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123Donna View Drop Down
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    Posted: Sep 25 2018 at 8:02am

Advances in the systemic treatment of triple-negative breast cancer


Triple-negative breast cancer constitutes a heterogeneous group of malignancies that are often aggressive and associated with a poor prognosis. Molecular characterization, while not a standard of care, can further subtype triple-negative breast cancer and provide insight into prognostication and behaviour. Optimal chemotherapy regimens have yet to be established; however, there have been advances in the systemic treatment of triple-negative breast cancer in the neoadjuvant, adjuvant, and metastatic settings. In this review, we discuss evidence for the potential benefit of neoadjuvant platinum-based chemotherapy, adjuvant combination chemotherapy with weekly paclitaxel, and BRCA mutation–directed therapy in the metastatic setting. The role for adjuvant capecitabine in patients who do not achieve a pathologic complete response with neoadjuvant chemotherapy is reviewed. Future directions and data concerning novel targeted agents are reviewed, including the most recent data on parp [poly (adp-ribose) polymerase] inhibitors, antiandrogen agents, and immunotherapy.

To read the entire article:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6001760/

DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2016 at 7:49am
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Dec 01 2013 at 9:31pm

Reputable resources on complementary medicine

• American Cancer Society. Guidelines for Using Complementary and Alternative Methods (http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/guidelines-for-using-complementary-and-alternative-methods)

• Medline Plus. Herbs and Supplements (http://www.nlm.nih.gov/medlineplus/druginfo/herb_All.html)

• Memorial Sloan–Kettering Cancer Center. About Herbs, Botanicals & Other Products (http://www.mskcc.org/aboutherbs)

• Memorial Sloan–Kettering Cancer Center. Integrative Medicine (http://www.MSKCC.org/IntegrativeMedicine)

• National Cancer Institute. Topics in Complementary and Alternative Therapies (PDQ®; http://www.cancer.gov/cancertopics/pdq/cam/topics-in-cam/healthprofessional)

• National Center for Complementary and Alternative Medicine (NCCAM). Cancer and Complementary Health Practices (http://nccam.nih.gov/health/cancer/camcancer.htm)

• NCCAM. Time to Talk: Ask Your Patients About Their Use of Complementary Health Practices (http://nccam.nih.gov/timetotalk/forphysicians.htm)

• NIH Office of Dietary Supplements. Dietary Supplement Fact Sheets (http://ods.od.nih.gov)

• Society for Integrative Oncology (http://www.integrativeonc.org)

• US Pharmacopeial Convention. USP Dietary Supplement Standards (http://www.usp.org/dietary-supplements/overview)

12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tracy Quote  Post ReplyReply Direct Link To This Post Posted: Nov 03 2013 at 6:49pm
Hi Martha, where are you being treated? After 5.5 years I had a new primary that grew lightning fast. I was worked up in San Diego and MDA. My tumor this time was also the aggressive sarcamatoid. I think I spelled it right. That thing came back 3 days after my first chemo. In the same place as the lumpectomy. Shocked all. So I had an immediate left breast masectomy and nodes. About 3 week went by between the last physical exam and when chemo started. I also had a mediastinal node biopsied as 3 were enlarged. The one the biopsied was negative. I'm on Ixempra and Xeloda chemo. I'm very very interested in this trial or whatever you call it. I may need more. Appreciate knowing where you go. Your doc name. Thank you. Best of all luck.
Tracy

San Diego

DX 12/20/07, Stage 2, TNBC, Grade 3/2.5 cm

Chemo start 2/14/08; rads ended 9/08; A/C - Taxol; Neg. Sentinol Node; lumpectomy; past 5 years!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Aug 29 2013 at 9:59pm
Problems with public reporting of clinical trials:
http://jco.ascopubs.org/content/31/24/2981.long

Quotes from article:

"They found that almost one half of trials had no publically available results at 3 years after completion."

"The consequences of nonreporting study results—in particular, those from clinical trials with statistically nonsignificant findings or where significant toxicities are identified which are more likely to remain unpublished7—have far reaching effects."

And importantly:
"Finally, study investigators must remember their commitment to research participant volunteers as well as future patients to see complete pictures of oncologic drugs."
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Aug 27 2013 at 4:55pm
12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Aug 22 2013 at 9:21pm
Progress in the Biological Understanding and Management of Breast Cancer-Associated Central Nervous System Metastases
  1. Ana M. Gonzalez-Angulo
First published online in THE ONCOLOGIST Express on June 5, 2013.

Abstract

Metastasis to the central nervous system (CNS) is a devastating neurological complication of systemic cancer. Brain metastases from breast cancer have been documented to occur in approximately 10%–16% of cases over the natural course of the disease with leptomeningeal metastases occurring in approximately 2%–5% of cases of breast cancer. CNS metastases among women with breast cancer tend to occur among those who are younger, have larger tumors, and have a more aggressive histological subtype such as the triple negative and HER2-positive subtypes. Treatment of CNS metastases involves various combinations of whole brain radiation therapy, surgery, stereotactic radiosurgery, and chemotherapy. We will discuss the progress made in the treatment and prevention of breast cancer-associated CNS metastases and will delve into the biological underpinnings of CNS metastases including evaluating the role of breast tumor subtype on the incidence, natural history, prognostic outcome, and impact of therapeutic efficacy.

http://theoncologist.alphamedpress.org/content/18/6/675.long
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Grateful for today Quote  Post ReplyReply Direct Link To This Post Posted: Aug 04 2013 at 9:22pm
Added on page 4 of this thread:

RADIOLOGY
Patient Safety: Radiation Dose in X-Ray and CT Exams                                
http://www.radiologyinfo.org/en/safety/index.cfm?pg=sfty_xray
My Medical Imaging History
http://www.radiologyinfo.org/en/safety/ImageWisely/7678_Medical%20Imaging%20History.pdf

In addition to getting copies of the imaging tests one has, one can consider keeping a self made history
list with the date, name of test, (amount of radiation if known).


Grateful for today...........Judy

-------------------------------

Added to page 4:

GENES

Gene Reviews.
Expert-authored summaries about diagnosis, management and genetic counseling for specific inherited conditions, University of Washington.
http://www.ncbi.nlm.nih.gov/books/NBK1116/

Among some of the topics covered:
BRCA1 and BRCA2 Hereditary Breast and Ovarian Cancer
http://www.ncbi.nlm.nih.gov/books/NBK1247/
Li-Fraumeni Syndrome
http://www.ncbi.nlm.nih.gov/books/NBK1311/

Edited by Grateful for today - Aug 10 2013 at 7:02pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Grateful for today Quote  Post ReplyReply Direct Link To This Post Posted: Jul 29 2013 at 12:50pm
TNBC Foundation just posted on their Facebook page:

"Aggressive breast cancer genes found.
Scientists at A*STAR’s Genome Institute of Singapore (GIS) led a study that has identified genes that are potential targets for therapeutic drugs against aggressive breast cancer. These findings were reported in the July 2013 issue of PNAS........They also showed that patients with TNBC tumours that have high levels of UBASH3B tend to be more likely to have early recurrence and metastasis......The scientists discovered that a protein tyrosine phosphatase, called UBASH3B, is overexpressed in one third of TNBC patients. UBASH3B controls the activity of an important breast cancer gene."
Article at:
http://www.sciencealert.com.au/news/20132807-24630.html
with source of http://www.a-star.edu.sg/Media/News/PressReleases/tabid/828/articleType/ArticleView/articleId/1855/Default.aspx


Grateful for today.............Judy

Edited by Grateful for today - Jul 29 2013 at 12:51pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Jun 14 2013 at 4:11pm

Relating Neuropsychological Test Performance To Cognitive Complaints After Breast Cancer

Approximately one out of five breast cancer patients treated for breast cancer had elevated memory and/or executive function complaints that were statistically significantly associated with domain-specific neuropsychological (NP) test performances and depressive symptoms. Combined chemotherapy and radiation treatment in these patients was also associated with memory complaints according to a study published April 18 in the Journal of the National Cancer Institute.

Cognitive complaints have been frequently reported following breast cancer treatments, however, their connection with neuropsychological (NP) test performance has not been well established.

In order to determine the relationship between cognitive complaints and neurocognitive testing, Patricia A. Ganz, M.D., at the Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center and colleagues, looked at early-stage post treatment breast cancer patients who were enrolled in a prospective, longitudinal, cohort study before they started receiving endocrine therapy and evaluated them using an NP test battery and questionnaires that were self-reported, which gauged their symptoms, including cognitive complaints.

The researchers found that of the 189-breast cancer patients evaluated, 23.3% had higher memory complaints and 19% reported higher executive function complaints than found in age-matched healthy women without breast cancer. They also found that higher memory complaints were statistically significantly associated with combined chemotherapy and radiation treatments, and not chemotherapy alone. “Our findings add further support for the value of patient-reported outcomes as a central measurement in evaluation of cancer treatment-related morbidities,” the authors write.

In an accompanying editorial, Christina A. Meyers, Ph.D., M.D. Anderson Cancer Center, writes that the studies that use subject data can obscure individual differences and may underestimate the true incidences of cognitive symptoms in breast cancer patients and feels that, “many cancer survivors can enjoy improved levels of functioning if properly diagnosed and provided with the right support.”

  1. JNCI J Natl Cancer Inst 105 (11): 1. doi: 10.1093/jnci/djt112 First published online: April 18, 2013
12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Jun 14 2013 at 4:05pm

Cancer Risks for BRCA1 and BRCA2 Mutation Carriers: Results From Prospective Analysis of EMBRACE

  1. on behalf of EMBRACE

+ Author Affiliations

  1. Affiliations of authors: Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care (NM, SP, DF, SE, RP, EF, ACA, DFE); Genetic Medicine, Manchester Academic Health Sciences Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK (DGE); South East Thames Regional Genetics Service, Guy’s Hospital, London, UK (LI); Oncogenetics Team, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK (RAE); Yorkshire Regional Genetics Service, Leeds, UK (JA); Ferguson-Smith Centre for Clinical Genetics, Yorkhill Hospitals, Glasgow, UK (RD); Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK (DE); West Midlands Regional Genetics Service, Birmingham Women’s Hospital Healthcare NHS Trust, Edgbaston, Birmingham, UK (TC); Sheffield Clinical Genetics Service, Sheffield Children’s Hospital, Sheffield, UK (JC); Department of Clinical Genetics, Royal Devon & Exeter Hospital, Exeter, UK (CB); Department of Clinical Genetics, East Anglian Regional Genetics Service, Addenbrookes Hospital, Cambridge, UK (MT); Institute of Genetic Medicine, Centre for Life, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK (FD); Clinical Genetics Department, St.Georges University of London, Tooting, London, UK (SH); Oxford Regional Genetics Service, Churchill Hospital, Oxford, UK (LW); South East of Scotland Regional Genetics Service, Western General Hospital, Edinburgh, UK (MEP); Northern Ireland Regional Genetics Centre, Belfast City Hospital, Belfast, UK (PJM); North East Thames Regional Genetics Service, Great Ormond Street Hospital for Children NHS Trust, London, UK (LES); Academic Unit of Clinical and Molecular Oncology, Trinity College Dublin and St James’s Hospital, Dublin, Ireland (MJK); Cheshire & Merseyside Clinical Genetics Service, Liverpool Women’s NHS Foundation Trust, Liverpool, UK (CH); South West Regional Genetics Service, Bristol, UK (AD); All Wales Medical Genetics Services, University Hospital of Wales, Cardiff, UK (MTR); North West Thames Regional Genetics Service, Kennedy-Galton Centre, Harrow, UK (HD); North of Scotland Regional Genetics Service, NHS Grampian & University of Aberdeen, Foresterhill, Aberdeen, UK (ZM, HG); Nottingham Clinical Genetics Service, Nottingham University Hospitals NHS Trust, UK (JE); Leicestershire Clinical Genetics Service, University Hospitals of Leicester NHS Trust, Leicester, UK (JB); All Wales Medical Genetics Service, Glan Clwyd Hospital, Rhyl, UK (EM, AM).
  1. Correspondence to: Nasim Mavaddat, MBBS, PhD, Strangeways Research Laboratory, Worts Causeway, Cambridge, CB1 8RN, UK (e-mail: nasim@srl.cam.ac.uk).
  • Received July 24, 2012.
  • Revision received March 20, 2013.
  • Accepted March 22, 2013.

Abstract

Background Reliable estimates of cancer risk are critical for guiding management of BRCA1 and BRCA2 mutation carriers. The aims of this study were to derive penetrance estimates for breast cancer, ovarian cancer, and contralateral breast cancer in a prospective series of mutation carriers and to assess how these risks are modified by common breast cancer susceptibility alleles.

Methods Prospective cancer risks were estimated using a cohort of 978 BRCA1 and 909 BRCA2 carriers from the United Kingdom. Nine hundred eighty-eight women had no breast or ovarian cancer diagnosis at baseline, 1509 women were unaffected by ovarian cancer, and 651 had been diagnosed with unilateral breast cancer. Cumulative risks were obtained using Kaplan–Meier estimates. Associations between cancer risk and covariables of interest were evaluated using Cox regression. All statistical tests were two-sided.

Results The average cumulative risks by age 70 years for BRCA1 carriers were estimated to be 60% (95% confidence interval [CI] = 44% to 75%) for breast cancer, 59% (95% CI = 43% to 76%) for ovarian cancer, and 83% (95% CI = 69% to 94%) for contralateral breast cancer. For BRCA2 carriers, the corresponding risks were 55% (95% CI = 41% to 70%) for breast cancer, 16.5% (95% CI = 7.5% to 34%) for ovarian cancer, and 62% (95% CI = 44% to 79.5%) for contralateral breast cancer. BRCA2 carriers in the highest tertile of risk, defined by the joint genotype distribution of seven single nucleotide polymorphisms associated with breast cancer risk, were at statistically significantly higher risk of developing breast cancer than those in the lowest tertile (hazard ratio = 4.1, 95% CI = 1.2 to 14.5; P = .02).

Conclusions Prospective risk estimates confirm that BRCA1 and BRCA2 carriers are at high risk of developing breast, ovarian, and contralateral breast cancer. Our results confirm findings from retrospective studies that common breast cancer susceptibility alleles in combination are predictive of breast cancer risk for BRCA2 carriers.

  1. JNCI J Natl Cancer Inst 105 (11): 812-822. doi: 10.1093/jnci/djt095 First published online: April 29, 2013



Edited by Lee21 - Jun 14 2013 at 4:20pm
12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Jun 06 2013 at 10:26am

Here's the actual abstract.

S0221: Comparison of two schedules of paclitaxel as adjuvant therapy for breast cancer.

Subcategory: 
Cytotoxic Chemotherapy
Session Type and Session Title: 

Oral Abstract Session, Breast Cancer - Triple-Negative/Cytotoxics/Local Therapy

Abstract Number: 

CRA1008

Citation: 

J Clin Oncol 31, 2013 (suppl; abstr CRA1008)

Author(s): 

G. Thomas Budd, William E. Barlow, Halle C. F. Moore, Timothy J. Hobday, James A. Stewart, Claudine Isaacs, Muhammad Salim, Jonathan K. Cho, Kristine Rinn, Kathy S. Albain, Helen K. Chew, Gary Von Burton, Timothy David Moore, Gordan Srkalovic, Bradley Alexander McGregor, Lawrence E. Flaherty, Robert B. Livingston, Danika Lew, Julie Gralow, Gabriel N. Hortobagyi; Cleveland Clinic, Cleveland, OH; Cancer Research and Biostatistics, Seattle, WA; Mayo Clinic, Rochester, MN; Baystate Medical Center, Springfield, MA; Lombardi Comprehensive Cancer Center, Washington, DC; Allan Blair Cancer Center, Saskatoon, SK, Canada; Oncare Hawaii, Honolulu, HI; Swedish Cancer Institute, Seattle, WA; Loyola University Medical Center, Maywood, IL; University of California, Davis Cancer Center, Sacramento, CA; LSU Health Sciences Center, Shreveport, LA; Mid Ohio Oncology Hematology, Inc., Columbus, OH; Sparrow Regional Cancer Center, Lansing, MI; Willford Hall Medical Center, Lackland, TX; Wayne State University School of Medicine, Detroit, MI; Arizona Cancer Center, Tucson, AZ; Southwest Oncology Group Statistical Center, Seattle, WA; Seattle Cancer Care Alliance, Seattle, WA; The University of Texas MD Anderson Cancer Center, Houston, TX

Background: S0221 is a SWOG-coordinated phase III adjuvant chemotherapy intergroup trial in node-positive and high-risk node-negative operable breast cancer which hypothesized that 1) the weekly AC+G regimen is superior to ddAC x 6 and 2) 12 weeks of weekly paclitaxel (wP) is superior to q 2 week paclitaxel x 6 (ddP). Methods: Between December 2003 and November 2010, 2,716 patients were randomized in a 2 x 2 factorial design to 1) AC+G vs ddAC and 2) P 80 mg/m2/week x 12 vs P 175 mg/m2 q 2 weeks x 6. If there was no significant interaction between the factors, the trial was powered to find a disease-free survival hazard ratio (HR) ≤ 0.82 for weekly vs q 2 week for each factor. At the first interim analysis, the AC randomization was halted for futility, and S0221 was closed to accrual 10 November 2010. S0221 reopened 15 December 2010, after which time all patients received 4 cycles of ddAC and randomization to P weekly x 12 and ddP x 6 continued. Accrual halted at a total of 3,294 in January 2012. Results: By September 7, 2012, 487 events and 340 deaths had occurred, prompting the third planned interim analysis. The Data Safety and Monitoring Committee recommended reporting the results since the futility boundary was crossed. A Cox model adjusting for the AC arms had a HR = 1.08 (95% CI 0.90-1.28; p=0.42), with the 99.5% CI excluding the original alternative hypothesis that the HR=0.82. There was no significant interaction of the two factors. Estimated 5-year progression-free survivals were 82% for weekly P and 81% for ddP. Toxicity data were available for 1,385 patients treated with ddP and 1,367 treated with weekly P. Grade 5 toxicity occurred in 4 patients on ddP and 2 on weekly P. Percent grade 3-4 toxicity per arm are shown in the Table. Conclusions: Either ddPx6 or weekly P x 12 are acceptable schedules of P administration. The differences in leukopenia likely reflect ascertainment bias against weekly P. If this is accepted, weekly P x 12 produces less overall toxicity than 6 cycles of ddP. Support: NCI grants CA32102, CA38926, CA21115, CA21076, CA77597, CA25224, CA77202, CCSRI15469, and Amgen, Inc. Clinical trial information: NCT00070564.

Grade 3-4 toxicity ddP Weekly P
Any 36% 35%
Allergy 14% 6%
Leukopenia 1% 6%
Neutropenic fever <1% <1%
Dermatologic 3% 0.1%
Musculoskeletal pain 11% 3%
Neurologic 17% 10%

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11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Jun 05 2013 at 11:07pm
ASCO 20132:  Dose dense Taxol vs. weekly Taxol, no difference in survival.

http://www.medpagetoday.com/HematologyOncology/BreastCancer/39636
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: May 30 2013 at 2:56pm

Breast-Conserving Therapy Achieves Locoregional Outcomes Comparable to Mastectomy in Women with T1-2N0 Triple-Negative Breast Cancer.

Ann Surg Oncol Epub May 19, 2013

Abstract

BACKGROUND:

Conflicting data exist regarding optimum local therapy for early-stage triple-negative breast cancer (TNBC). We examined outcomes according to local treatment type in a large cohort of node-negative TNBC patients.

METHODS:

A total of 1,242 consecutive patients with TNBC treated at a single institution from 1999 to 2008 were identified. Of these, 646 with pathologic stage T1-2N0 TNBC underwent breast-conserving therapy (BCT) (N = 448) or total mastectomy (TM) without postmastectomy radiation (N = 198) and comprised the study population. Locoregional recurrence (LRR), distant metastasis (DM), and overall recurrence were investigated with a competing risk analysis using Gray's test and multivariable Fine and Gray competing risk regression. Overall survival was assessed using standard Kaplan-Meier methods and a Cox proportional hazards analysis.

RESULTS:

Median follow-up was 78.3 months (range 1-156). Eight-one percent of patients received adjuvant chemotherapy. TM patients were younger, were more likely to have lymphovascular invasion, and had larger tumors than patients undergoing BCT (all P ≤ 0.05). The 5-year cumulative incidence of LRR was 4.2 and 5.4 % for patients undergoing BCT and TM, respectively. There was no significant difference in LRR, DM, overall recurrence, disease free survival, or overall survival between groups on univariate analysis, or after adjusting for other variables in multivariate models. Lack of chemotherapy and high tumor stage independently predicted for decreased overall survival (both P < 0.001).

CONCLUSIONS:

A low, 5-year risk of LRR (4.7 %) was achieved in a large group of women with T1-2N0 TNBC treated with multimodality therapy. BCT was as equally effective as TM for local and distant control.

http://www.ncbi.nlm.nih.gov/pubmed/23686101


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11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Apr 15 2013 at 11:19am
Catheters and Ports in Cancer Treatment

From time to time, questions have come up related to ports, placed for venous access to IV drugs.  I came across this link (cancer.net) that offers authoritative information:
http://www.cancer.net/all-about-cancer/cancernet-feature-articles/cancer-basics/catheters-and-ports-cancer-treatment

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Apr 13 2013 at 6:11pm
Breast Cancer Res Treat. 2013 Mar 31. [Epub ahead of print]

The use of neoadjuvant platinum-based chemotherapy in locally advanced breast cancer that is triple negative: retrospective analysis of 144 patients.

Source

Division of Hematology/Oncology, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, 1475 NW 12th Avenue, D8-4, Miami, FL, 33136, USA, jhurley@miami.edu.

Abstract

Triple-negative breast cancers comprise about 20 % of breast cancers. They have poor prognosis and have no standard therapy. The aim of this study was to evaluate pathologic complete response (pCR), progression-free survival (PFS), and overall survival (OS) in patients with TNBC treated with neoadjuvant platinum-based chemotherapy. This is a retrospective study of one hundred and forty-four women with TNBC treated with neoadjuvant platinum-containing chemotherapy for locally advanced breast cancer at the University of Miami between January 1, 1999, and January 1, 2011. The medical record was reviewed to obtain data on clinical characteristics, including ethnicity, race, age, clinical stage, treatment regimen, and vital status. This study was approved by the University of Miami IRB. All patients had locally advanced breast cancer with at least one of the following features at presentation: T3, T4, N2, and N3. The mean tumor size by palpation was 9.4 cm. The clinical T-stage at presentation was 1.4 % T1, 8.3 % T2, 52.8 % T3, and 37.5 % T4 (19.4 % T4d). The nodal status by physical exam at presentation was 23 % N0, 37.5 % N1, 34 % N2, and 5.5 % N3. pCR in breast and axilla was seen in 31 %. PFS and OS were 55 and 59 %, respectively, at 7 years. Cisplatin offered a survival advantage over carboplatin in both PFS (P = 0.007) and OS (P = 0.018). Node positivity was the most important predictor of survival. Cisplatin/docetaxel neoadjuvant therapy was well tolerated and an effective therapy in locally advanced TNB.

12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Lee21 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Apr 11 2013 at 2:03pm


A Dickens Tale of the Treatment of Advanced Breast Cancer: The Past, the Present, and the Future



Category:
Breast Cancer

Meeting:
2012 Educational Book

Author(s):
By George W. Sledge Jr., MD, Fatima Cardoso, MD, Eric P. Winer, MD, and Martine J. Piccart, MD

Article Summary:

Overview: Metastatic breast cancer (MBC), a usually incurable disease, continues to vex physicians and patients. Recent decades have seen great improvements in the treatment of MBC, based on the availability of novel targeted therapeutics and more standard chemotherapeutic agents. This article describes the goals of therapy for MBC, the progress made against MBC in recent decades, the current standard of care, and the ongoing efforts of basic and translational researchers to transfer the fruits of modern scientific discovery to patients in the clinic.

Full Article - go to this link, then click on the "View Full Educational Article" to download pdf.

http://origin.asco.org/ASCOv2/Education+%26+Training/Educational+Book?&vmview=edbk_detail_view&confID=114&abstractID=306




12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Apr 05 2013 at 1:20pm

Don't take cancer sitting down

A new survivorship research agenda

Abstract

Cancer survival is associated with considerable physical and psychosocial burden. Broadly accessible, nonpharmacologic measures that may extend disease-free survival, limit comorbid disease, and enhance quality of life are required. Sedentary behavior (too much sitting) is now understood to be a health risk that is additional to, and distinct from, the hazards of too little exercise. Of particular note, it is associated with adiposity, insulin resistance, and markers of inflammation. Therefore, it is plausible that sedentary behavior may contribute to adverse cancer outcomes (disease progression, recurrence, or death) and to the development of comorbid chronic disease. Initial studies indicate that cancer survivors spend two-thirds of their waking hours sitting. Among colorectal cancer survivors, sedentary behavior may contribute to all-cause and disease-specific mortality, weight gain, comorbid cardiovascular disease, and diminished quality of life. There is a need for dose-response evidence, and for a broader understanding of the underlying mechanisms by which prolonged sitting time may affect cancer survivors' health. Cancer 2013. © 2013 American Cancer Society.

http://onlinelibrary.wiley.com/doi/10.1002/cncr.28028/abstract


12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Apr 03 2013 at 2:03pm
I thought the article was interesting and therefore posted it.  The study cohort is highly selected though, patients with only lung mets -- how common is that? Also the patients who do best are the ones with solitary lung mets < 3 cm.  It is something to keep in mind.  With TN, it seems like when metastasis is detected, there are mets in multiple organs.
Maybe it argues for closer surveillance.
12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Apr 02 2013 at 2:03pm
Lee,

Your article brings up a good topic about treating mets.  My friend was diagnosed almost 3 years ago with Stage 4 Peritonneal Cancer (similar to Ovarian).  Besides chemo, she's had 3 de-bulking surgeries (one that resected part of the liver) that I believe have helped her have a good quality of life and live longer than the original prognosis.  Her oncologist didn't want her to have the last surgery and just wanted to do more chemo.  She consulted with a top liver surgeon who agreed to perform the surgery.  I think it's something patients should investigate further with a good, qualified surgeon.

Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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