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

18 August 2017 Approximately 15%  of women diagnosed with breast 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 of cancer…

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Comparison of Treatments for Cancer-Related Fatigue

1 August 2017 A meta-analysis recently published in JAMA Oncology evaluated studies that reported on therapies for cancer-related fatigue (CRF). CRF is very common, can persist for years after treatment, and is exacerbated by depression, anxiety, sleep disturbance and pain – which can also be long-term effects of cancer therapy. The authors focused on papers that reported the effects of pharmaceutical…

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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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Genetic Testing for Breast Cancer

7 February 2017 A research letter recently published in the Journal of the American Medical Association found that patients diagnosed with breast cancer were not appropriately referred for genetic counseling and testing. The researchers used the SEER Registry to study the records of patients diagnosed between July 2013 – September 2014. Registry patients in the state of Georgia and Los…

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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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Axillary Surgery for Early Stage Breast Cancer

9 January 2017 The American Society of Clinical Oncology recently updated their guideline on sentinel node biopsy for patients with early stage breast cancer. Axillary dissection, or removal of underarm lymph nodes, has traditionally accompanied mastectomy and lumpectomy surgery. It was initially felt that removal of these nodes was important to prevent the cancer from spreading to other areas in…

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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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Surgeon Recommendation a Factor in Contralateral Prophylactic Mastectomy Decision

21 December 2016 A study published in JAMA Surgery found that in women with early stage breast cancer, a surgeon recommendation against removal of the unaffected, healthy breast (known as a contralateral prophylactic mastectomy or CPM) often led to the patient not undergoing that procedure. However, if the surgeon did not make a specific recommendation for or against the procedure,…

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Do Social Connections Predict Breast Cancer Outcomes?

13 December 2016 A study published in the journal Cancer concluded that women with larger social networks have better breast cancer (BC) outcomes. In noting that large social networks predict lower overall mortality in healthy populations, the researchers analyzed a group of women who were already participating in four cohort studies. They evaluated associations between social networks within 2 years…

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