ability to absorb and validate the worries of patients. Instead of dismissing them, she said, focus on messages that acknowledge concerns but are also firm: “That’s real, that sucks. But we’ve got to do it.”

It’s also helpful to guide patients away from thinking that taking a pill every day means they’re sick. “I try to flip that paradigm: ‘You’re taking this pill every day because you have power over this thing that happened to you.’”

Education is also key, she said, so that patients “understand very clearly why this medication is important for them: It increases the chance of surviving breast cancer or it increases the chances that the cancer will never come back in your arm or in your breast. Then, whether they make a decision to take it or not, at least they’re making the choice with knowledge.”

As for adverse effects, Colonna said medications such as antidepressants and painkillers can relieve hot flashes, which can disturb sleep.

Identifying the best strategy to address adverse effects “requires keeping in frequent contact with the patient during the first 6 months of endocrine therapy, which are really critical,” she said. “Once they’ve been on it for a year, they can see the light at the end of the tunnel and hang in there even if they have adverse effects.”

Some guidelines suggest that no doctor visits are needed until the 6-month mark, but Colonna prefers to check in at the 4- to 6-week mark, even if it’s just via a phone call. Otherwise, “often they’ll stop taking the pill, and then you won’t know about it until you see them at 6 six months.” At that point, she said, a critical period for treatment has passed.

The Role of Nurse Navigators

In another session at the Tampa regional meeting, AVAHO president-elect Cindy Bowman, MSN, RN, OCN, will moderate a session about the role of nurse navigators in VA cancer care. She is the coordinator of the Cancer Care Navigation Program at the C. W. Bill Young VA Medical Center in Bay Pines, Florida.

“Veterans become survivors the day they’re diagnosed with cancer,” she said. Within the VA, cancer-care navigator teams developed over the past decade aim to help patients find their way forward through survivorship, she said, and nurses are crucial to the effort.

As Sharp and Scheid reported in a 2018 Journal Oncology Navigation Survivorship article, “research demonstrates that navigation can improve access to the cancer care system by addressing barriers, as well as facilitating quality care. The benefits of patient navigation for improving cancer patient outcomes is considerable.” McKenney and colleagues found that “patient navigation has been demonstrated to increase access to screening, shorten time to diagnostic resolution, and improve cancer outcomes, particularly in health disparity populations, such as women of color, rural populations, and poor women.” 

According to Bowman, “it has become standard practice to have nurse navigators be there each step of the way from a high suspicion of cancer to diagnosis and through the clinical workup into active treatment and survivorship.” Within the VA, she said, “the focus right now is to look at standardizing care that all VAs will be able to offer holistic, comprehensive cancer-care navigation teams.”

At the regional meeting, Bowman’s session will include updates from nurse navigators about helping patients through breast/gynecological cancer, abnormal mammograms, and survivorship.

Nurse navigators are typically the second medical professionals who talk to cancer patients after their physicians, Bowman said. The unique knowledge of oncology nurse navigators gives them invaluable insight into treatment plans and cancer drug regimens, she said.

“They’re able to sit down and discuss the actual cancer drug regimen with patients—what each of those drugs do, how they’re administered, the short-term and long-term side effects,” she said. “They have the knowledge about all aspects of cancer care that can really only come from somebody who’s specialty trained.”

Other sessions at the AVAHO regional meeting will highlight breast cancer and lymphedema, breast cancer and bone health; diet, exercise and cancer; sexual health for breast/gynecological cancer survivors; and imaging surveillance after diagnosis.

As the number of female veterans continues to grow, the US Department of Veterans Affairs (VA) is adjusting by focusing more on breast/gynecological cancer and referring fewer cases to outside clinicians.

The VA’s effort reflects the reality that female veterans from the wars in Afghanistan and Iraq are approaching the ages—50s, 60s, and 70s—when cancer diagnoses become more common, said Sarah Colonna, MD, national medical director of breast oncology for VA's Breast and Gynecologic Oncology System of Excellence and an oncologist at the Huntsman Cancer Institute and Wahlen VA Medical Center in Salt Lake City, Utah. “This is preparation for the change that we know is coming.”

In response, the Association of VA Hematology/Oncology (AVAHO) is devoting a regional meeting in Tampa, Florida (July 29, 2023) to improving survivorship for patients with women’s cancers. “This meeting is designed to educate both cancer experts and primary care providers on the care of women who have already gone through breast and gynecological cancer treatment,” Colonna explained.

Adherence Challenges

Colonna will speak in a session about the importance of adherence to endocrine therapy. “When we prescribe endocrine therapy for breast cancer, we usually ask women to stay on it for 5 to 10 years, and sometimes that’s hard for them,” she said. “I’ll talk about tips and tricks to help women stay on endocrine therapy for the long haul because we know that is linked to better survival.”

Between two-thirds and three-quarters of women with breast cancer are advised to stay on endocrine drugs, she said, but the medications can be difficult to tolerate due to adverse effects such as hot flashes and sleep disturbances.

In addition, patients are often anxious about the medications. “Women are very leery of anything that changes or makes their hormones different,” Colonna noted. “They feel like it’s messing with something that is natural for them.”

Colonna urges colleagues to focus on their “soft skills,” the ability to absorb and validate the worries of patients. Instead of dismissing them, she said, focus on messages that acknowledge concerns but are also firm: “That’s real, that sucks. But we’ve got to do it.”

It’s also helpful to guide patients away from thinking that taking a pill every day means they’re sick. “I try to flip that paradigm: ‘You’re taking this pill every day because you have power over this thing that happened to you.’”

Education is also key, she said, so that patients “understand very clearly why this medication is important for them: It increases the chance of surviving breast cancer or it increases the chances that the cancer will never come back in your arm or in your breast. Then, whether they make a decision to take it or not, at least they’re making the choice with knowledge.”

As for adverse effects, Colonna said medications such as antidepressants and painkillers can relieve hot flashes, which can disturb sleep.

Identifying the best strategy to address adverse effects “requires keeping in frequent contact with the patient during the first 6 months of endocrine therapy, which are really critical,” she said. “Once they’ve been on it for a year, they can see the light at the end of the tunnel and hang in there even if they have adverse effects.”

Some guidelines suggest that no doctor visits are needed until the 6-month mark, but Colonna prefers to check in at the 4- to 6-week mark, even if it’s just via a phone call. Otherwise, “often they’ll stop taking the pill, and then you won’t know about it until you see them at 6 six months.” At that point, she said, a critical period for treatment has passed.

The Role of Nurse Navigators

In another session at the Tampa regional meeting, AVAHO president-elect Cindy Bowman, MSN, RN, OCN, will moderate a session about the role of nurse navigators in VA cancer care. She is the coordinator of the Cancer Care Navigation Program at the C. W. Bill Young VA Medical Center in Bay Pines, Florida.

“Veterans become survivors the day they’re diagnosed with cancer,” she said. Within the VA, cancer-care navigator teams developed over the past decade aim to help patients find their way forward through survivorship, she said, and nurses are crucial to the effort.

As Sharp and Scheid reported in a 2018 Journal Oncology Navigation Survivorship article, “research demonstrates that navigation can improve access to the cancer care system by addressing barriers, as well as facilitating quality care. The benefits of patient navigation for improving cancer patient outcomes is considerable.” McKenney and colleagues found that “patient navigation has been demonstrated to increase access to screening, shorten time to diagnostic resolution, and improve cancer outcomes, particularly in health disparity populations, such as women of color, rural populations, and poor women.” 

According to Bowman, “it has become standard practice to have nurse navigators be there each step of the way from a high suspicion of cancer to diagnosis and through the clinical workup into active treatment and survivorship.” Within the VA, she said, “the focus right now is to look at standardizing care that all VAs will be able to offer holistic, comprehensive cancer-care navigation teams.”

At the regional meeting, Bowman’s session will include updates from nurse navigators about helping patients through breast/gynecological cancer, abnormal mammograms, and survivorship.

Nurse navigators are typically the second medical professionals who talk to cancer patients after their physicians, Bowman said. The unique knowledge of oncology nurse navigators gives them invaluable insight into treatment plans and cancer drug regimens, she said.

“They’re able to sit down and discuss the actual cancer drug regimen with patients—what each of those drugs do, how they’re administered, the short-term and long-term side effects,” she said. “They have the knowledge about all aspects of cancer care that can really only come from somebody who’s specialty trained.”

Other sessions at the AVAHO regional meeting will highlight breast cancer and lymphedema, breast cancer and bone health; diet, exercise and cancer; sexual health for breast/gynecological cancer survivors; and imaging surveillance after diagnosis.

As the number of female veterans continues to grow, the US Department of Veterans Affairs (VA) is adjusting by focusing more on breast/gynecological cancer and referring fewer cases to outside clinicians.

The VA’s effort reflects the reality that female veterans from the wars in Afghanistan and Iraq are approaching the ages—50s, 60s, and 70s—when cancer diagnoses become more common, said Sarah Colonna, MD, national medical director of breast oncology for VA's Breast and Gynecologic Oncology System of Excellence and an oncologist at the Huntsman Cancer Institute and Wahlen VA Medical Center in Salt Lake City, Utah. “This is preparation for the change that we know is coming.”

In response, the Association of VA Hematology/Oncology (AVAHO) is devoting a regional meeting in Tampa, Florida (July 29, 2023) to improving survivorship for patients with women’s cancers. “This meeting is designed to educate both cancer experts and primary care providers on the care of women who have already gone through breast and gynecological cancer treatment,” Colonna explained.

Adherence Challenges

Colonna will speak in a session about the importance of adherence to endocrine therapy. “When we prescribe endocrine therapy for breast cancer, we usually ask women to stay on it for 5 to 10 years, and sometimes that’s hard for them,” she said. “I’ll talk about tips and tricks to help women stay on endocrine therapy for the long haul because we know that is linked to better survival.”

Between two-thirds and three-quarters of women with breast cancer are advised to stay on endocrine drugs, she said, but the medications can be difficult to tolerate due to adverse effects such as hot flashes and sleep disturbances.

In addition, patients are often anxious about the medications. “Women are very leery of anything that changes or makes their hormones different,” Colonna noted. “They feel like it’s messing with something that is natural for them.”

Colonna urges colleagues to focus on their “soft skills,” the ability to absorb and validate the worries of patients. Instead of dismissing them, she said, focus on messages that acknowledge concerns but are also firm: “That’s real, that sucks. But we’ve got to do it.”

It’s also helpful to guide patients away from thinking that taking a pill every day means they’re sick. “I try to flip that paradigm: ‘You’re taking this pill every day because you have power over this thing that happened to you.’”

Education is also key, she said, so that patients “understand very clearly why this medication is important for them: It increases the chance of surviving breast cancer or it increases the chances that the cancer will never come back in your arm or in your breast. Then, whether they make a decision to take it or not, at least they’re making the choice with knowledge.”

As for adverse effects, Colonna said medications such as antidepressants and painkillers can relieve hot flashes, which can disturb sleep.

Identifying the best strategy to address adverse effects “requires keeping in frequent contact with the patient during the first 6 months of endocrine therapy, which are really critical,” she said. “Once they’ve been on it for a year, they can see the light at the end of the tunnel and hang in there even if they have adverse effects.”

Some guidelines suggest that no doctor visits are needed until the 6-month mark, but Colonna prefers to check in at the 4- to 6-week mark, even if it’s just via a phone call. Otherwise, “often they’ll stop taking the pill, and then you won’t know about it until you see them at 6 six months.” At that point, she said, a critical period for treatment has passed.

The Role of Nurse Navigators

In another session at the Tampa regional meeting, AVAHO president-elect Cindy Bowman, MSN, RN, OCN, will moderate a session about the role of nurse navigators in VA cancer care. She is the coordinator of the Cancer Care Navigation Program at the C. W. Bill Young VA Medical Center in Bay Pines, Florida.

“Veterans become survivors the day they’re diagnosed with cancer,” she said. Within the VA, cancer-care navigator teams developed over the past decade aim to help patients find their way forward through survivorship, she said, and nurses are crucial to the effort.

As Sharp and Scheid reported in a 2018 Journal Oncology Navigation Survivorship article, “research demonstrates that navigation can improve access to the cancer care system by addressing barriers, as well as facilitating quality care. The benefits of patient navigation for improving cancer patient outcomes is considerable.” McKenney and colleagues found that “patient navigation has been demonstrated to increase access to screening, shorten time to diagnostic resolution, and improve cancer outcomes, particularly in health disparity populations, such as women of color, rural populations, and poor women.” 

According to Bowman, “it has become standard practice to have nurse navigators be there each step of the way from a high suspicion of cancer to diagnosis and through the clinical workup into active treatment and survivorship.” Within the VA, she said, “the focus right now is to look at standardizing care that all VAs will be able to offer holistic, comprehensive cancer-care navigation teams.”

At the regional meeting, Bowman’s session will include updates from nurse navigators about helping patients through breast/gynecological cancer, abnormal mammograms, and survivorship.

Nurse navigators are typically the second medical professionals who talk to cancer patients after their physicians, Bowman said. The unique knowledge of oncology nurse navigators gives them invaluable insight into treatment plans and cancer drug regimens, she said.

“They’re able to sit down and discuss the actual cancer drug regimen with patients—what each of those drugs do, how they’re administered, the short-term and long-term side effects,” she said. “They have the knowledge about all aspects of cancer care that can really only come from somebody who’s specialty trained.”

Other sessions at the AVAHO regional meeting will highlight breast cancer and lymphedema, breast cancer and bone health; diet, exercise and cancer; sexual health for breast/gynecological cancer survivors; and imaging surveillance after diagnosis.

Key clinical point: Women who survive stages I-III breast cancer (BC) may experience improved survival outcomes on adhering to a low-carbohydrate diet, particularly one that is plant-rich.

Major finding: Compared with women having the highest carbohydrate intake, lowest protein intake, and lowest fat intake after BC diagnosis, those adhering to an overall low‐carbohydrate diet (hazard ratio [HR] 0.82; P_trend = .0001) and a plant‐rich low‐carbohydrate diet (HR 0.73; P_trend < .0001) had a significantly lower risk for all-cause mortality.

Study details: Findings are from an analysis of two ongoing cohort studies, the Nurses’ Health Study (NHS) and NHS II, including 9621 women with stages I-III BC, of which 1269 women died from BC.

Disclosures: This study was sponsored by the US National Institutes of Health and University of Toronto. Two authors declared being the founder of or receiving personal fees, nonfinancial support, and grants from various sources. The other authors declared no conflicts of interest.

Source: Farvid MS et al. Associations of low-carbohydrate diets with breast cancer survival. Cancer. 2023 (Jun 10). Doi: 10.1002/cncr.34819

Key clinical point: Women who survive stages I-III breast cancer (BC) may experience improved survival outcomes on adhering to a low-carbohydrate diet, particularly one that is plant-rich.

Major finding: Compared with women having the highest carbohydrate intake, lowest protein intake, and lowest fat intake after BC diagnosis, those adhering to an overall low‐carbohydrate diet (hazard ratio [HR] 0.82; P_trend = .0001) and a plant‐rich low‐carbohydrate diet (HR 0.73; P_trend < .0001) had a significantly lower risk for all-cause mortality.

Study details: Findings are from an analysis of two ongoing cohort studies, the Nurses’ Health Study (NHS) and NHS II, including 9621 women with stages I-III BC, of which 1269 women died from BC.

Disclosures: This study was sponsored by the US National Institutes of Health and University of Toronto. Two authors declared being the founder of or receiving personal fees, nonfinancial support, and grants from various sources. The other authors declared no conflicts of interest.

Source: Farvid MS et al. Associations of low-carbohydrate diets with breast cancer survival. Cancer. 2023 (Jun 10). Doi: 10.1002/cncr.34819

Key clinical point: Women who survive stages I-III breast cancer (BC) may experience improved survival outcomes on adhering to a low-carbohydrate diet, particularly one that is plant-rich.

Major finding: Compared with women having the highest carbohydrate intake, lowest protein intake, and lowest fat intake after BC diagnosis, those adhering to an overall low‐carbohydrate diet (hazard ratio [HR] 0.82; P_trend = .0001) and a plant‐rich low‐carbohydrate diet (HR 0.73; P_trend < .0001) had a significantly lower risk for all-cause mortality.

Study details: Findings are from an analysis of two ongoing cohort studies, the Nurses’ Health Study (NHS) and NHS II, including 9621 women with stages I-III BC, of which 1269 women died from BC.

Disclosures: This study was sponsored by the US National Institutes of Health and University of Toronto. Two authors declared being the founder of or receiving personal fees, nonfinancial support, and grants from various sources. The other authors declared no conflicts of interest.

Source: Farvid MS et al. Associations of low-carbohydrate diets with breast cancer survival. Cancer. 2023 (Jun 10). Doi: 10.1002/cncr.34819

Key clinical point: The level of stromal tumor-infiltrating lymphocytes (TIL) can provide insights on disease-free survival (DFS) outcomes in human epidermal growth factor receptor 2-low-positive (HER2-low+) early-stage breast cancer (BC).

Major finding: High (>10%) vs low (≤10%) TIL levels were associated with a 53% improvement in DFS in HER2-low+ BC (hazard ratio [HR] 0.47; P = .035) and 58% improvement in DFS in hormone receptor-positive/HER2-low+ BC (HR 0.42; P = .032).

Study details: Findings are from a single-institution retrospective analysis including 1763 patients with early-stage BC who underwent surgery, of whom 429 patients were HER2+, 739 were HER2-low+, and 595 were HER2-0.

Disclosures: This study was supported by the National Natural Science Foundation of China and the Natural Science Foundation of Shandong Province. The authors declared no conflicts of interest.

Source: Sun T et al. Tumor-infiltrating lymphocytes provides recent survival information for early-stage HER2-low-positive breast cancer: A large cohort retrospective study. Front Oncol. 2023;13:1148228 (Jun 20). Doi: 10.3389/fonc.2023.1148228

Key clinical point: The level of stromal tumor-infiltrating lymphocytes (TIL) can provide insights on disease-free survival (DFS) outcomes in human epidermal growth factor receptor 2-low-positive (HER2-low+) early-stage breast cancer (BC).

Major finding: High (>10%) vs low (≤10%) TIL levels were associated with a 53% improvement in DFS in HER2-low+ BC (hazard ratio [HR] 0.47; P = .035) and 58% improvement in DFS in hormone receptor-positive/HER2-low+ BC (HR 0.42; P = .032).

Study details: Findings are from a single-institution retrospective analysis including 1763 patients with early-stage BC who underwent surgery, of whom 429 patients were HER2+, 739 were HER2-low+, and 595 were HER2-0.

Disclosures: This study was supported by the National Natural Science Foundation of China and the Natural Science Foundation of Shandong Province. The authors declared no conflicts of interest.

Source: Sun T et al. Tumor-infiltrating lymphocytes provides recent survival information for early-stage HER2-low-positive breast cancer: A large cohort retrospective study. Front Oncol. 2023;13:1148228 (Jun 20). Doi: 10.3389/fonc.2023.1148228

Key clinical point: The level of stromal tumor-infiltrating lymphocytes (TIL) can provide insights on disease-free survival (DFS) outcomes in human epidermal growth factor receptor 2-low-positive (HER2-low+) early-stage breast cancer (BC).

Major finding: High (>10%) vs low (≤10%) TIL levels were associated with a 53% improvement in DFS in HER2-low+ BC (hazard ratio [HR] 0.47; P = .035) and 58% improvement in DFS in hormone receptor-positive/HER2-low+ BC (HR 0.42; P = .032).

Study details: Findings are from a single-institution retrospective analysis including 1763 patients with early-stage BC who underwent surgery, of whom 429 patients were HER2+, 739 were HER2-low+, and 595 were HER2-0.

Disclosures: This study was supported by the National Natural Science Foundation of China and the Natural Science Foundation of Shandong Province. The authors declared no conflicts of interest.

Source: Sun T et al. Tumor-infiltrating lymphocytes provides recent survival information for early-stage HER2-low-positive breast cancer: A large cohort retrospective study. Front Oncol. 2023;13:1148228 (Jun 20). Doi: 10.3389/fonc.2023.1148228

Key clinical point: High cardiorespiratory fitness (CRF) may prevent the development of breast cancer (BC) in postmenopausal women.

Major finding: Compared with women with low-to-moderate estimated CRF, those with high eCRF had 24% lower odds of developing BC (adjusted subdistribution hazard ratio 0.76; 95% CI 0.60-0.97).

Study details: This study used the UK Biobank data to evaluate 17,840 post-menopausal women who were free of cancer and were followed for 11 years, of which 529 women developed BC.

Disclosures: This project was funded in part by the Canadian Institutes of Health Research and discretionary funds held by JD Brooks. The authors declared no conflicts of interest.

Source: Christensen RAG et al. Association between estimated cardiorespiratory fitness and breast cancer: A prospective cohort study. Br J Sports Med. 2023 (Jun 19). Doi: 10.1136/bjsports-2021-104870

Key clinical point: High cardiorespiratory fitness (CRF) may prevent the development of breast cancer (BC) in postmenopausal women.

Major finding: Compared with women with low-to-moderate estimated CRF, those with high eCRF had 24% lower odds of developing BC (adjusted subdistribution hazard ratio 0.76; 95% CI 0.60-0.97).

Study details: This study used the UK Biobank data to evaluate 17,840 post-menopausal women who were free of cancer and were followed for 11 years, of which 529 women developed BC.

Disclosures: This project was funded in part by the Canadian Institutes of Health Research and discretionary funds held by JD Brooks. The authors declared no conflicts of interest.

Source: Christensen RAG et al. Association between estimated cardiorespiratory fitness and breast cancer: A prospective cohort study. Br J Sports Med. 2023 (Jun 19). Doi: 10.1136/bjsports-2021-104870

Key clinical point: High cardiorespiratory fitness (CRF) may prevent the development of breast cancer (BC) in postmenopausal women.

Major finding: Compared with women with low-to-moderate estimated CRF, those with high eCRF had 24% lower odds of developing BC (adjusted subdistribution hazard ratio 0.76; 95% CI 0.60-0.97).

Study details: This study used the UK Biobank data to evaluate 17,840 post-menopausal women who were free of cancer and were followed for 11 years, of which 529 women developed BC.

Disclosures: This project was funded in part by the Canadian Institutes of Health Research and discretionary funds held by JD Brooks. The authors declared no conflicts of interest.

Source: Christensen RAG et al. Association between estimated cardiorespiratory fitness and breast cancer: A prospective cohort study. Br J Sports Med. 2023 (Jun 19). Doi: 10.1136/bjsports-2021-104870

Key clinical point: Breast-conserving surgery (BCS) led to similar overall survival (OS) and better disease-specific survival (DSS) outcomes compared with mastectomy in patients with stage I/II adenoid cystic carcinoma of the breast (BACC).

Major finding: The 10-year OS rates were comparable between the BCS and mastectomy groups (P = .968), whereas DSS was significantly improved in patients who underwent BCS vs mastectomy (95% vs 89%; P = .002).

Study details: Findings are from an analysis of the Surveillance, Epidemiology, and End Results Program (SEER) including 583 patients with stage I/II BACC, of whom 386 patients underwent BCS and 197 patients underwent mastectomy.

Disclosures: This study was supported by various grants from the Science and Technology Department of Henan Province, China. The authors declared no conflicts of interest.

Source: Huang T et al. Optimal surgical procedure for treating early-stage adenoid cystic carcinoma of the breast. Sci Rep. 2023;13:10222 (Jun 23). Doi: 10.1038/s41598-023-36644-w

Key clinical point: Breast-conserving surgery (BCS) led to similar overall survival (OS) and better disease-specific survival (DSS) outcomes compared with mastectomy in patients with stage I/II adenoid cystic carcinoma of the breast (BACC).

Major finding: The 10-year OS rates were comparable between the BCS and mastectomy groups (P = .968), whereas DSS was significantly improved in patients who underwent BCS vs mastectomy (95% vs 89%; P = .002).

Study details: Findings are from an analysis of the Surveillance, Epidemiology, and End Results Program (SEER) including 583 patients with stage I/II BACC, of whom 386 patients underwent BCS and 197 patients underwent mastectomy.

Disclosures: This study was supported by various grants from the Science and Technology Department of Henan Province, China. The authors declared no conflicts of interest.

Source: Huang T et al. Optimal surgical procedure for treating early-stage adenoid cystic carcinoma of the breast. Sci Rep. 2023;13:10222 (Jun 23). Doi: 10.1038/s41598-023-36644-w

Key clinical point: Breast-conserving surgery (BCS) led to similar overall survival (OS) and better disease-specific survival (DSS) outcomes compared with mastectomy in patients with stage I/II adenoid cystic carcinoma of the breast (BACC).

Major finding: The 10-year OS rates were comparable between the BCS and mastectomy groups (P = .968), whereas DSS was significantly improved in patients who underwent BCS vs mastectomy (95% vs 89%; P = .002).

Study details: Findings are from an analysis of the Surveillance, Epidemiology, and End Results Program (SEER) including 583 patients with stage I/II BACC, of whom 386 patients underwent BCS and 197 patients underwent mastectomy.

Disclosures: This study was supported by various grants from the Science and Technology Department of Henan Province, China. The authors declared no conflicts of interest.

Source: Huang T et al. Optimal surgical procedure for treating early-stage adenoid cystic carcinoma of the breast. Sci Rep. 2023;13:10222 (Jun 23). Doi: 10.1038/s41598-023-36644-w

Key clinical point: Adherence and persistence to adjuvant hormone therapy was associated with improved survival outcomes in older women with hormone receptor-positive (HR+) breast cancer (BC).

Major finding: The risk for all-cause mortality reduced by 25% in patients with vs without cumulative adherence to hormone therapy (hazard ratio [HR] 0.75; P < .001) and decreased by 11% for every 1-year increase in persistence (HR 0.89; P < .001). Each 1-year increase in persistence to hormone therapy also significantly improved breast cancer-specific mortality (HR 0.63; P < .001).

Study details: Findings are from a retrospective analysis of the Surveillance, Epidemiology, and End Results (SEER) data linked with US Medicare claims that included 25,796 older women with HR+ BC who were ≥66 years old and received adjuvant hormone therapy.

Disclosures: This study was partly supported by a grant from the Lilly Endowment, Inc. The authors declared no conflicts of interest.

Source: Zheng D and Thomas J 3rd. Survival benefits associated with being adherent and having longer persistence to adjuvant hormone therapy across up to five years among U.S. Medicare population with breast cancer. Breast Cancer Res Treat. 2023;201:89-104 (Jun 16). Doi: 10.1007/s10549-023-06992-2

Key clinical point: Adherence and persistence to adjuvant hormone therapy was associated with improved survival outcomes in older women with hormone receptor-positive (HR+) breast cancer (BC).

Major finding: The risk for all-cause mortality reduced by 25% in patients with vs without cumulative adherence to hormone therapy (hazard ratio [HR] 0.75; P < .001) and decreased by 11% for every 1-year increase in persistence (HR 0.89; P < .001). Each 1-year increase in persistence to hormone therapy also significantly improved breast cancer-specific mortality (HR 0.63; P < .001).

Study details: Findings are from a retrospective analysis of the Surveillance, Epidemiology, and End Results (SEER) data linked with US Medicare claims that included 25,796 older women with HR+ BC who were ≥66 years old and received adjuvant hormone therapy.

Disclosures: This study was partly supported by a grant from the Lilly Endowment, Inc. The authors declared no conflicts of interest.

Source: Zheng D and Thomas J 3rd. Survival benefits associated with being adherent and having longer persistence to adjuvant hormone therapy across up to five years among U.S. Medicare population with breast cancer. Breast Cancer Res Treat. 2023;201:89-104 (Jun 16). Doi: 10.1007/s10549-023-06992-2

Key clinical point: Adherence and persistence to adjuvant hormone therapy was associated with improved survival outcomes in older women with hormone receptor-positive (HR+) breast cancer (BC).

Major finding: The risk for all-cause mortality reduced by 25% in patients with vs without cumulative adherence to hormone therapy (hazard ratio [HR] 0.75; P < .001) and decreased by 11% for every 1-year increase in persistence (HR 0.89; P < .001). Each 1-year increase in persistence to hormone therapy also significantly improved breast cancer-specific mortality (HR 0.63; P < .001).

Study details: Findings are from a retrospective analysis of the Surveillance, Epidemiology, and End Results (SEER) data linked with US Medicare claims that included 25,796 older women with HR+ BC who were ≥66 years old and received adjuvant hormone therapy.

Disclosures: This study was partly supported by a grant from the Lilly Endowment, Inc. The authors declared no conflicts of interest.

Source: Zheng D and Thomas J 3rd. Survival benefits associated with being adherent and having longer persistence to adjuvant hormone therapy across up to five years among U.S. Medicare population with breast cancer. Breast Cancer Res Treat. 2023;201:89-104 (Jun 16). Doi: 10.1007/s10549-023-06992-2

Key clinical point: Although patients with early breast cancer (BC) can undergo immediate breast reconstruction (IBR) after mastectomy, those with invasive BC should be made aware of the possibility of local recurrence (LR) if they have undergone skin- or nipple-sparing mastectomy (SSM/NSM), have not received radiotherapy, or had lymphovascular invasion or cancer at the surgical margin.

Major finding: The rate of 7-year LR was generally low (3.6%) but was higher in invasive vs non-invasive BC (4.3% vs 2.1%; P < .001). SSM/NSM (P < .001), lymphovascular invasion (P = .005), cancer at the surgical margin (P < .001), and no radiotherapy (P = .003) were associated with worse LR rates in invasive BC.

Study details: This retrospective, observational study included 4153 patients with early BC who underwent mastectomy with IBR, of which 2851 and 1272 patients had invasive and non-invasive BC, respectively.

Disclosures: This study was supported by a grant from the scientific committee of the Japanese Breast Cancer Society. The authors declared no conflicts of interest.

Source: Ogiya A et al, on behalf of Collaborative Study Group of Scientific Research of the Japanese Breast Cancer Society. Long-term outcomes of breast cancer patients with local recurrence after mastectomy undergoing immediate breast reconstruction: A retrospective multi-institutional study of 4153 cases. Ann Surg Oncol. 2023 (Jul 5). Doi: 10.1245/s10434-023-13832-6

Key clinical point: Although patients with early breast cancer (BC) can undergo immediate breast reconstruction (IBR) after mastectomy, those with invasive BC should be made aware of the possibility of local recurrence (LR) if they have undergone skin- or nipple-sparing mastectomy (SSM/NSM), have not received radiotherapy, or had lymphovascular invasion or cancer at the surgical margin.

Major finding: The rate of 7-year LR was generally low (3.6%) but was higher in invasive vs non-invasive BC (4.3% vs 2.1%; P < .001). SSM/NSM (P < .001), lymphovascular invasion (P = .005), cancer at the surgical margin (P < .001), and no radiotherapy (P = .003) were associated with worse LR rates in invasive BC.

Study details: This retrospective, observational study included 4153 patients with early BC who underwent mastectomy with IBR, of which 2851 and 1272 patients had invasive and non-invasive BC, respectively.

Disclosures: This study was supported by a grant from the scientific committee of the Japanese Breast Cancer Society. The authors declared no conflicts of interest.

Source: Ogiya A et al, on behalf of Collaborative Study Group of Scientific Research of the Japanese Breast Cancer Society. Long-term outcomes of breast cancer patients with local recurrence after mastectomy undergoing immediate breast reconstruction: A retrospective multi-institutional study of 4153 cases. Ann Surg Oncol. 2023 (Jul 5). Doi: 10.1245/s10434-023-13832-6

Key clinical point: Although patients with early breast cancer (BC) can undergo immediate breast reconstruction (IBR) after mastectomy, those with invasive BC should be made aware of the possibility of local recurrence (LR) if they have undergone skin- or nipple-sparing mastectomy (SSM/NSM), have not received radiotherapy, or had lymphovascular invasion or cancer at the surgical margin.

Major finding: The rate of 7-year LR was generally low (3.6%) but was higher in invasive vs non-invasive BC (4.3% vs 2.1%; P < .001). SSM/NSM (P < .001), lymphovascular invasion (P = .005), cancer at the surgical margin (P < .001), and no radiotherapy (P = .003) were associated with worse LR rates in invasive BC.

Study details: This retrospective, observational study included 4153 patients with early BC who underwent mastectomy with IBR, of which 2851 and 1272 patients had invasive and non-invasive BC, respectively.

Disclosures: This study was supported by a grant from the scientific committee of the Japanese Breast Cancer Society. The authors declared no conflicts of interest.

Source: Ogiya A et al, on behalf of Collaborative Study Group of Scientific Research of the Japanese Breast Cancer Society. Long-term outcomes of breast cancer patients with local recurrence after mastectomy undergoing immediate breast reconstruction: A retrospective multi-institutional study of 4153 cases. Ann Surg Oncol. 2023 (Jul 5). Doi: 10.1245/s10434-023-13832-6

Key clinical point: Invasive lobular carcinoma (ILC), the most common special histological type of breast cancer (BC), had poorer survival outcomes than invasive ductal carcinoma (IDC) and no-lobular special type BC.

Major finding: Patients with ILC vs no-lobular special type BC and IDC had the shortest duration of both disease-free survival (197.2 vs 216.7 and 226.5 months, respectively) and overall survival (209.8 vs 227.9 and 233.2 months, respectively), and ILC vs IDC was associated with significantly worse overall survival (hazard ratio 1.45; P = .045).

Study details: Findings are from a retrospective study including 2157 patients with invasive carcinoma of the breast who were categorized into IDC (n = 1814), ILC (n = 193), and no-lobular special type BC (n = 150).

Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.

Source: Cosar R et al. Classifying invasive lobular carcinoma as special type breast cancer may be reducing its treatment success: A comparison of survival among invasive lobular carcinoma, invasive ductal carcinoma, and no-lobular special type breast cancer. PLoS One. 2023;18(7):e0283445 (Jul 10). Doi: 10.1371/journal.pone.0283445

Key clinical point: Invasive lobular carcinoma (ILC), the most common special histological type of breast cancer (BC), had poorer survival outcomes than invasive ductal carcinoma (IDC) and no-lobular special type BC.

Major finding: Patients with ILC vs no-lobular special type BC and IDC had the shortest duration of both disease-free survival (197.2 vs 216.7 and 226.5 months, respectively) and overall survival (209.8 vs 227.9 and 233.2 months, respectively), and ILC vs IDC was associated with significantly worse overall survival (hazard ratio 1.45; P = .045).

Study details: Findings are from a retrospective study including 2157 patients with invasive carcinoma of the breast who were categorized into IDC (n = 1814), ILC (n = 193), and no-lobular special type BC (n = 150).

Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.

Source: Cosar R et al. Classifying invasive lobular carcinoma as special type breast cancer may be reducing its treatment success: A comparison of survival among invasive lobular carcinoma, invasive ductal carcinoma, and no-lobular special type breast cancer. PLoS One. 2023;18(7):e0283445 (Jul 10). Doi: 10.1371/journal.pone.0283445

Key clinical point: Invasive lobular carcinoma (ILC), the most common special histological type of breast cancer (BC), had poorer survival outcomes than invasive ductal carcinoma (IDC) and no-lobular special type BC.

Major finding: Patients with ILC vs no-lobular special type BC and IDC had the shortest duration of both disease-free survival (197.2 vs 216.7 and 226.5 months, respectively) and overall survival (209.8 vs 227.9 and 233.2 months, respectively), and ILC vs IDC was associated with significantly worse overall survival (hazard ratio 1.45; P = .045).

Study details: Findings are from a retrospective study including 2157 patients with invasive carcinoma of the breast who were categorized into IDC (n = 1814), ILC (n = 193), and no-lobular special type BC (n = 150).

Disclosures: This study did not receive any specific funding. The authors declared no conflicts of interest.

Source: Cosar R et al. Classifying invasive lobular carcinoma as special type breast cancer may be reducing its treatment success: A comparison of survival among invasive lobular carcinoma, invasive ductal carcinoma, and no-lobular special type breast cancer. PLoS One. 2023;18(7):e0283445 (Jul 10). Doi: 10.1371/journal.pone.0283445

Key clinical point: A higher body mass index (BMI) was not linked directly to survival outcomes but was linked to worse prognostic clinicopathologic variables in estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) invasive lobular carcinoma (ILC) of the breast.

Major finding: Although BMI was not directly associated with disease-free survival and overall survival outcomes (both P = .08), a higher BMI was associated with larger tumor size (≥2 cm; P < .001), higher tumor grade (grade 3; P = .014), nodal involvement (P < .001), and multifocal BC (P = .01), which indicated significantly worsened prognosis.

Study details: This multicenter, retrospective study included 2490 patients with ER+/HER2− ILC of the breast, of which 1410, 712, and 368 patients were lean, overweight, and obese, respectively.

Disclosures: This study was funded by the Luxembourg Cancer Foundation and other sources. The authors declared no conflicts of interest.

Source: Baelen KV, Nguyen H-L, et al. Association of body mass index with clinicopathological features and survival in patients with primary invasive lobular breast cancer. Eur J Cancer. 2023;112988 (Jul 12). Doi: 10.1016/j.ejca.2023.112988

Key clinical point: A higher body mass index (BMI) was not linked directly to survival outcomes but was linked to worse prognostic clinicopathologic variables in estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) invasive lobular carcinoma (ILC) of the breast.

Major finding: Although BMI was not directly associated with disease-free survival and overall survival outcomes (both P = .08), a higher BMI was associated with larger tumor size (≥2 cm; P < .001), higher tumor grade (grade 3; P = .014), nodal involvement (P < .001), and multifocal BC (P = .01), which indicated significantly worsened prognosis.

Study details: This multicenter, retrospective study included 2490 patients with ER+/HER2− ILC of the breast, of which 1410, 712, and 368 patients were lean, overweight, and obese, respectively.

Disclosures: This study was funded by the Luxembourg Cancer Foundation and other sources. The authors declared no conflicts of interest.

Source: Baelen KV, Nguyen H-L, et al. Association of body mass index with clinicopathological features and survival in patients with primary invasive lobular breast cancer. Eur J Cancer. 2023;112988 (Jul 12). Doi: 10.1016/j.ejca.2023.112988

Key clinical point: A higher body mass index (BMI) was not linked directly to survival outcomes but was linked to worse prognostic clinicopathologic variables in estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) invasive lobular carcinoma (ILC) of the breast.

Major finding: Although BMI was not directly associated with disease-free survival and overall survival outcomes (both P = .08), a higher BMI was associated with larger tumor size (≥2 cm; P < .001), higher tumor grade (grade 3; P = .014), nodal involvement (P < .001), and multifocal BC (P = .01), which indicated significantly worsened prognosis.

Study details: This multicenter, retrospective study included 2490 patients with ER+/HER2− ILC of the breast, of which 1410, 712, and 368 patients were lean, overweight, and obese, respectively.

Disclosures: This study was funded by the Luxembourg Cancer Foundation and other sources. The authors declared no conflicts of interest.

Source: Baelen KV, Nguyen H-L, et al. Association of body mass index with clinicopathological features and survival in patients with primary invasive lobular breast cancer. Eur J Cancer. 2023;112988 (Jul 12). Doi: 10.1016/j.ejca.2023.112988