Updated Breast Cancer Staging System – AJCC 8th Edition

1 January 2018 The American Joint Committee on Cancer (AJCC) has recently updated the staging system used for breast cancer. Cancer stage refers to the amount of cancer (size of the main tumor, spread to lymph nodes or other areas). The definitions of each stage vary depending on cancer type. Cancer stage often correlates with outcomes, and treatment recommendations usually…

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How Well Informed Do Patients Feel About Their Breast Cancer Surgery?

26 December 2017 A study recently published in the Journal of the American College of Surgeons evaluated patient perceptions regarding knowledge about their breast cancer surgery. An online survey was distributed via email to patients who had participated in previous online surveys and had agreed to be contacted again. Enrollment quotas were set for geographic area, insurance status, and income level…

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Cognitive Dysfunction after Breast Cancer Treatment

19 December 2017 Up to 70% of patients treated for breast cancer experience some degree of cognitive dysfunction (more commonly known as “chemobrain”) during and immediately after treatment, and the symptoms may persist in up to 15-25% of patients. The impact on quality of life and ability to work varies; patients may experience forgetfulness, challenges with multitasking, and difficulty finding…

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Risk of Breast Cancer Recurrence after Endocrine Therapy

9 November 2017 In patients with a common form of breast cancer, known as estrogen receptor (ER) “positive”, endocrine therapy is often recommended after other treatments such as surgery, chemotherapy, and radiation are complete. Tamoxifen, most commonly used in pre-menopausal women, blocks the estrogen receptor on the breast cell, so estrogen cannot impact cell growth. In post-menopausal women, aromatase inhibitors…

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After 10 years, Less is Still More

12 September 2017 A common misconception among patients is that more aggressive surgery for breast cancer leads to better outcomes. In fact, nothing could be further from the truth. The standard operation for breast cancer for years (up until the 1960-70s) was the Halsted radical mastectomy, during which the breast, pectoralis muscle of the chest, and underarm lymph nodes were…

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Genetic Testing in Women with a History of Breast or Ovarian Cancer

18 August 2017 Approximately 15%  of women diagnosed with breast or ovarian cancer will be found to carry a mutation in one or more genes that predisposes to the cancer. The most familiar are the BRCA 1 and BRCA 2 genes. These are tumor suppressor genes, if mutated, they do not function properly and can result in a higher likelihood…

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Updates from ASBrS 2017

8 May 2017 As a past-president of the American Society of Breast Surgeons I am probably more than a little biased. However, as always, the annual meeting held April 26-30th in Las Vegas was terrific. Topics including the full spectrum of breast disease, including benign and high risk lesions, genetic testing, breast cancer diagnosis and treatment including medical and radiation…

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Active Surveillance for DCIS

20 March 2017 Over 50,000 women in the US are diagnosed every year with ductal carcinoma in-situ (DCIS), also known as Stage 0 breast cancer. DCIS is most often diagnosed on screening mammography and usually presents as a cluster of calcium deposits rather than a lump. In cases of DCIS, malignant appearing cells grow within the milk duct, but do not invade…

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Misunderstanding Prognosis and Test Results

17 January 2017 A study recently published in the Journal of Oncology Practice noted that patients with incurable breast cancer often have poor awareness of their prognosis after oncologist discussion of scan results. The researchers analyzed audio recordings of conversations between patients and oncologists. They found that oncologists tended to spend more time discussing treatment recommendations rather than scan results…

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Extended Endocrine Therapy – Not So Fast?

26 December 2016 Approximately 75% of breast cancers express the estrogen receptor – we term these breast cancers ER positive (ER+) or hormone-sensitive. Endocrine therapy refers to using medications to exploit this cancer cell property. Tamoxifen is used in premenopausal women and it blocks the estrogen receptor. In post-menopausal women, aromatase inhibitors (AI) are used which prevent estrogen from being produced…

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