San Antonio Breast Cancer Symposium, Dec. 8-12, 2010

The 33rd Annual San Antonio Breast Cancer Symposium

The annual San Antonio Breast Cancer Symposium -- presented by the Cancer Therapy & Research Center, the American Association for Cancer Research, and the Baylor College of Medicine -- was held from Dec. 8 to 12 and attracted approximately 9,000 participants. The conference highlighted recent advances in the diagnosis, treatment, and prevention of breast cancer, with presentations focusing on the risk of breast cancer and hormone therapy, lack of mammogram screening, combination therapy for hormone receptor positive breast cancer, and predictors of breast cancer outcomes.

In one study, Sibylle Loibl, M.D., of the German Breast Group in Neu-Isenburg, and colleagues found that pregnant women with breast cancer undergoing treatment with chemotherapy do not appear to be harming their fetus, with more harm caused by early delivery.

"At this time, there does not appear any reason to perform early delivery to start chemotherapy after pregnancy, as the risk of morbidity is much higher than the side effects associated with chemotherapy. Literature has previously shown that the lower the week of gestation and the lower the weight of the baby, the higher the morbidity and mortality," Loibl said.

Between April 2003 and June 2010, the investigators collected data from 313 pregnant women (23 percent diagnosed in the first trimester, 42 percent in the second, and 36 percent in the third trimester), aged 23 to 47 years old, with various subtypes of breast cancer and varying stages of the disease upon diagnosis.

"When you compare the outcomes of pregnant women who received chemotherapy versus those who did not during pregnancy, the outcomes are similar. Many of the events among babies were due to preterm delivery or related to genetic defect or malformation and not necessarily a consequence of chemotherapy," Loibl added. "We also found that women who did not get chemotherapy during pregnancy tended to deliver earlier as compared to women who received chemotherapy during pregnancy. In terms of disease-free survival, we found no difference between those who did and those who did not receive chemotherapy during pregnancy."

According to Loibl, patients with breast cancer during pregnancy should be treated as closely as possible to standards for breast cancer patients who are not pregnant.

Abstract No. S6-2

In another study, Paul E. Goss, M.D., Ph.D., of the Massachusetts General Hospital in Boston, and colleagues found that exemestane, an aromatase inhibitor (AI), may provide postmenopausal women with hormone receptor positive, early-stage breast cancer with another treatment option. The investigators compared the efficacy and safety of two AIs, exemestane (steroidal irreversible AI) and anastrozole (non-steroidal reversible AI), among 7,576 women from Canada, the United States, and Europe.

"The results of our study showed that exemestane was not superior or inferior to anastrozole in terms of breast cancer recurrence, but the effectiveness of the two drugs in terms of reducing the risk of all breast cancer recurrences was essentially equal. We also found similar results for overall survival and for the development of internal metastases, or stage 4 breast cancer," Goss said. "In terms of the side effect profile, as hypothesized we found fewer adverse outcomes associated with exemestane as compared to anastrozole. Fewer patients developed new onset osteoporosis, hypercholesterolemia, and/or hypertriglyceridemia. Overall, our study showed that exemestane was equally effective to anastrozole, with a more favorable side effect profile, providing a new option for patients with breast cancer."

Abstract No. S1-1

In the phase III GeparQuinto study, Gunter von Minckwitz, M.D., Ph.D., of the German Breast Group in Neu-Isenburg, and colleagues found that bevacizumab does not appear to improve pathological complete response (pCR) in patients with early human epidermal growth factor receptor 2-negative breast cancer in the neoadjuvant setting. The investigators evaluated whether adding bevacizumab to treatment with four cycles of epirubicin/cyclophosphamide followed by four cycles of docetaxel improved the rate of pCR. Between May 2007 and June 2010, 944 patients were assigned to chemotherapy treatment with epirubicin/cyclophosphamide followed by docetaxel, while 945 patients were assigned to chemotherapy treatment with epirubicin/cyclophosphamide followed by docetaxel plus bevacizumab.

The researchers found that the addition of bevacizumab to neoadjuvant chemotherapy did not increase the pCR rate significantly. The tolerability and compliance of bevacizumab with epirubicin/cyclophosphamide, followed by docetaxel, was acceptable and with no new safety concerns. The effect of bevacizumab may be restricted to triple-negative breast cancer patients. However, the researchers noted that other studies evaluating long-term survival may need to be completed prior to making any definite conclusions.

Abstract No. S4-6

SABCS: Circulating Tumor Cells Predict Breast Cancer Outcome

MONDAY, Dec. 13 (HealthDay News) -- Circulating tumor cells (CTCs) may serve as markers to predict outcomes and determine treatment among patients with early-stage or metastatic breast cancer, according to three studies presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 8 to 12.

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SABCS: Depression Drug Reduces Pain in Breast Cancer

MONDAY, Dec. 13 (HealthDay News) -- Duloxetine (Cymbalta) appears to reduce joint and muscle pain commonly associated with the use of aromatase inhibitors in the treatment of breast cancer, according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 8 to 12.

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SABCS: Breast Cancer Variant May Predict Onset of Disease

MONDAY, Dec. 13 (HealthDay News) -- A polymorphic variant in human histone deacetylase 9 (HDAC9) appears to be associated with an earlier onset of estrogen receptor (ER) positive breast cancer, while another variant may be associated with recurrence of progesterone receptor-positive disease, according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 8 to 12.

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SABCS: HER2-Positive Breast Cancer Treatments Assessed

FRIDAY, Dec. 10 (HealthDay News) -- Novel combinations of targeted therapies appear to improve outcomes among patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer, according to studies presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 8 to 12.

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SABCS: Breast CA Survival Not Improved With Zoledronic Acid

FRIDAY, Dec. 10 (HealthDay News) -- Adjuvant use of zoledronic acid does not appear to improve disease-free survival among women with stage II/III breast cancer, according a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 8 to 12.

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SABCS: One-Half of Women Not Getting Regular Mammograms

THURSDAY, Dec. 9 (HealthDay News) -- In the United States, only 50 percent of eligible women get a yearly mammogram, according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 8 to 12.

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SABCS: Aromatase Inhibitors Linked to Heart Disease Risk

THURSDAY, Dec. 9 (HealthDay News) -- Postmenopausal women who undergo breast cancer treatment with aromatase inhibitors appear to be at an elevated risk of cardiovascular disease, according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 8 to 12.

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SABCS: Estrogen Alone May Reduce Breast Cancer Risk

THURSDAY, Dec. 9 (HealthDay News) -- Hormone replacement therapy (HRT) involving estrogen alone appears to reduce the risk of breast cancer among women without a strong family history of the disease, according a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 8 to 12.

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SABCS: Weights Not Tied to Breast CA-Related Lymphedema

THURSDAY, Dec. 9 (HealthDay News) -- A slow, progressive weight lifting program does not appear to increase the incidence of breast cancer-related lymphedema (BCRL) in breast cancer survivors, according to research published online Dec. 8 in the Journal of the American Medical Association to coincide with presentation at the annual San Antonio Breast Cancer Symposium, held from Dec. 8 to 12.

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