Breast Cancer

Key clinical point: In elderly patients who received endocrine monotherapy for breast cancer (BC), the risk of dying due to other conditions was more than twice the risk for eventually requiring invasive local treatment.

Major finding: Within 5 years, 28% of patients required invasive local treatment (surgery or radiotherapy) and the overall mortality risk (overall survival 42%) was >2 times higher than the risk of undergoing invasive local treatment.

Study details: Findings are from a retrospective cohort study including 91 elderly (≥70 years) female patients with estrogen receptor-positive (ER+) BC who received endocrine monotherapy as a definitive treatment.

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Gooijer SA et al. Long-term outcome of sustained endocrine monotherapy for elderly breast cancer patients. Ann Surg Oncol. 2022 (Nov 3). Doi: 10.1245/s10434-022-12662-2

Key clinical point: In elderly patients who received endocrine monotherapy for breast cancer (BC), the risk of dying due to other conditions was more than twice the risk for eventually requiring invasive local treatment.

Major finding: Within 5 years, 28% of patients required invasive local treatment (surgery or radiotherapy) and the overall mortality risk (overall survival 42%) was >2 times higher than the risk of undergoing invasive local treatment.

Study details: Findings are from a retrospective cohort study including 91 elderly (≥70 years) female patients with estrogen receptor-positive (ER+) BC who received endocrine monotherapy as a definitive treatment.

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Gooijer SA et al. Long-term outcome of sustained endocrine monotherapy for elderly breast cancer patients. Ann Surg Oncol. 2022 (Nov 3). Doi: 10.1245/s10434-022-12662-2

Key clinical point: In elderly patients who received endocrine monotherapy for breast cancer (BC), the risk of dying due to other conditions was more than twice the risk for eventually requiring invasive local treatment.

Major finding: Within 5 years, 28% of patients required invasive local treatment (surgery or radiotherapy) and the overall mortality risk (overall survival 42%) was >2 times higher than the risk of undergoing invasive local treatment.

Study details: Findings are from a retrospective cohort study including 91 elderly (≥70 years) female patients with estrogen receptor-positive (ER+) BC who received endocrine monotherapy as a definitive treatment.

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Gooijer SA et al. Long-term outcome of sustained endocrine monotherapy for elderly breast cancer patients. Ann Surg Oncol. 2022 (Nov 3). Doi: 10.1245/s10434-022-12662-2

Key clinical point: Women with breast cancer (BC), especially those with low-grade malignancy, had a greater risk of developing a second primary lung cancer.

Major finding: The risk for second primary lung cancer was 1.4 (95% CI 1.25-1.55) times higher in patients with BC compared with the general population, with estrogen receptor-negative BC, low Ki67 levels, and no lymph node metastasis (all P = .01) being significant risk factors. Among patients who developed lung cancer, the rate of epidermal growth factor receptor mutation was high (78.5%).

Study details: This study analyzed the data of 9179 patients with BC, of which 6512 patients had undergone diagnostic chest computed tomography and 55 patients were diagnosed with a second primary lung cancer.

Disclosures: This study was supported by the National Key Research and Development Program of China and other sources. The authors declared no conflicts of interest.

Source: Zeng T et al. High rate of epidermal growth factor receptor-mutated primary lung cancer in patients with primary breast cancer. Front Oncol. 2022;12:985734 (Oct 13). Doi: 10.3389/fonc.2022.985734

Key clinical point: Women with breast cancer (BC), especially those with low-grade malignancy, had a greater risk of developing a second primary lung cancer.

Major finding: The risk for second primary lung cancer was 1.4 (95% CI 1.25-1.55) times higher in patients with BC compared with the general population, with estrogen receptor-negative BC, low Ki67 levels, and no lymph node metastasis (all P = .01) being significant risk factors. Among patients who developed lung cancer, the rate of epidermal growth factor receptor mutation was high (78.5%).

Study details: This study analyzed the data of 9179 patients with BC, of which 6512 patients had undergone diagnostic chest computed tomography and 55 patients were diagnosed with a second primary lung cancer.

Disclosures: This study was supported by the National Key Research and Development Program of China and other sources. The authors declared no conflicts of interest.

Source: Zeng T et al. High rate of epidermal growth factor receptor-mutated primary lung cancer in patients with primary breast cancer. Front Oncol. 2022;12:985734 (Oct 13). Doi: 10.3389/fonc.2022.985734

Key clinical point: Women with breast cancer (BC), especially those with low-grade malignancy, had a greater risk of developing a second primary lung cancer.

Major finding: The risk for second primary lung cancer was 1.4 (95% CI 1.25-1.55) times higher in patients with BC compared with the general population, with estrogen receptor-negative BC, low Ki67 levels, and no lymph node metastasis (all P = .01) being significant risk factors. Among patients who developed lung cancer, the rate of epidermal growth factor receptor mutation was high (78.5%).

Study details: This study analyzed the data of 9179 patients with BC, of which 6512 patients had undergone diagnostic chest computed tomography and 55 patients were diagnosed with a second primary lung cancer.

Disclosures: This study was supported by the National Key Research and Development Program of China and other sources. The authors declared no conflicts of interest.

Source: Zeng T et al. High rate of epidermal growth factor receptor-mutated primary lung cancer in patients with primary breast cancer. Front Oncol. 2022;12:985734 (Oct 13). Doi: 10.3389/fonc.2022.985734

Key clinical point: The risk of developing breast cancer (BC) was slightly elevated in women who received treatment for thyroid cancer, with increasing cumulative ¹³¹I activity being an important risk factor.

Major finding: Compared with the general population, the risk for BC was 1.5 times higher in thyroid cancer survivors (standardized incidence ratio 1.52; 95% CI 1.36-1.69). Although ¹³¹I treatment did not increase the risk for subsequent BC, the risk increased with increasing cumulative ¹³¹I activity (excess relative risk per 100 mCi 17%; 95% CI 2%-38%).

Study details: This pooled analysis included 8475 women who were treated for differentiated thyroid cancer, of which 62% received radiotherapy with ¹³¹I.

Disclosures: This study was supported by grants from the European Commission and other sources. The authors declared no conflicts of interest.

Source: Tran TVT et al. Breast cancer risk among thyroid cancer survivors and the role of I-131 treatment. Br J Cancer. 2022 (Oct 12). Doi: 10.1038/s41416-022-01982-5

Key clinical point: The risk of developing breast cancer (BC) was slightly elevated in women who received treatment for thyroid cancer, with increasing cumulative ¹³¹I activity being an important risk factor.

Major finding: Compared with the general population, the risk for BC was 1.5 times higher in thyroid cancer survivors (standardized incidence ratio 1.52; 95% CI 1.36-1.69). Although ¹³¹I treatment did not increase the risk for subsequent BC, the risk increased with increasing cumulative ¹³¹I activity (excess relative risk per 100 mCi 17%; 95% CI 2%-38%).

Study details: This pooled analysis included 8475 women who were treated for differentiated thyroid cancer, of which 62% received radiotherapy with ¹³¹I.

Disclosures: This study was supported by grants from the European Commission and other sources. The authors declared no conflicts of interest.

Source: Tran TVT et al. Breast cancer risk among thyroid cancer survivors and the role of I-131 treatment. Br J Cancer. 2022 (Oct 12). Doi: 10.1038/s41416-022-01982-5

Key clinical point: The risk of developing breast cancer (BC) was slightly elevated in women who received treatment for thyroid cancer, with increasing cumulative ¹³¹I activity being an important risk factor.

Major finding: Compared with the general population, the risk for BC was 1.5 times higher in thyroid cancer survivors (standardized incidence ratio 1.52; 95% CI 1.36-1.69). Although ¹³¹I treatment did not increase the risk for subsequent BC, the risk increased with increasing cumulative ¹³¹I activity (excess relative risk per 100 mCi 17%; 95% CI 2%-38%).

Study details: This pooled analysis included 8475 women who were treated for differentiated thyroid cancer, of which 62% received radiotherapy with ¹³¹I.

Disclosures: This study was supported by grants from the European Commission and other sources. The authors declared no conflicts of interest.

Source: Tran TVT et al. Breast cancer risk among thyroid cancer survivors and the role of I-131 treatment. Br J Cancer. 2022 (Oct 12). Doi: 10.1038/s41416-022-01982-5

Key clinical point: Concomitant use of ribociclib and proton-pump-inhibitors (PPI) did not affect survival outcomes in a real-world population of patients with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer (mBC).

Major finding: Progression-free survival was similar among users vs nonusers of PPI in the overall population (hazard ratio [HR] 1.18; P = .594) and in the subgroup of patients with endocrine-sensitive (HR 1.22; 95% CI 0.63-2.39) and endocrine-resistant (HR 1.37; 95% CI 0.30-6.16) BC.

Study details: Findings are from a retrospective cohort study including 128 patients with HR+/HER2− mBC who received ribociclib+endocrine therapy with (n = 50) or without (n = 78) concomitant PPI.

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Re MD et al. Concomitant administration of proton pump inhibitors does not significantly affect clinical outcomes in metastatic breast cancer patients treated with ribociclib. Breast. 2022;66:157-161 (Oct 15). Doi: 10.1016/j.breast.2022.10.005

Key clinical point: Concomitant use of ribociclib and proton-pump-inhibitors (PPI) did not affect survival outcomes in a real-world population of patients with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer (mBC).

Major finding: Progression-free survival was similar among users vs nonusers of PPI in the overall population (hazard ratio [HR] 1.18; P = .594) and in the subgroup of patients with endocrine-sensitive (HR 1.22; 95% CI 0.63-2.39) and endocrine-resistant (HR 1.37; 95% CI 0.30-6.16) BC.

Study details: Findings are from a retrospective cohort study including 128 patients with HR+/HER2− mBC who received ribociclib+endocrine therapy with (n = 50) or without (n = 78) concomitant PPI.

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Re MD et al. Concomitant administration of proton pump inhibitors does not significantly affect clinical outcomes in metastatic breast cancer patients treated with ribociclib. Breast. 2022;66:157-161 (Oct 15). Doi: 10.1016/j.breast.2022.10.005

Key clinical point: Concomitant use of ribociclib and proton-pump-inhibitors (PPI) did not affect survival outcomes in a real-world population of patients with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer (mBC).

Major finding: Progression-free survival was similar among users vs nonusers of PPI in the overall population (hazard ratio [HR] 1.18; P = .594) and in the subgroup of patients with endocrine-sensitive (HR 1.22; 95% CI 0.63-2.39) and endocrine-resistant (HR 1.37; 95% CI 0.30-6.16) BC.

Study details: Findings are from a retrospective cohort study including 128 patients with HR+/HER2− mBC who received ribociclib+endocrine therapy with (n = 50) or without (n = 78) concomitant PPI.

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Re MD et al. Concomitant administration of proton pump inhibitors does not significantly affect clinical outcomes in metastatic breast cancer patients treated with ribociclib. Breast. 2022;66:157-161 (Oct 15). Doi: 10.1016/j.breast.2022.10.005

Key clinical point: Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) was associated with a higher incidence of chemotherapy-induced peripheral neuropathy (CIPN) than docetaxel or paclitaxel in women with invasive breast cancer (BC).

Major finding: The risk for patient-reported CIPN was lower in the paclitaxel (hazard ratio [HR] 0.59; P = .008) and docetaxel (HR 0.65; P = .02) groups compared with the nab-paclitaxel group, with lesser sensory discomfort being reported by patients receiving paclitaxel (HR 0.44) or docetaxel (HR 0.52; both P < .001) vs nab-paclitaxel.

Study details: Findings are from a prospective cohort study including 1234 patients with invasive BC who received taxane-containing chemotherapy, of which 23.9%, 41.7%, and 34.4% of patients received nab-paclitaxel, paclitaxel, and docetaxel, respectively.

Disclosures: This study was supported by the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences. Dr. Xu declared receiving personal fees from several sources.

Source: Mo H et al. Association of taxane type with patient-reported chemotherapy-induced peripheral neuropathy among patients with breast cancer. JAMA Netw Open. 2022;5(11):e2239788 (Nov 2). Doi: 10.1001/jamanetworkopen.2022.39788

Key clinical point: Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) was associated with a higher incidence of chemotherapy-induced peripheral neuropathy (CIPN) than docetaxel or paclitaxel in women with invasive breast cancer (BC).

Major finding: The risk for patient-reported CIPN was lower in the paclitaxel (hazard ratio [HR] 0.59; P = .008) and docetaxel (HR 0.65; P = .02) groups compared with the nab-paclitaxel group, with lesser sensory discomfort being reported by patients receiving paclitaxel (HR 0.44) or docetaxel (HR 0.52; both P < .001) vs nab-paclitaxel.

Study details: Findings are from a prospective cohort study including 1234 patients with invasive BC who received taxane-containing chemotherapy, of which 23.9%, 41.7%, and 34.4% of patients received nab-paclitaxel, paclitaxel, and docetaxel, respectively.

Disclosures: This study was supported by the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences. Dr. Xu declared receiving personal fees from several sources.

Source: Mo H et al. Association of taxane type with patient-reported chemotherapy-induced peripheral neuropathy among patients with breast cancer. JAMA Netw Open. 2022;5(11):e2239788 (Nov 2). Doi: 10.1001/jamanetworkopen.2022.39788

Key clinical point: Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) was associated with a higher incidence of chemotherapy-induced peripheral neuropathy (CIPN) than docetaxel or paclitaxel in women with invasive breast cancer (BC).

Major finding: The risk for patient-reported CIPN was lower in the paclitaxel (hazard ratio [HR] 0.59; P = .008) and docetaxel (HR 0.65; P = .02) groups compared with the nab-paclitaxel group, with lesser sensory discomfort being reported by patients receiving paclitaxel (HR 0.44) or docetaxel (HR 0.52; both P < .001) vs nab-paclitaxel.

Study details: Findings are from a prospective cohort study including 1234 patients with invasive BC who received taxane-containing chemotherapy, of which 23.9%, 41.7%, and 34.4% of patients received nab-paclitaxel, paclitaxel, and docetaxel, respectively.

Disclosures: This study was supported by the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences. Dr. Xu declared receiving personal fees from several sources.

Source: Mo H et al. Association of taxane type with patient-reported chemotherapy-induced peripheral neuropathy among patients with breast cancer. JAMA Netw Open. 2022;5(11):e2239788 (Nov 2). Doi: 10.1001/jamanetworkopen.2022.39788

Key clinical point: Invasive lobular carcinomas (ILC) are often detected at more advanced stages and have worse survival outcomes than invasive ductal carcinomas (IDC).

Major finding: ILCs vs IDC were more frequently diagnosed at later stages (stage III and IV; 20.7% vs 10.4%), with more lymph node involvement (N2 and 3; 9.9% vs 5.5%), and at larger sizes (T3 and 4; 14.7% vs 4.0%; all P < .001). Among patients with estrogen receptor-positive and human epidermal growth factor receptor 2-negative breast cancer (BC), ILC vs IDC were associated with worse overall survival (hazard ratio [HR] 1.32; P < .001) and disease-free survival (HR 1.18; P = .03).

Study details: Findings are from a retrospective cohort study, the Great Lakes Breast Cancer Consortium, including 33,662 patients with BC, of which 10.7% of patients had ILC and 89.3% of patients had IDC.

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

Source: Oesterreich S et al. Clinicopathological features and outcomes comparing patients with invasive ductal and lobular breast cancer. J Natl Cancer Inst. 2022 (Oct 14). Doi: 10.1093/jnci/djac157

Key clinical point: Invasive lobular carcinomas (ILC) are often detected at more advanced stages and have worse survival outcomes than invasive ductal carcinomas (IDC).

Major finding: ILCs vs IDC were more frequently diagnosed at later stages (stage III and IV; 20.7% vs 10.4%), with more lymph node involvement (N2 and 3; 9.9% vs 5.5%), and at larger sizes (T3 and 4; 14.7% vs 4.0%; all P < .001). Among patients with estrogen receptor-positive and human epidermal growth factor receptor 2-negative breast cancer (BC), ILC vs IDC were associated with worse overall survival (hazard ratio [HR] 1.32; P < .001) and disease-free survival (HR 1.18; P = .03).

Study details: Findings are from a retrospective cohort study, the Great Lakes Breast Cancer Consortium, including 33,662 patients with BC, of which 10.7% of patients had ILC and 89.3% of patients had IDC.

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

Source: Oesterreich S et al. Clinicopathological features and outcomes comparing patients with invasive ductal and lobular breast cancer. J Natl Cancer Inst. 2022 (Oct 14). Doi: 10.1093/jnci/djac157

Key clinical point: Invasive lobular carcinomas (ILC) are often detected at more advanced stages and have worse survival outcomes than invasive ductal carcinomas (IDC).

Major finding: ILCs vs IDC were more frequently diagnosed at later stages (stage III and IV; 20.7% vs 10.4%), with more lymph node involvement (N2 and 3; 9.9% vs 5.5%), and at larger sizes (T3 and 4; 14.7% vs 4.0%; all P < .001). Among patients with estrogen receptor-positive and human epidermal growth factor receptor 2-negative breast cancer (BC), ILC vs IDC were associated with worse overall survival (hazard ratio [HR] 1.32; P < .001) and disease-free survival (HR 1.18; P = .03).

Study details: Findings are from a retrospective cohort study, the Great Lakes Breast Cancer Consortium, including 33,662 patients with BC, of which 10.7% of patients had ILC and 89.3% of patients had IDC.

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

Source: Oesterreich S et al. Clinicopathological features and outcomes comparing patients with invasive ductal and lobular breast cancer. J Natl Cancer Inst. 2022 (Oct 14). Doi: 10.1093/jnci/djac157

Key clinical point: The prespecified second interim analysis of the OlympiA trial revealed a significant improvement in overall survival (OS) with adjuvant olaparib vs placebo in patients with pathogenic variants in BRCA1 or BRCA2 (gBRCA1/2pv) and high-risk, human epidermal growth factor receptor 2-negative (HER2−), early breast cancer (BC).

Major finding: After a median follow-up of 3.5 years, OS improved significantly (hazard ratio 0.68; P = .009) and improvement in 4-year invasive disease-free survival was maintained (82.7% vs 75.4%) in the olaparib vs placebo group. No new safety signals were identified.

Study details: Findings are from the double-blind, phase 3, OlympiA study including 1836 patients with gBRCA1/2pv-associated high-risk, HER2−, early BC who were randomly assigned to receive olaparib or placebo in the adjuvant setting.

Disclosures: This work was supported by the US National Institutes of Health. Some authors declared receiving research funding, honoraria, consulting fees, compensation, accommodations and travel expenses, and royalties from and having other ties with several sources.

Source: Geyer CE Jr et al. Overall survival in the OlympiA phase III trial of adjuvant olaparib in patients with germline pathogenic variants in BRCA1/2 and high risk, early breast cancer. Ann Oncol. 2022 (Oct 10). Doi: 10.1016/j.annonc.2022.09.159

Key clinical point: The prespecified second interim analysis of the OlympiA trial revealed a significant improvement in overall survival (OS) with adjuvant olaparib vs placebo in patients with pathogenic variants in BRCA1 or BRCA2 (gBRCA1/2pv) and high-risk, human epidermal growth factor receptor 2-negative (HER2−), early breast cancer (BC).

Major finding: After a median follow-up of 3.5 years, OS improved significantly (hazard ratio 0.68; P = .009) and improvement in 4-year invasive disease-free survival was maintained (82.7% vs 75.4%) in the olaparib vs placebo group. No new safety signals were identified.

Study details: Findings are from the double-blind, phase 3, OlympiA study including 1836 patients with gBRCA1/2pv-associated high-risk, HER2−, early BC who were randomly assigned to receive olaparib or placebo in the adjuvant setting.

Disclosures: This work was supported by the US National Institutes of Health. Some authors declared receiving research funding, honoraria, consulting fees, compensation, accommodations and travel expenses, and royalties from and having other ties with several sources.

Source: Geyer CE Jr et al. Overall survival in the OlympiA phase III trial of adjuvant olaparib in patients with germline pathogenic variants in BRCA1/2 and high risk, early breast cancer. Ann Oncol. 2022 (Oct 10). Doi: 10.1016/j.annonc.2022.09.159

Key clinical point: The prespecified second interim analysis of the OlympiA trial revealed a significant improvement in overall survival (OS) with adjuvant olaparib vs placebo in patients with pathogenic variants in BRCA1 or BRCA2 (gBRCA1/2pv) and high-risk, human epidermal growth factor receptor 2-negative (HER2−), early breast cancer (BC).

Major finding: After a median follow-up of 3.5 years, OS improved significantly (hazard ratio 0.68; P = .009) and improvement in 4-year invasive disease-free survival was maintained (82.7% vs 75.4%) in the olaparib vs placebo group. No new safety signals were identified.

Study details: Findings are from the double-blind, phase 3, OlympiA study including 1836 patients with gBRCA1/2pv-associated high-risk, HER2−, early BC who were randomly assigned to receive olaparib or placebo in the adjuvant setting.

Disclosures: This work was supported by the US National Institutes of Health. Some authors declared receiving research funding, honoraria, consulting fees, compensation, accommodations and travel expenses, and royalties from and having other ties with several sources.

Source: Geyer CE Jr et al. Overall survival in the OlympiA phase III trial of adjuvant olaparib in patients with germline pathogenic variants in BRCA1/2 and high risk, early breast cancer. Ann Oncol. 2022 (Oct 10). Doi: 10.1016/j.annonc.2022.09.159

Key clinical point: Patients who had survived breast cancer (BC) were more likely to develop soft tissue sarcoma if they received radiotherapy.

Major finding: A very small fraction of BC survivors (~0.1%) developed thoracic soft tissue sarcoma, with radiotherapy being the strongest risk factor in the Kaiser Permanente (KP) cohort (relative risk [RR] 8.1; P = .0052) and the Surveillance, Epidemiology, and End Results (SEER) 13 registries cohort (RR 3.0; P < .0001).

Study details: This retrospective study of data sourced from two cohorts, the KP cohort (n = 15,940) and the SEER 13 registries cohort (n = 457,300) and included patients who had BC surgery and survived ≥1 year after BC diagnosis.

Disclosures: This study was supported by the US National Cancer Institute and National Institutes of Health. The authors declared no conflicts of interest.

Source: Veiga LHS et al. Treatment-related thoracic soft tissue sarcomas in US breast cancer survivors: A retrospective cohort study. Lancet Oncol. 2022;23(11):1451-1464 (Oct 11). Doi: 10.1016/S1470-2045(22)00561-7

Key clinical point: Patients who had survived breast cancer (BC) were more likely to develop soft tissue sarcoma if they received radiotherapy.

Major finding: A very small fraction of BC survivors (~0.1%) developed thoracic soft tissue sarcoma, with radiotherapy being the strongest risk factor in the Kaiser Permanente (KP) cohort (relative risk [RR] 8.1; P = .0052) and the Surveillance, Epidemiology, and End Results (SEER) 13 registries cohort (RR 3.0; P < .0001).

Study details: This retrospective study of data sourced from two cohorts, the KP cohort (n = 15,940) and the SEER 13 registries cohort (n = 457,300) and included patients who had BC surgery and survived ≥1 year after BC diagnosis.

Disclosures: This study was supported by the US National Cancer Institute and National Institutes of Health. The authors declared no conflicts of interest.

Source: Veiga LHS et al. Treatment-related thoracic soft tissue sarcomas in US breast cancer survivors: A retrospective cohort study. Lancet Oncol. 2022;23(11):1451-1464 (Oct 11). Doi: 10.1016/S1470-2045(22)00561-7

Key clinical point: Patients who had survived breast cancer (BC) were more likely to develop soft tissue sarcoma if they received radiotherapy.

Major finding: A very small fraction of BC survivors (~0.1%) developed thoracic soft tissue sarcoma, with radiotherapy being the strongest risk factor in the Kaiser Permanente (KP) cohort (relative risk [RR] 8.1; P = .0052) and the Surveillance, Epidemiology, and End Results (SEER) 13 registries cohort (RR 3.0; P < .0001).

Study details: This retrospective study of data sourced from two cohorts, the KP cohort (n = 15,940) and the SEER 13 registries cohort (n = 457,300) and included patients who had BC surgery and survived ≥1 year after BC diagnosis.

Disclosures: This study was supported by the US National Cancer Institute and National Institutes of Health. The authors declared no conflicts of interest.

Source: Veiga LHS et al. Treatment-related thoracic soft tissue sarcomas in US breast cancer survivors: A retrospective cohort study. Lancet Oncol. 2022;23(11):1451-1464 (Oct 11). Doi: 10.1016/S1470-2045(22)00561-7

Key clinical point: Breast cancer (BC) surgery may be eliminated in patients with early-stage triple-negative BC (TNBC) or human epidermal growth factor receptor 2-positive (HER2+) BC who have achieved pathological complete response (pCR) after neoadjuvant systemic therapy (NST).

Major finding: After a median follow-up of 26.4 months, there were no incidences of ipsilateral breast tumor recurrence in the 31 patients who had achieved a pCR on percutaneous image-guided vacuum-assisted core biopsy (VACB) after NST.

Study details: Findings are from a multicenter, single-arm, phase 2 study including 50 patients with invasive HER2+ BC or TNBC who received percutaneous image-guided VACB after NST.

Disclosures: This study was funded by the US National Cancer Institute. Some authors declared serving in leadership roles or receiving consulting fees, honorarium, royalties, or research funding from several sources.

Source: Kuerer HM et al. Eliminating breast surgery for invasive breast cancer in exceptional responders to neoadjuvant systemic therapy: A multicentre, single-arm, phase 2 trial. Lancet Oncol. 2022 (Oct 25). Doi: 10.1016/S1470-2045(22)00613-1

Key clinical point: Breast cancer (BC) surgery may be eliminated in patients with early-stage triple-negative BC (TNBC) or human epidermal growth factor receptor 2-positive (HER2+) BC who have achieved pathological complete response (pCR) after neoadjuvant systemic therapy (NST).

Major finding: After a median follow-up of 26.4 months, there were no incidences of ipsilateral breast tumor recurrence in the 31 patients who had achieved a pCR on percutaneous image-guided vacuum-assisted core biopsy (VACB) after NST.

Study details: Findings are from a multicenter, single-arm, phase 2 study including 50 patients with invasive HER2+ BC or TNBC who received percutaneous image-guided VACB after NST.

Disclosures: This study was funded by the US National Cancer Institute. Some authors declared serving in leadership roles or receiving consulting fees, honorarium, royalties, or research funding from several sources.

Source: Kuerer HM et al. Eliminating breast surgery for invasive breast cancer in exceptional responders to neoadjuvant systemic therapy: A multicentre, single-arm, phase 2 trial. Lancet Oncol. 2022 (Oct 25). Doi: 10.1016/S1470-2045(22)00613-1

Key clinical point: Breast cancer (BC) surgery may be eliminated in patients with early-stage triple-negative BC (TNBC) or human epidermal growth factor receptor 2-positive (HER2+) BC who have achieved pathological complete response (pCR) after neoadjuvant systemic therapy (NST).

Major finding: After a median follow-up of 26.4 months, there were no incidences of ipsilateral breast tumor recurrence in the 31 patients who had achieved a pCR on percutaneous image-guided vacuum-assisted core biopsy (VACB) after NST.

Study details: Findings are from a multicenter, single-arm, phase 2 study including 50 patients with invasive HER2+ BC or TNBC who received percutaneous image-guided VACB after NST.

Disclosures: This study was funded by the US National Cancer Institute. Some authors declared serving in leadership roles or receiving consulting fees, honorarium, royalties, or research funding from several sources.

Source: Kuerer HM et al. Eliminating breast surgery for invasive breast cancer in exceptional responders to neoadjuvant systemic therapy: A multicentre, single-arm, phase 2 trial. Lancet Oncol. 2022 (Oct 25). Doi: 10.1016/S1470-2045(22)00613-1

A new model for predicting breast cancer risk that is based on standard clinical measures could be used to develop personalized breast screening strategies that are more effective than the current “one size fits all” approach, say researchers.

“Several breast cancer risk prediction models have been created, but we believe this is one of the first models designed to guide breast screening strategies over a person’s lifetime using real data from a screening program,” said study author Javier Louro, PhD, Hospital del Mar Medical Research Institute, Barcelona, Spain.

“Our model might be considered a key for designing personalized screening aimed at reducing the harms and increasing the benefits of mammographic screening,” he said in a statement.

Someone with a low risk “might be offered screening with standard mammography every 3 or 4 years instead of 2 years,” Dr. Louro explained.

“Someone with medium risk might be offered screening with advanced 3D mammography every 3 years, while those at a high risk might be offered a new screening test with mammography or MRI every year.”

However, he cautioned that “all of these strategies are still theoretical and should be studied with regard to their effectiveness.”

Dr. Louro was talking about the new model at the 13th European Breast Cancer Conference.
 

Details of the new prediction model

To develop the new model, Louro and colleagues conducted a retrospective study of 57,411 women who underwent mammography in four counties in Norway between 2007 and 2019 as part of the BreastScreen Norway program, and followed them up to 2022.

The team gathered data on age, breast density, family history of breast cancer, body mass index, age at menarche, alcohol habit, exercise, pregnancy, hormone replacement therapy, and benign breast disease, and compared women with and those without a breast cancer diagnosis.

All of these 10 variables used were found to significantly explain part of the variability in the breast cancer risk.

Overall, the 4-year breast cancer risk predicted by the resulting model varied across the participants, from 0.22% to 7.43%, at a median of 1.10%.

Bootstrap resampling analysis revealed that the model overestimated the risk for breast cancer, at an expected-to-observed ratio of 1.10.

The largest effect on risk was from breast density on mammography. Women with dense breasts were at much higher risk: the adjusted hazard ratio was 1.71 for women with Volpara Density Grade 4 vs Grade 2 and was 1.37 when compared with Grade 3.

Exercise had a large impact on breast cancer risk, the researchers found. Women who exercised for 4 or more hours per week had an adjusted hazard ratio of 0.65 for breast cancer risk compared with women who never exercised. Although this effect of exercise reducing the risk for breast cancer is now widely known, it is not usually included in models that predict breast cancer risk, the team pointed out.

The team concluded that their prediction model could be used to personalize breast screening for women according to their risk assessment, although they acknowledge that more work is needed. This work is based on one screening program in one country, and similar studies in different settings are needed.

Reacting to the findings, Laura Biganzoli, MD, co-chair of the European Breast Cancer Conference and director of the Breast Centre at Santo Stefano Hospital, Prato, Italy, commented, “We know that breast screening programs are beneficial, but we also know that some people will experience potential harms caused by false-positives or overdiagnosis.”

“This research shows how we might be able to identify people with a high risk of breast cancer, but equally how we could identify those with a low risk. So it’s an important step toward personalized screening,” Dr. Biganzoli said.

This study was supported by a grant from Instituto de Salud Carlos III FEDER (grant PI/00047). No relevant financial relationships declared.

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

A new model for predicting breast cancer risk that is based on standard clinical measures could be used to develop personalized breast screening strategies that are more effective than the current “one size fits all” approach, say researchers.

“Several breast cancer risk prediction models have been created, but we believe this is one of the first models designed to guide breast screening strategies over a person’s lifetime using real data from a screening program,” said study author Javier Louro, PhD, Hospital del Mar Medical Research Institute, Barcelona, Spain.

“Our model might be considered a key for designing personalized screening aimed at reducing the harms and increasing the benefits of mammographic screening,” he said in a statement.

Someone with a low risk “might be offered screening with standard mammography every 3 or 4 years instead of 2 years,” Dr. Louro explained.

“Someone with medium risk might be offered screening with advanced 3D mammography every 3 years, while those at a high risk might be offered a new screening test with mammography or MRI every year.”

However, he cautioned that “all of these strategies are still theoretical and should be studied with regard to their effectiveness.”

Dr. Louro was talking about the new model at the 13th European Breast Cancer Conference.
 

Details of the new prediction model

To develop the new model, Louro and colleagues conducted a retrospective study of 57,411 women who underwent mammography in four counties in Norway between 2007 and 2019 as part of the BreastScreen Norway program, and followed them up to 2022.

The team gathered data on age, breast density, family history of breast cancer, body mass index, age at menarche, alcohol habit, exercise, pregnancy, hormone replacement therapy, and benign breast disease, and compared women with and those without a breast cancer diagnosis.

All of these 10 variables used were found to significantly explain part of the variability in the breast cancer risk.

Overall, the 4-year breast cancer risk predicted by the resulting model varied across the participants, from 0.22% to 7.43%, at a median of 1.10%.

Bootstrap resampling analysis revealed that the model overestimated the risk for breast cancer, at an expected-to-observed ratio of 1.10.

The largest effect on risk was from breast density on mammography. Women with dense breasts were at much higher risk: the adjusted hazard ratio was 1.71 for women with Volpara Density Grade 4 vs Grade 2 and was 1.37 when compared with Grade 3.

Exercise had a large impact on breast cancer risk, the researchers found. Women who exercised for 4 or more hours per week had an adjusted hazard ratio of 0.65 for breast cancer risk compared with women who never exercised. Although this effect of exercise reducing the risk for breast cancer is now widely known, it is not usually included in models that predict breast cancer risk, the team pointed out.

The team concluded that their prediction model could be used to personalize breast screening for women according to their risk assessment, although they acknowledge that more work is needed. This work is based on one screening program in one country, and similar studies in different settings are needed.

Reacting to the findings, Laura Biganzoli, MD, co-chair of the European Breast Cancer Conference and director of the Breast Centre at Santo Stefano Hospital, Prato, Italy, commented, “We know that breast screening programs are beneficial, but we also know that some people will experience potential harms caused by false-positives or overdiagnosis.”

“This research shows how we might be able to identify people with a high risk of breast cancer, but equally how we could identify those with a low risk. So it’s an important step toward personalized screening,” Dr. Biganzoli said.

This study was supported by a grant from Instituto de Salud Carlos III FEDER (grant PI/00047). No relevant financial relationships declared.

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

A new model for predicting breast cancer risk that is based on standard clinical measures could be used to develop personalized breast screening strategies that are more effective than the current “one size fits all” approach, say researchers.

“Several breast cancer risk prediction models have been created, but we believe this is one of the first models designed to guide breast screening strategies over a person’s lifetime using real data from a screening program,” said study author Javier Louro, PhD, Hospital del Mar Medical Research Institute, Barcelona, Spain.

“Our model might be considered a key for designing personalized screening aimed at reducing the harms and increasing the benefits of mammographic screening,” he said in a statement.

Someone with a low risk “might be offered screening with standard mammography every 3 or 4 years instead of 2 years,” Dr. Louro explained.

“Someone with medium risk might be offered screening with advanced 3D mammography every 3 years, while those at a high risk might be offered a new screening test with mammography or MRI every year.”

However, he cautioned that “all of these strategies are still theoretical and should be studied with regard to their effectiveness.”

Dr. Louro was talking about the new model at the 13th European Breast Cancer Conference.
 

Details of the new prediction model

To develop the new model, Louro and colleagues conducted a retrospective study of 57,411 women who underwent mammography in four counties in Norway between 2007 and 2019 as part of the BreastScreen Norway program, and followed them up to 2022.

The team gathered data on age, breast density, family history of breast cancer, body mass index, age at menarche, alcohol habit, exercise, pregnancy, hormone replacement therapy, and benign breast disease, and compared women with and those without a breast cancer diagnosis.

All of these 10 variables used were found to significantly explain part of the variability in the breast cancer risk.

Overall, the 4-year breast cancer risk predicted by the resulting model varied across the participants, from 0.22% to 7.43%, at a median of 1.10%.

Bootstrap resampling analysis revealed that the model overestimated the risk for breast cancer, at an expected-to-observed ratio of 1.10.

The largest effect on risk was from breast density on mammography. Women with dense breasts were at much higher risk: the adjusted hazard ratio was 1.71 for women with Volpara Density Grade 4 vs Grade 2 and was 1.37 when compared with Grade 3.

Exercise had a large impact on breast cancer risk, the researchers found. Women who exercised for 4 or more hours per week had an adjusted hazard ratio of 0.65 for breast cancer risk compared with women who never exercised. Although this effect of exercise reducing the risk for breast cancer is now widely known, it is not usually included in models that predict breast cancer risk, the team pointed out.

The team concluded that their prediction model could be used to personalize breast screening for women according to their risk assessment, although they acknowledge that more work is needed. This work is based on one screening program in one country, and similar studies in different settings are needed.

Reacting to the findings, Laura Biganzoli, MD, co-chair of the European Breast Cancer Conference and director of the Breast Centre at Santo Stefano Hospital, Prato, Italy, commented, “We know that breast screening programs are beneficial, but we also know that some people will experience potential harms caused by false-positives or overdiagnosis.”

“This research shows how we might be able to identify people with a high risk of breast cancer, but equally how we could identify those with a low risk. So it’s an important step toward personalized screening,” Dr. Biganzoli said.

This study was supported by a grant from Instituto de Salud Carlos III FEDER (grant PI/00047). No relevant financial relationships declared.

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