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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TMIST Study to Evaluate 3D Mammograms

27 September 2017 3D mammography, also known as tomosynthesis, is becoming more widely available. The thin “slices” (images) make it easier to spot cancers in patients with dense breast tissue. In addition, the use of 3D mammography can decrease the rate of “callbacks” – additional images that are often recommended after a screening mammogram due to uncertainty about the findings.…

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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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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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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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Do I Need Chemotherapy?

25 August 2016 A study published today in the New England Journal of Medicine reports on the 5 year results of the MINDACT (Microarray In Node-negative and 1 to 3 positive lymph node Disease may Avoid ChemoTherapy) trial. This study was designed to evaluate the use of a tumor gene signature test (MammaPrint) compared with standard factors to assess the…

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Extended Hormone Therapy for Postmenopausal Breast Cancer

09 June 2016 A study presented at the recent American Society of Clinical Oncology meeting evaluated the use of extended endocrine therapy in post-menopausal women. I’ve covered some of the basics of endocrine therapy for breast cancer in a previous post. In 2012, results of the ATLAS Trial were published, and found that when tamoxifen was given for 10 years instead of the standard…

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Race and Breast Cancer

15 October 2015 A recent study has noted that African American and Hispanic women are more likely to be diagnosed with aggressive forms of breast cancer. Drs. Lu Chen and Christopher Lee published their findings, Racial Disparities in Breast Cancer Diagnosis and Treatment by Hormone Receptor and Her2 Status, in a recent issue of the journal Cancer Epidemiology, Biomarkers and…

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Chemotherapy Can Be Avoided in Certain Patients

29 September 2015 One of the most common questions asked by a newly diagnosed cancer patient is “Will I need chemotherapy?”. Almost everyone is aware of the toxicity related to chemotherapy, and the fact that it is a common component of cancer treatment. A recent study sheds some light on which patients can safely avoid chemotherapy. We have known for many years that…

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Do I Need Surgery for DCIS?

9 June 2015 Surgery doesn’t help women with early-stage breast cancer. That’s certainly a headline that will get attention! The recent NPR article referred to a study published in JAMA Surgery: Survival Benefit of Breast Surgery for Low Risk Ductal Carcinoma In Situ – A Population-Based Cohort Study(1). The study raises some very interesting points, but the NPR headline is misleading.…

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