Every year, the American Society of Clinical Oncologists hosts a Breast Cancer Symposium to promote discussion about developments in breast cancer care and treatment. This event is an exceptional opportunity to learn about current trends and future directions that affect our patients and our daily practice. I was excited to attend the 2015 ASCO Breast Cancer Symposium and appreciate the thought-provoking dialogue that occurred. In addition, I was also invited to present our own data on multi-gene panel testing.
Several topics of interest included the development of a new model for evaluating breast cancer risk in women with atypical hyperplasia, new data on recurrence in women with ductal carcinoma in situ (DCIS), and the ability of MRI to aid screening in women with average risk for breast cancer.
Evaluating Breast Cancer Risk in Women with Atypical Hyperplasia
Atypical hyperplasia is a condition that affects the cells in the breast. It is often referred to as a ‘precancer’ and women with atypical hyperplasia are at higher risk for developing breast cancer. Making treatment recommendations for women with atypical hyperplasia can complicated because has typically been difficult to determine which of these women would develop breast cancer.
Researchers from the University of New Mexico School of Medicine and the Vanderbilt University Medical Center proposed a new model for calculating breast cancer risk in women with atypical hyperplasia. This model considers age at biopsy to diagnose atypical hyperplasia and number of foci of atypia to produce an absolute risk value. This information could help women with atypical hyperplasia to make more appropriate treatment decisions based on their risk.
Reducing Recurrence in Women with DCIS
In recent years, recurrence rates have dropped among women with DCIS. Researchers from Memorial Sloan Kettering Cancer Center in New York looked at a total of 2,996 DCIS cases. Their study compared outcomes for women treated between 1978 and 1998 with outcomes for women treated between 1999 and 2010. All women included in the study were treated with breast-conserving surgery followed by radiation therapy.
Researchers determined that 5-year recurrence rates dropped by 40 percent in the 1999 to 2010 group compared with the 1978 to 1998 group, from 13.6 percent to 6.6 percent. They attributed the decline to advancements in mammography and pathological assessments. These results suggest that more women can benefit now from breast-conserving strategy than in earlier decades.
Using MRI in Women with Average Risk for Breast Cancer
Breast MRI is typically reserved to aid screening in women at high risk for breast cancer or to investigate clinical abnormalities not detected on mammogram. However, one eloquent study presented at the Symposium shows how MRI can aid breast cancer detection in women at average risk.
Researchers from the University of Aachen in Germany investigated the use of MRI in 2,120 women at average risk for breast cancer. Women were randomized to undergo MRI and mammography screening at intervals of 12, 24 and 36 months. A total of 61 cancers were detected over the course of 3,861 total screenings. Of these, 60 were detected by MRI alone while only 1 was detected by both MRI and mammography.
Benefits and Safety of Multigene Panel Testing
I was honored to receive an invitation to present a poster based on data collected at Breastlink centers. Our study evaluated the ability of multigene panel tests to detect BRCA1 and BRCA2 mutations and additional genes. Multigene panel tests evaluate up to 43 breast cancer-related genes while conventional testing requires initial testing for BRCA1 and BRCA2 followed by sequential testing for other genes.
In our study, multigene panel testing was able to safely and effectively evaluate BRCA1 and BRCA2 pathogenic mutations. Additionally, multigene panel testing nearly double the total rate of detection of pathogenic mutations. This research was featured by Oncology Times.
At Breastlink, my colleagues and I are committed to maintaining up-to-date knowledge of trends in breast cancer care and treatment. This helps us to ensure that our patients benefit from all that modern medicine has to offer. If you would like to learn more about ongoing developments in breast cancer care and treatment, please contact us.