Diagnosing and managing depression before and after BC diagnosis may improve survival outcomes

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Key clinical point: Presence of depression before and after the diagnosis of breast cancer (BC) was associated with worsened survival outcomes in women with primary invasive BC.

Major finding: Compared with patients without depression, survival was worse among patients who had depression either before (hazard ratio [HR] 1.38; P = .007) or after (HR 1.48; P < .001) BC diagnosis but not among patients with persistent depression.

Study details: Findings are from an analysis of 6054 women with primary invasive BC from the Kentucky Cancer Registry, of which 3.7%, 6.0%, and 4.1% of patients had pre‐diagnosis depression only, post‐diagnosis depression only, and persistent depression, respectively.

Disclosures: This study was funded by US Centers for Disease Control and Prevention and other sources. Two authors declared receiving fees or grant funding from the funding agencies and other sources.

Source: Lei F et al. Influence of depression on breast cancer treatment and survival: A Kentucky population-based study. Cancer. 2023 (Apr 17). Doi: 10.1002/cncr.34676

 

 

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Key clinical point: Presence of depression before and after the diagnosis of breast cancer (BC) was associated with worsened survival outcomes in women with primary invasive BC.

Major finding: Compared with patients without depression, survival was worse among patients who had depression either before (hazard ratio [HR] 1.38; P = .007) or after (HR 1.48; P < .001) BC diagnosis but not among patients with persistent depression.

Study details: Findings are from an analysis of 6054 women with primary invasive BC from the Kentucky Cancer Registry, of which 3.7%, 6.0%, and 4.1% of patients had pre‐diagnosis depression only, post‐diagnosis depression only, and persistent depression, respectively.

Disclosures: This study was funded by US Centers for Disease Control and Prevention and other sources. Two authors declared receiving fees or grant funding from the funding agencies and other sources.

Source: Lei F et al. Influence of depression on breast cancer treatment and survival: A Kentucky population-based study. Cancer. 2023 (Apr 17). Doi: 10.1002/cncr.34676

 

 

Key clinical point: Presence of depression before and after the diagnosis of breast cancer (BC) was associated with worsened survival outcomes in women with primary invasive BC.

Major finding: Compared with patients without depression, survival was worse among patients who had depression either before (hazard ratio [HR] 1.38; P = .007) or after (HR 1.48; P < .001) BC diagnosis but not among patients with persistent depression.

Study details: Findings are from an analysis of 6054 women with primary invasive BC from the Kentucky Cancer Registry, of which 3.7%, 6.0%, and 4.1% of patients had pre‐diagnosis depression only, post‐diagnosis depression only, and persistent depression, respectively.

Disclosures: This study was funded by US Centers for Disease Control and Prevention and other sources. Two authors declared receiving fees or grant funding from the funding agencies and other sources.

Source: Lei F et al. Influence of depression on breast cancer treatment and survival: A Kentucky population-based study. Cancer. 2023 (Apr 17). Doi: 10.1002/cncr.34676

 

 

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Pathogenic variants in PALB2 and ATM genes associated with increased male BC risk

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Key clinical point: Germline pathogenic variants (PV) in genes other than BRCA1/2, such as ATM and PALB2, are associated with an increased risk for breast cancer (BC) in men.

Major finding: A higher proportion of males with vs without BC had PV in genes other than BRCA1/2 (4.8% vs 1.8%). Overall, PV in genes other than BRCA1/2 were associated with a >3-fold increased risk for BC (odds ratio [OR] 3.48; P < .0001), with the risk being even higher with PV in PALB2 (OR 7.28; P = .034) and ATM (OR 4.79; P = .035) genes.

Study details: Findings are from a retrospective, case-control study including 767 males with BC who were BRCA1/2-negative and 1349 male control individuals without a personal history of cancer.

Disclosures: This study was supported by Associazione Italiana Ricerca Cancro and other sources. The authors declared no conflicts of interest.

Source: Bucalo A et al. Male breast cancer risk associated with pathogenic variants in genes other than BRCA1/2: An Italian case-control study. Eur J Cancer. 2023 (May 2). Doi: 10.1016/j.ejca.2023.04.022

 

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Key clinical point: Germline pathogenic variants (PV) in genes other than BRCA1/2, such as ATM and PALB2, are associated with an increased risk for breast cancer (BC) in men.

Major finding: A higher proportion of males with vs without BC had PV in genes other than BRCA1/2 (4.8% vs 1.8%). Overall, PV in genes other than BRCA1/2 were associated with a >3-fold increased risk for BC (odds ratio [OR] 3.48; P < .0001), with the risk being even higher with PV in PALB2 (OR 7.28; P = .034) and ATM (OR 4.79; P = .035) genes.

Study details: Findings are from a retrospective, case-control study including 767 males with BC who were BRCA1/2-negative and 1349 male control individuals without a personal history of cancer.

Disclosures: This study was supported by Associazione Italiana Ricerca Cancro and other sources. The authors declared no conflicts of interest.

Source: Bucalo A et al. Male breast cancer risk associated with pathogenic variants in genes other than BRCA1/2: An Italian case-control study. Eur J Cancer. 2023 (May 2). Doi: 10.1016/j.ejca.2023.04.022

 

Key clinical point: Germline pathogenic variants (PV) in genes other than BRCA1/2, such as ATM and PALB2, are associated with an increased risk for breast cancer (BC) in men.

Major finding: A higher proportion of males with vs without BC had PV in genes other than BRCA1/2 (4.8% vs 1.8%). Overall, PV in genes other than BRCA1/2 were associated with a >3-fold increased risk for BC (odds ratio [OR] 3.48; P < .0001), with the risk being even higher with PV in PALB2 (OR 7.28; P = .034) and ATM (OR 4.79; P = .035) genes.

Study details: Findings are from a retrospective, case-control study including 767 males with BC who were BRCA1/2-negative and 1349 male control individuals without a personal history of cancer.

Disclosures: This study was supported by Associazione Italiana Ricerca Cancro and other sources. The authors declared no conflicts of interest.

Source: Bucalo A et al. Male breast cancer risk associated with pathogenic variants in genes other than BRCA1/2: An Italian case-control study. Eur J Cancer. 2023 (May 2). Doi: 10.1016/j.ejca.2023.04.022

 

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ER+/HER2− BC: Real-world data show improvement in OS with chemotherapy plus ET

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Wed, 06/07/2023 - 13:51

Key clinical point: Chemotherapy plus endocrine therapy (CET) was more effective than endocrine therapy (ET) alone in improving overall survival (OS) outcomes in patients with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) breast cancer (BC) and a recurrence score (RS) of 20-25.

Major finding: Although OS was significantly inferior in patients with RS of >20 (P < .001-.019), CET vs ET improved OS in patients with RS of 20-25 regardless of age (age ≤50: hazard ratio [HR] 0.334; P = .002 and age >50: HR 0.521; P = .019).

Study details: This retrospective cohort study of real-world data from the US National Cancer Database included 28,427 women with stage I-III HR+/HER2− BC and 1-3 positive axillary lymph nodes, of which 26.3% and 73.7% of patients received CET and ET, respectively.

Disclosures: The lead author is supported by the Sociedade Beneficente Israelita Brasileira Albert Einstein. The authors declared no conflicts of interest.

Source: Stabellini N et al. Adjuvant chemotherapy is associated with an overall survival benefit regardless of age in ER+/HER2- breast cancer pts with 1-3 positive nodes and oncotype DX recurrence score 20 to 25: An NCDB analysis. Front Oncol. 2023;13:1115208 (Apr 24). Doi: 10.3389/fonc.2023.1115208

 

 

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Key clinical point: Chemotherapy plus endocrine therapy (CET) was more effective than endocrine therapy (ET) alone in improving overall survival (OS) outcomes in patients with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) breast cancer (BC) and a recurrence score (RS) of 20-25.

Major finding: Although OS was significantly inferior in patients with RS of >20 (P < .001-.019), CET vs ET improved OS in patients with RS of 20-25 regardless of age (age ≤50: hazard ratio [HR] 0.334; P = .002 and age >50: HR 0.521; P = .019).

Study details: This retrospective cohort study of real-world data from the US National Cancer Database included 28,427 women with stage I-III HR+/HER2− BC and 1-3 positive axillary lymph nodes, of which 26.3% and 73.7% of patients received CET and ET, respectively.

Disclosures: The lead author is supported by the Sociedade Beneficente Israelita Brasileira Albert Einstein. The authors declared no conflicts of interest.

Source: Stabellini N et al. Adjuvant chemotherapy is associated with an overall survival benefit regardless of age in ER+/HER2- breast cancer pts with 1-3 positive nodes and oncotype DX recurrence score 20 to 25: An NCDB analysis. Front Oncol. 2023;13:1115208 (Apr 24). Doi: 10.3389/fonc.2023.1115208

 

 

Key clinical point: Chemotherapy plus endocrine therapy (CET) was more effective than endocrine therapy (ET) alone in improving overall survival (OS) outcomes in patients with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) breast cancer (BC) and a recurrence score (RS) of 20-25.

Major finding: Although OS was significantly inferior in patients with RS of >20 (P < .001-.019), CET vs ET improved OS in patients with RS of 20-25 regardless of age (age ≤50: hazard ratio [HR] 0.334; P = .002 and age >50: HR 0.521; P = .019).

Study details: This retrospective cohort study of real-world data from the US National Cancer Database included 28,427 women with stage I-III HR+/HER2− BC and 1-3 positive axillary lymph nodes, of which 26.3% and 73.7% of patients received CET and ET, respectively.

Disclosures: The lead author is supported by the Sociedade Beneficente Israelita Brasileira Albert Einstein. The authors declared no conflicts of interest.

Source: Stabellini N et al. Adjuvant chemotherapy is associated with an overall survival benefit regardless of age in ER+/HER2- breast cancer pts with 1-3 positive nodes and oncotype DX recurrence score 20 to 25: An NCDB analysis. Front Oncol. 2023;13:1115208 (Apr 24). Doi: 10.3389/fonc.2023.1115208

 

 

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Extending anastrozole treatment beyond 5 years may benefit postmenopausal HR+ BC patients

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Key clinical point: In postmenopausal women with hormone receptor-positive (HR+) early-stage breast cancer (BC), extending anastrozole treatment for an additional 5 years after initial 5-year treatment with anastrozole-containing hormone therapy improved disease-free survival (DFS) without any major adverse event occurrence.

Major finding: Continuation of anastrozole treatment for an additional 5 years significantly improved 5-year DFS (hazard ratio [HR] 0.62; P = .0010). The incidence of grade ≥3 adverse events was <1% in both groups, with no significant difference observed between both the groups.

Study details: Findings are from the phase 3, AERAS trial including 1593 postmenopausal women with HR+ early-stage invasive BC who were disease-free at 5 years after postoperative endocrine therapy and were randomly assigned to stop or continue receiving anastrozole for an additional 5 years.

Disclosures: This study was supported by Public Health Research Foundation, Japan. Several authors declared receiving honoraria or research funding or serving on speaker’s bureaus, in consulting roles, or in advisory roles for various sources.

Source: Iwase T et al. Postoperative adjuvant anastrozole for 10 or 5 Years in patients with hormone receptor-positive breast cancer: AERAS, a randomized multicenter open-label phase III trial. J Clin Oncol. 2023 (Apr 20). Doi: 10.1200/JCO.22.00577

 

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Key clinical point: In postmenopausal women with hormone receptor-positive (HR+) early-stage breast cancer (BC), extending anastrozole treatment for an additional 5 years after initial 5-year treatment with anastrozole-containing hormone therapy improved disease-free survival (DFS) without any major adverse event occurrence.

Major finding: Continuation of anastrozole treatment for an additional 5 years significantly improved 5-year DFS (hazard ratio [HR] 0.62; P = .0010). The incidence of grade ≥3 adverse events was <1% in both groups, with no significant difference observed between both the groups.

Study details: Findings are from the phase 3, AERAS trial including 1593 postmenopausal women with HR+ early-stage invasive BC who were disease-free at 5 years after postoperative endocrine therapy and were randomly assigned to stop or continue receiving anastrozole for an additional 5 years.

Disclosures: This study was supported by Public Health Research Foundation, Japan. Several authors declared receiving honoraria or research funding or serving on speaker’s bureaus, in consulting roles, or in advisory roles for various sources.

Source: Iwase T et al. Postoperative adjuvant anastrozole for 10 or 5 Years in patients with hormone receptor-positive breast cancer: AERAS, a randomized multicenter open-label phase III trial. J Clin Oncol. 2023 (Apr 20). Doi: 10.1200/JCO.22.00577

 

Key clinical point: In postmenopausal women with hormone receptor-positive (HR+) early-stage breast cancer (BC), extending anastrozole treatment for an additional 5 years after initial 5-year treatment with anastrozole-containing hormone therapy improved disease-free survival (DFS) without any major adverse event occurrence.

Major finding: Continuation of anastrozole treatment for an additional 5 years significantly improved 5-year DFS (hazard ratio [HR] 0.62; P = .0010). The incidence of grade ≥3 adverse events was <1% in both groups, with no significant difference observed between both the groups.

Study details: Findings are from the phase 3, AERAS trial including 1593 postmenopausal women with HR+ early-stage invasive BC who were disease-free at 5 years after postoperative endocrine therapy and were randomly assigned to stop or continue receiving anastrozole for an additional 5 years.

Disclosures: This study was supported by Public Health Research Foundation, Japan. Several authors declared receiving honoraria or research funding or serving on speaker’s bureaus, in consulting roles, or in advisory roles for various sources.

Source: Iwase T et al. Postoperative adjuvant anastrozole for 10 or 5 Years in patients with hormone receptor-positive breast cancer: AERAS, a randomized multicenter open-label phase III trial. J Clin Oncol. 2023 (Apr 20). Doi: 10.1200/JCO.22.00577

 

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High-risk HR+/HER2− early BC: Higher pCR rate with neoadjuvant nab-paclitaxel vs dose-dense solvent-based paclitaxel

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Key clinical point: Pathologic complete response (pCR) rate was higher in patients with high-risk hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) breast cancer (BC) who received neoadjuvant nanoparticle albumin-bound (nab)-paclitaxel vs solvent-based (sb)-paclitaxel.

Major finding: The pCR rate was higher in the overall population receiving nab-paclitaxel vs sb-paclitaxel (20.8% vs 12.9%; P = .002), subgroups with recurrence score of >25 vs ≤25 (16.0% vs 8.4%; P = .021), and endocrine therapy non-responders vs responders (15.1% vs 6.0%; P = .027). Distant disease-free survival was longer in patients who achieved pCR (hazard ratio 0.42; P = .024).

Study details: Findings are from the WSG-ADAPT trial including 864 patients with high-risk HR+/HER2− early BC who were randomly assigned to receive neoadjuvant sb-paclitaxel or nab-paclitaxel, both followed by epirubicin+cyclophosphamide.

Disclosures: This study was supported by Exact Science, Celgene, Amgen, and AOK Rheinland/Hamburg. Some authors declared receiving consulting fees, honoraria, payment, research funding, or travel support, or having other ties with several sources.

Source: Gluz O et al. Nab-paclitaxel weekly versus dose-dense solvent-based paclitaxel followed by dose-dense epirubicin plus cyclophosphamide in high-risk HR+/HER2- early breast cancer: Results from the neoadjuvant part of the WSG-ADAPT-HR+/HER2- trial. Ann Oncol. 2023 (Apr 14). Doi: 10.1016/j.annonc.2023.04.002

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Key clinical point: Pathologic complete response (pCR) rate was higher in patients with high-risk hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) breast cancer (BC) who received neoadjuvant nanoparticle albumin-bound (nab)-paclitaxel vs solvent-based (sb)-paclitaxel.

Major finding: The pCR rate was higher in the overall population receiving nab-paclitaxel vs sb-paclitaxel (20.8% vs 12.9%; P = .002), subgroups with recurrence score of >25 vs ≤25 (16.0% vs 8.4%; P = .021), and endocrine therapy non-responders vs responders (15.1% vs 6.0%; P = .027). Distant disease-free survival was longer in patients who achieved pCR (hazard ratio 0.42; P = .024).

Study details: Findings are from the WSG-ADAPT trial including 864 patients with high-risk HR+/HER2− early BC who were randomly assigned to receive neoadjuvant sb-paclitaxel or nab-paclitaxel, both followed by epirubicin+cyclophosphamide.

Disclosures: This study was supported by Exact Science, Celgene, Amgen, and AOK Rheinland/Hamburg. Some authors declared receiving consulting fees, honoraria, payment, research funding, or travel support, or having other ties with several sources.

Source: Gluz O et al. Nab-paclitaxel weekly versus dose-dense solvent-based paclitaxel followed by dose-dense epirubicin plus cyclophosphamide in high-risk HR+/HER2- early breast cancer: Results from the neoadjuvant part of the WSG-ADAPT-HR+/HER2- trial. Ann Oncol. 2023 (Apr 14). Doi: 10.1016/j.annonc.2023.04.002

Key clinical point: Pathologic complete response (pCR) rate was higher in patients with high-risk hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) breast cancer (BC) who received neoadjuvant nanoparticle albumin-bound (nab)-paclitaxel vs solvent-based (sb)-paclitaxel.

Major finding: The pCR rate was higher in the overall population receiving nab-paclitaxel vs sb-paclitaxel (20.8% vs 12.9%; P = .002), subgroups with recurrence score of >25 vs ≤25 (16.0% vs 8.4%; P = .021), and endocrine therapy non-responders vs responders (15.1% vs 6.0%; P = .027). Distant disease-free survival was longer in patients who achieved pCR (hazard ratio 0.42; P = .024).

Study details: Findings are from the WSG-ADAPT trial including 864 patients with high-risk HR+/HER2− early BC who were randomly assigned to receive neoadjuvant sb-paclitaxel or nab-paclitaxel, both followed by epirubicin+cyclophosphamide.

Disclosures: This study was supported by Exact Science, Celgene, Amgen, and AOK Rheinland/Hamburg. Some authors declared receiving consulting fees, honoraria, payment, research funding, or travel support, or having other ties with several sources.

Source: Gluz O et al. Nab-paclitaxel weekly versus dose-dense solvent-based paclitaxel followed by dose-dense epirubicin plus cyclophosphamide in high-risk HR+/HER2- early breast cancer: Results from the neoadjuvant part of the WSG-ADAPT-HR+/HER2- trial. Ann Oncol. 2023 (Apr 14). Doi: 10.1016/j.annonc.2023.04.002

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Antibiotic use after TNBC diagnosis associated with worse survival outcomes

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Key clinical point: Survival outcomes were worsened in women with triple-negative breast cancer (TNBC) who were prescribed monthly antibiotics after TNBC diagnosis.

Major finding: Each additional total and unique monthly antimicrobial prescription was associated with inferior breast cancer-specific survival (hazard ratio [HR] 1.05; 95% CI 1.01-1.08, and HR 1.18; 95% CI 1.13-1.24, respectively) and overall survival (HR 1.05; 95% CI 1.02-1.08, and HR 1.17; 95% CI 1.12-1.23, respectively), with the association sustaining through the third year after TNBC diagnosis.

Study details: This study analyzed the data of 772 women with stage I-III TNBC from the Oncoshare database (including integrated data of electronic medical records and California Cancer Registry) who were treated with or without standard cytotoxic chemotherapy, of which 654 women received antibiotics.

Disclosures: This study was supported by the Breast Cancer Research Foundation, New York, and other sources. The authors declared no conflicts of interest.

Source: Ransohoff JD et al. Antimicrobial exposure is associated with decreased survival in triple-negative breast cancer. Nat Commun. 2023;14:2053 (Apr 12). Doi: 10.1038/s41467-023-37636-0

 

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Key clinical point: Survival outcomes were worsened in women with triple-negative breast cancer (TNBC) who were prescribed monthly antibiotics after TNBC diagnosis.

Major finding: Each additional total and unique monthly antimicrobial prescription was associated with inferior breast cancer-specific survival (hazard ratio [HR] 1.05; 95% CI 1.01-1.08, and HR 1.18; 95% CI 1.13-1.24, respectively) and overall survival (HR 1.05; 95% CI 1.02-1.08, and HR 1.17; 95% CI 1.12-1.23, respectively), with the association sustaining through the third year after TNBC diagnosis.

Study details: This study analyzed the data of 772 women with stage I-III TNBC from the Oncoshare database (including integrated data of electronic medical records and California Cancer Registry) who were treated with or without standard cytotoxic chemotherapy, of which 654 women received antibiotics.

Disclosures: This study was supported by the Breast Cancer Research Foundation, New York, and other sources. The authors declared no conflicts of interest.

Source: Ransohoff JD et al. Antimicrobial exposure is associated with decreased survival in triple-negative breast cancer. Nat Commun. 2023;14:2053 (Apr 12). Doi: 10.1038/s41467-023-37636-0

 

Key clinical point: Survival outcomes were worsened in women with triple-negative breast cancer (TNBC) who were prescribed monthly antibiotics after TNBC diagnosis.

Major finding: Each additional total and unique monthly antimicrobial prescription was associated with inferior breast cancer-specific survival (hazard ratio [HR] 1.05; 95% CI 1.01-1.08, and HR 1.18; 95% CI 1.13-1.24, respectively) and overall survival (HR 1.05; 95% CI 1.02-1.08, and HR 1.17; 95% CI 1.12-1.23, respectively), with the association sustaining through the third year after TNBC diagnosis.

Study details: This study analyzed the data of 772 women with stage I-III TNBC from the Oncoshare database (including integrated data of electronic medical records and California Cancer Registry) who were treated with or without standard cytotoxic chemotherapy, of which 654 women received antibiotics.

Disclosures: This study was supported by the Breast Cancer Research Foundation, New York, and other sources. The authors declared no conflicts of interest.

Source: Ransohoff JD et al. Antimicrobial exposure is associated with decreased survival in triple-negative breast cancer. Nat Commun. 2023;14:2053 (Apr 12). Doi: 10.1038/s41467-023-37636-0

 

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Slower decrease in mammographic breast density observed in women who developed breast cancer

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Key clinical point: Women who developed breast cancer (BC) showed a significantly slower rate of decrease in mammographic breast density over time compared with control individuals who did not develop BC.

Major finding: Although breast density decreased over time in all women, the rate of change in breast density was significantly slower in the breast that later developed cancer compared with the cancer-free breast in control individuals (estimate 0.027; P = .04).

Study details: This prospective, nested case-control cohort study followed women with no history of any cancer for 10 years based on screening mammogram or risk factors and subsequently analyzed 289 women who developed BC and 658 matched control individuals.

Disclosures: This study was supported by grants from the Breast Cancer Research Foundation, New York (BCRF) and partly by the US National Cancer Institute (NCI). Two authors declared receiving grants from BCRF and NCI and holding a pending patent for assessment of digital mammograms.

Source: Jiang S et al. Longitudinal analysis of change in mammographic density in each breast and its association with breast cancer risk. JAMA Oncol. 2023 (Apr 27). Doi: 10.1001/jamaoncol.2023.0434

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Key clinical point: Women who developed breast cancer (BC) showed a significantly slower rate of decrease in mammographic breast density over time compared with control individuals who did not develop BC.

Major finding: Although breast density decreased over time in all women, the rate of change in breast density was significantly slower in the breast that later developed cancer compared with the cancer-free breast in control individuals (estimate 0.027; P = .04).

Study details: This prospective, nested case-control cohort study followed women with no history of any cancer for 10 years based on screening mammogram or risk factors and subsequently analyzed 289 women who developed BC and 658 matched control individuals.

Disclosures: This study was supported by grants from the Breast Cancer Research Foundation, New York (BCRF) and partly by the US National Cancer Institute (NCI). Two authors declared receiving grants from BCRF and NCI and holding a pending patent for assessment of digital mammograms.

Source: Jiang S et al. Longitudinal analysis of change in mammographic density in each breast and its association with breast cancer risk. JAMA Oncol. 2023 (Apr 27). Doi: 10.1001/jamaoncol.2023.0434

Key clinical point: Women who developed breast cancer (BC) showed a significantly slower rate of decrease in mammographic breast density over time compared with control individuals who did not develop BC.

Major finding: Although breast density decreased over time in all women, the rate of change in breast density was significantly slower in the breast that later developed cancer compared with the cancer-free breast in control individuals (estimate 0.027; P = .04).

Study details: This prospective, nested case-control cohort study followed women with no history of any cancer for 10 years based on screening mammogram or risk factors and subsequently analyzed 289 women who developed BC and 658 matched control individuals.

Disclosures: This study was supported by grants from the Breast Cancer Research Foundation, New York (BCRF) and partly by the US National Cancer Institute (NCI). Two authors declared receiving grants from BCRF and NCI and holding a pending patent for assessment of digital mammograms.

Source: Jiang S et al. Longitudinal analysis of change in mammographic density in each breast and its association with breast cancer risk. JAMA Oncol. 2023 (Apr 27). Doi: 10.1001/jamaoncol.2023.0434

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Trastuzumab deruxtecan bests standard-of-care in trastuzumab emtansine-resistant HER2+ metastatic BC

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Key clinical point: Trastuzumab deruxtecan demonstrated a favorable benefit-risk profile in patients with human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC) who were refractory or resistant to trastuzumab emtansine and had scarce treatment options.

Major finding: The median progression-free survival was significantly prolonged in the trastuzumab deruxtecan vs physician’s choice treatment group (17.8 vs 6.9 months; hazard ratio 0.36; P < .0001). No new safety signals were reported for trastuzumab deruxtecan.

Study details: Findings are from the phase 3, DESTINY-Breast02 trial including 608 patients with HER2+ metastatic BC who were refractory or resistant to trastuzumab emtansine and were randomly assigned to receive trastuzumab deruxtecan or treatment of physician's choice.

Disclosures: This study was funded by Daiichi Sankyo and AstraZeneca. Five authors declared being current or former employees of Daichi Sankyo, and two authors declared owning stock options in AstraZeneca or Daiichi Sankyo. The other authors reported ties with several sources.

Source: Andre F et al. Trastuzumab deruxtecan versus treatment of physician's choice in patients with HER2-positive metastatic breast cancer (DESTINY-Breast02): A randomised, open-label, multicentre, phase 3 trial. Lancet. 2023 (Apr 19). Doi: 10.1016/S0140-6736(23)00725-0

 

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Key clinical point: Trastuzumab deruxtecan demonstrated a favorable benefit-risk profile in patients with human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC) who were refractory or resistant to trastuzumab emtansine and had scarce treatment options.

Major finding: The median progression-free survival was significantly prolonged in the trastuzumab deruxtecan vs physician’s choice treatment group (17.8 vs 6.9 months; hazard ratio 0.36; P < .0001). No new safety signals were reported for trastuzumab deruxtecan.

Study details: Findings are from the phase 3, DESTINY-Breast02 trial including 608 patients with HER2+ metastatic BC who were refractory or resistant to trastuzumab emtansine and were randomly assigned to receive trastuzumab deruxtecan or treatment of physician's choice.

Disclosures: This study was funded by Daiichi Sankyo and AstraZeneca. Five authors declared being current or former employees of Daichi Sankyo, and two authors declared owning stock options in AstraZeneca or Daiichi Sankyo. The other authors reported ties with several sources.

Source: Andre F et al. Trastuzumab deruxtecan versus treatment of physician's choice in patients with HER2-positive metastatic breast cancer (DESTINY-Breast02): A randomised, open-label, multicentre, phase 3 trial. Lancet. 2023 (Apr 19). Doi: 10.1016/S0140-6736(23)00725-0

 

Key clinical point: Trastuzumab deruxtecan demonstrated a favorable benefit-risk profile in patients with human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC) who were refractory or resistant to trastuzumab emtansine and had scarce treatment options.

Major finding: The median progression-free survival was significantly prolonged in the trastuzumab deruxtecan vs physician’s choice treatment group (17.8 vs 6.9 months; hazard ratio 0.36; P < .0001). No new safety signals were reported for trastuzumab deruxtecan.

Study details: Findings are from the phase 3, DESTINY-Breast02 trial including 608 patients with HER2+ metastatic BC who were refractory or resistant to trastuzumab emtansine and were randomly assigned to receive trastuzumab deruxtecan or treatment of physician's choice.

Disclosures: This study was funded by Daiichi Sankyo and AstraZeneca. Five authors declared being current or former employees of Daichi Sankyo, and two authors declared owning stock options in AstraZeneca or Daiichi Sankyo. The other authors reported ties with several sources.

Source: Andre F et al. Trastuzumab deruxtecan versus treatment of physician's choice in patients with HER2-positive metastatic breast cancer (DESTINY-Breast02): A randomised, open-label, multicentre, phase 3 trial. Lancet. 2023 (Apr 19). Doi: 10.1016/S0140-6736(23)00725-0

 

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Reproductive tract infections associated with lower risk and better prognosis in breast cancer

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Key clinical point: Presence of reproductive tract infections had a protective effect against the development of breast cancer (BC) and was associated with a better prognosis in patients with BC.

Major finding: Reproductive tract infections were associated with a lower risk for BC (odds ratio [OR] 0.80; 95% CI 0.65-0.98). Patients with reproductive vs non-reproductive tract infections showed improved overall survival (hazard ratio [HR] 0.61; 95% CI 0.40-0.94), whereas the risk for disease progression was lower in women with reproductive tract infections and >327 vs ≤327 menstrual cycles (HR 0.52; 95% CI 0.34-0.79).

Study details: Findings are from a case-control study including 1003 patients with BC and 1107 cancer-free control individuals and a cohort study including 4264 patients with BC, of which 685 women had a history of reproductive tract infections.

Disclosures: This study was funded by the National Natural Science Foundation of China and Science and Technology Planning Project of Guangdong Province. The authors declared no conflicts of interest.

Source: Li Y et al. Interaction of reproductive tract infections with estrogen exposure on breast cancer risk and prognosis. BMC Womens Health. 2023;23:238 (May 8). Doi: 10.1186/s12905-023-02383-3

 

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Key clinical point: Presence of reproductive tract infections had a protective effect against the development of breast cancer (BC) and was associated with a better prognosis in patients with BC.

Major finding: Reproductive tract infections were associated with a lower risk for BC (odds ratio [OR] 0.80; 95% CI 0.65-0.98). Patients with reproductive vs non-reproductive tract infections showed improved overall survival (hazard ratio [HR] 0.61; 95% CI 0.40-0.94), whereas the risk for disease progression was lower in women with reproductive tract infections and >327 vs ≤327 menstrual cycles (HR 0.52; 95% CI 0.34-0.79).

Study details: Findings are from a case-control study including 1003 patients with BC and 1107 cancer-free control individuals and a cohort study including 4264 patients with BC, of which 685 women had a history of reproductive tract infections.

Disclosures: This study was funded by the National Natural Science Foundation of China and Science and Technology Planning Project of Guangdong Province. The authors declared no conflicts of interest.

Source: Li Y et al. Interaction of reproductive tract infections with estrogen exposure on breast cancer risk and prognosis. BMC Womens Health. 2023;23:238 (May 8). Doi: 10.1186/s12905-023-02383-3

 

Key clinical point: Presence of reproductive tract infections had a protective effect against the development of breast cancer (BC) and was associated with a better prognosis in patients with BC.

Major finding: Reproductive tract infections were associated with a lower risk for BC (odds ratio [OR] 0.80; 95% CI 0.65-0.98). Patients with reproductive vs non-reproductive tract infections showed improved overall survival (hazard ratio [HR] 0.61; 95% CI 0.40-0.94), whereas the risk for disease progression was lower in women with reproductive tract infections and >327 vs ≤327 menstrual cycles (HR 0.52; 95% CI 0.34-0.79).

Study details: Findings are from a case-control study including 1003 patients with BC and 1107 cancer-free control individuals and a cohort study including 4264 patients with BC, of which 685 women had a history of reproductive tract infections.

Disclosures: This study was funded by the National Natural Science Foundation of China and Science and Technology Planning Project of Guangdong Province. The authors declared no conflicts of interest.

Source: Li Y et al. Interaction of reproductive tract infections with estrogen exposure on breast cancer risk and prognosis. BMC Womens Health. 2023;23:238 (May 8). Doi: 10.1186/s12905-023-02383-3

 

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Breast cancer survivors face increased risk for sexual dysfunction

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Key clinical point: Female breast cancer (BC) survivors are at a higher risk of experiencing sexual dysfunction symptoms compared with women from the general population.

Major finding: The risk for sexual dysfunction was higher in female BC survivors compared with women from the general population (hazard ratio [HR] 1.60; 95% CI 1.51-1.70), with the risk being more prominent within the first 5 years after BC diagnosis (HR 2.05; 95% CI 1.89-2.22) and in women who were <50 years old at the time of BC diagnosis (HR 3.05; 95% CI 2.65-3.51).

Study details: Findings are from the Utah Population Database cohort study including 19,709 women age ≥18 years who had survived BC and 93,389 age- and birth state-matched women from the general population.

Disclosures: This study was supported by grants from the US National Institutes of Health and other sources. The authors declared no conflicts of interest.

Source: Chang CP et al. Breast cancer survivorship and sexual dysfunction: A population-based cohort study. Breast Cancer Res Treat. 2023 (May 9). Doi: 10.1007/s10549-023-06953-9

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Key clinical point: Female breast cancer (BC) survivors are at a higher risk of experiencing sexual dysfunction symptoms compared with women from the general population.

Major finding: The risk for sexual dysfunction was higher in female BC survivors compared with women from the general population (hazard ratio [HR] 1.60; 95% CI 1.51-1.70), with the risk being more prominent within the first 5 years after BC diagnosis (HR 2.05; 95% CI 1.89-2.22) and in women who were <50 years old at the time of BC diagnosis (HR 3.05; 95% CI 2.65-3.51).

Study details: Findings are from the Utah Population Database cohort study including 19,709 women age ≥18 years who had survived BC and 93,389 age- and birth state-matched women from the general population.

Disclosures: This study was supported by grants from the US National Institutes of Health and other sources. The authors declared no conflicts of interest.

Source: Chang CP et al. Breast cancer survivorship and sexual dysfunction: A population-based cohort study. Breast Cancer Res Treat. 2023 (May 9). Doi: 10.1007/s10549-023-06953-9

Key clinical point: Female breast cancer (BC) survivors are at a higher risk of experiencing sexual dysfunction symptoms compared with women from the general population.

Major finding: The risk for sexual dysfunction was higher in female BC survivors compared with women from the general population (hazard ratio [HR] 1.60; 95% CI 1.51-1.70), with the risk being more prominent within the first 5 years after BC diagnosis (HR 2.05; 95% CI 1.89-2.22) and in women who were <50 years old at the time of BC diagnosis (HR 3.05; 95% CI 2.65-3.51).

Study details: Findings are from the Utah Population Database cohort study including 19,709 women age ≥18 years who had survived BC and 93,389 age- and birth state-matched women from the general population.

Disclosures: This study was supported by grants from the US National Institutes of Health and other sources. The authors declared no conflicts of interest.

Source: Chang CP et al. Breast cancer survivorship and sexual dysfunction: A population-based cohort study. Breast Cancer Res Treat. 2023 (May 9). Doi: 10.1007/s10549-023-06953-9

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