Review - Haymarket Media Group

More documents

Recommendations

Info

Commentary and chemokine receptors: new insights in the biology of inflammatory breast cancer. Ann Oncol. 2007;18:1021-1029. 5. Parton M, Dowsett M, Ashley S, et al. High incidence of HER- 2 positivity in inflammatory breast cancer. Breast. 2004;13:97- 103. 6. Dawood S, Broglio K, Gong Y, et al. Prognostic significance of HER-2 status in women with inflammatory breast cancer. Cancer. 2008;112:1905-1911. 7. Bertucci F, Finetti P, Rougemont J, et al. Gene expression profiling identifies molecular subtypes of inflammatory breast cancer. Cancer Res. 2005;65:2170-2178. 8. Van Laere S, Van der Auwera I, Van den Eynden GG, et al. Distinct molecular signature of inflammatory breast cancer by cDNA microarray analysis. Breast Cancer Res Treat. 2005;93:237- 246. 9. Gennari A, Sormani MP, Pronzato P, et al. HER2 status and efficacy of adjuvant anthracyclines in early breast cancer: a pooled analysis of randomized trials. J Natl Cancer Inst. 2008;100:14-20. 10. Gianni L, Semiglazov V, Manikhas GM, et al. Neoadjuvant trastuzumab in locally advanced breast cancer (NOAH): antitumor and safety analysis. J Clin Oncol. 2007;25(June 20 supplement). Abstract 532. 11. Johnston S, Trudeau M, Kaufman B, et al. Phase II study of pre- HER2 status and inflammatory breast cancer (continued from page 19) References 1. Jaiyesimi IA, Buzdar AU, Hortobagyi G. Inflammatory breast cancer: a review. J Clin Oncol. 1992;10:1014-1024. 2. Cristofanilli M, Buzdar AU, Hortobagyi GN. Update on the management of inflammatory breast cancer. Oncologist. 2003;8:141-148. 3. Buzdar AU, Singeltary SE, Booser DJ, et al. Combined modality treatment of stage III and inflammatory breast cancer. M.D. Anderson Cancer Center experience. Surg Oncol Clin N Am. 1995;4:715-734. 4. Slamon DJ, Clark GM, Wong SG, et al. Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science. 1987;235:177-182. 5. Borg A, Tandon AK, Sigurdsson H, et al. HER-2/neu amplification predicts poor survival in node-positive breast cancer. Cancer Res. 1990;50:4322-4327. 6. Winstanley J, Cooke T, Murray GD, et al. The long term prognostic significance of c-erb-2 in primary breast cancer. Br J Cancer. 1991;63:447-450. 7. Slamon DJ, Leyland-Jones B, Shak S, et al. Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2. N Engl J Med. 2001;344:783-792. 8. Romond EH, Perez EA, Bryant J, et al. Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med. 2005;353:1673-1684. 9. Piccart-Gebhart MJ, Procter M, Leyland-Jones B, et al. Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Engl J Med. 2005;353:1659-1672. 22 The American Journal of Hematology/Oncology dictive biomarker profiles for response targeting human epidermal growth factor receptor 2 (HER-2) in advanced inflammatory breast cancer with lapatinib monotherapy. J Clin Oncol. 2008;26:1066-1072. 12. Kleer CG, van Golen KL, Merajver SD. Molecular biology of breast cancer metastasis. Inflammatory breast cancer: clinical syndrome and molecular determinants. Breast Cancer Res. 2000;2:423-429. 13. Wedam SB, Low JA, Yang SX, et al. Antiangiogenic and antitumor effects of bevacizumab in patients with inflammatory and locally advanced breast cancer. J Clin Oncol. 2006;24:769-777. 14. Overmoyer B, Fu P, Hoppel C, et al. Inflammatory breast cancer as a model disease to study tumor angiogenesis: results of a phase IB trial of combination SU5416 and doxorubicin. Clin Cancer Res. 2007;13:5862-5868. Author disclosures: Research support: Genentech, Glaxo- SmithKline; consultant: GlaxoSmithKline (
CaseStudy Risk of Local Recurrence for Breast Cancer Subtypes Defined by ER, PR, and HER2 Status Paul L. Nguyen, MD 1,2 ; Alphonse G. Taghian, MD, PhD 2,3 ; Jay R. Harris, MD 2,4 1 Harvard Radiation Oncology Program; 2 Harvard Medical School; 3 Department of Radiation Oncology, Massachusetts General Hospital; 4 Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women’s Hospital; all Boston, Massachusetts A60-year-old female had a routine screening mammogram that showed a 1 cm density with associated microcalcifications in the upper outer quadrant of the patient’s left breast. A core biopsy revealed an infiltrating ductal carcinoma (IDC), grade 2, with associated ductal carcinoma in situ (DCIS). The tumor was estrogen receptor (ER) positive, progesterone receptor (PR) positive, and HER2 negative. The patient elected breast-conserving therapy and had a negative sentinel lymph node biopsy. Pathology from the lumpectomy showed a 1.2 cm grade 2 IDC without evidence of extensive intraductal component (EIC). There was no lymphovascular invasion. There was a focally positive inferior margin, but all other margins were >2 mm. The Oncotype DX recurrence score was 11 (low risk). A reexcision of the inferior margin was performed and was negative except for a single 1 mm focus of DCIS that came within 1 mm of the final inferior reexcision margin. The issue of a second reexcision to achieve a >2 mm inferior margin was discussed, but both the patient and surgeon were concerned that this might lead to a poor cosmetic result given the patient’s relatively small breast size. Discussion Classic Predictors of Local Recurrence After Breast- Conserving Therapy For women who undergo breast-conserving therapy for invasive breast cancer, the risk of local recurrence has been shown in several studies to be based on factors such as margin status, nodal status, young age, and presence or absence of EIC (defined as an infiltrating ductal cancer in which greater than 25% of the tumor volume is DCIS, and DCIS extends beyond the invasive cancer into surrounding breast parenchyma). 1-3 While the exact relative importance of each of the factors is not always consistent across studies, most have agreed that margin status is one of the most important predictors of local recurrence for women undergoing breast-conserving therapy, and patients are almost always advised to undergo reexcision if the tumor involves an inked margin (ie, a positive margin), unless that positive margin is at the skin or is a deep margin that has already extended to the pectoral fascia. The issue of whether a “close margin,” as our patient has, is a risk factor for local recurrence is less clear. Investigators have variably . . . most have agreed that margin status is one of the most important predictors of local recurrence. defined a close margin as having tumor within 1 or 2 mm of the inked surface, and while several studies have found an association between increasing margin width and lower local recurrence, only three published studies have subdivided this width enough to make finer comparisons. 2,4 One study from Tufts- New England Medical Center showed a 12-year local recurrence rate of 9% for margins 0.1 to 2.0 mm, 5% for 2.1 to 5.0 mm, and 0% for >5 mm. 5 Also, the Harvard Joint Center for Radiation Therapy found that 8-year rates of local recurrence were 7% for margins 0.1 to 1.0 mm, 6% for 1.1 to 2.0 mm, and 4% for November 2008 • Vol 7 • Supplement 5 23
Page 1 and 2: ajho.com November 2008 • Vol 7
Page 3 and 4: LettertoOurReaders Dear Colleague,
Page 5 and 6: hand-foot syndrome, 23.9% vs 31.1%;
Page 7 and 8: Figure Paclitaxel 175 mg/m2 every 2
Page 9 and 10: and demonstrated that patients with
Page 11 and 12: Commentary Optimizing Taxane Therap
Page 13 and 14: HER2 Status and Inflammatory Breast
Page 15 and 16: year OS was 53.1% (95% CI, 44.0%-61
Page 17: include those related to cell motil
Page 21 and 22: factors such as age and margin stat

Review - Haymarket Media Group

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?