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Leader Commentary: Nancy
E. Davidson, MD
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on the topic below for comments by Dr
Nancy E. Davidson to comment on. You will also find links to related
articles and clinical trials.
Intergroup
study of adjuvant ovarian suppression Main
results of Intergroup adjuvant premenopausal study Management
of node-postive, ER+ premenopausal patients Ovarian
ablation after chemotherapy in patients who continue to menstrate Harvey
study of estrogen receptors Use
of adjuvant tamoxifen Choice
of aromatase inhibitor Management
of metastatic disease in younger women Combined
endocrine therapy in premenopausal patients with metastases Tamoxifen
for patients with DCIS Psychosocial
issue in young breast cancer patients Risk
for recurrence and use of cytotoxic therapy Use
of prognostic factors in invasive breast cancer
Interview
with Neil Love, MD from Breast Cancer Update for Medical Oncologists ,
Program 3 2000
Play
Audio Below:
We
use histology and histologic grades. Our pathologists have gotten
a lot more together in our center about doing it routinely and doing
it in a uniform fashion. So I use that to help me – although
lots of times, of course, it doesn’t help you very much, because
it’s two or it’s three in somebody who already had four
lymph nodes and it doesn’t help you in the least. Our pathologists
pretty routinely get KI67 and again, I use it to support my biases.
The only place where it’s very difficult for me is when I have
an otherwise favorable tumor that has a very high KI67, and I’d
have to say I probably don’t factor that in, in a major way,
for most of those women. We don’t get S-phase fraction anymore
and the HER2 business is really a problem. Because we are gearing
up to participate in these large randomized adjuvant Herceptin trials,
we’ve been routinely getting HER2 in our center for about a
year, so I now get it on everybody. It’s going to help you
when that trial opens because if somebody is floridly HER2-positive,
then she would obviously be a candidate for these trials that involve
randomization to Herceptin or not. Right now, most of the time,
again, I use it to support my biases and most of the time it’s
negative, so it's not a big deal. If it’s positive and somebody
is headed towards chemotherapy, I do talk with her about the fact
that some people believe that she might be a better candidate for
Adriamycin. I mean, I tell her that it’s kind of all over the
map – that there’s not a real consensus here – but
if she’s oriented towards chemo and thinks that the AC is a
reasonable combination for her, that just makes it that much easier.
Relevant
Articles:
Prognostic
factors in breast cancer. College of American Pathologists Consensus
Statement 1999. Fitzgibbons
PL, Page DL, Weaver D, Thor AD, Allred DC, Clark GM, Ruby SG, O'Malley
F, Simpson JF, Connolly JL, Hayes DF, Edge SB, Lichter A, Schnitt
SJ. Arch Pathol Lab Med. 2000 Jul;124(7):966-78.
Histologic
grading in breast cancer--reproducibility between seven pathologic
departments. South Sweden Breast Cancer Group. Boiesen
P, Bendahl PO, Anagnostaki L, Domanski H, Holm E, Idvall I, Johansson
S, Ljungberg O, Ringberg A, Ostberg G, Ferno M. Acta Oncol.
2000;39(1):41-5.
Prognostic
significance of young age in breast cancer. Yildirim
E, Dalgic T, Berberoglu U. J Surg Oncol. 2000 Aug;74(4):267-72.
Pathology
characteristics that optimize outcome prediction of a breast screening
trial. Anderson TJ, Alexander
FE, Lamb J, Smith A, Forrest AP. Br J Cancer. 2000 Aug;83(4):487-92.
Cytologic
grading of invasive breast carcinoma. Correlation with clinicopathologic
variables and predictive value of nodal metastasis. Taniguchi
E, Yang Q, Tang W, Nakamura Y, Shan L, Nakamura M, Sato M, Mori
I, Sakurai T, Kakudo K. Acta Cytol. 2000 Jul-Aug;44(4):587-91.
Relationship
between tumor location and relapse in 6,781 women with early invasive
breast cancer. Lohrisch
C, Jackson J, Jones A, Mates D, Olivotto IA. J
Clin Oncol. 2000 Aug;18(15):2828-35.
Time-dependent
relevance of steroid receptors in breast cancer. Coradini
D, Daidone MG, Boracchi P, Biganzoli E, Oriana S, Bresciani G, Pellizzaro
C, Tomasic G, Di Fronzo G, Marubini E.. J Clin Oncol. 2000
Jul;18(14):2702-9.
P53
determination alongside classical prognostic factors in node-negative
breast cancer: an evaluation at more than 10-year follow-up. Ferrero
JM, Ramaioli A, Formento JL, Francoual M, Etienne MC, Peyrottes
I, Ettore F, Leblanc-Talent P, Namer M, Milano G. Ann Oncol.
2000 Apr;11(4):393-7.
Metastatic
breast cancer: clinical course, prognosis and therapy related to
the first site of metastasis. Solomayer
EF, Diel IJ, Meyberg GC, Gollan C, Bastert G. Breast Cancer Res
Treat. 2000 Feb;59(3):271-8 .
Prognostic
variables in male breast cancer. Clark
JL, Nguyen PL, Jaszcz WB, Jatoi A, Niehans GA. Am Surg. 2000
May;66(5):502-11.
Prognostic
significance of an increased number of micrometastatic tumor cells
in the bone marrow of patients with first recurrence of breast carcinoma. Janni
W, Gastroph S, Hepp F, Kentenich C, Rjosk D, Schindlbeck C, Dimpfl
T, Sommer H, Braun S. Cancer. 2000 May 15;88(10):2252-9.
Prognostic
significance of immunohistochemically localized biomarkers in stage
II and stage III breast cancer: a multivariate analysis. Bhatavdekar
JM, Patel DD, Shah NG, Vora HH, Suthar TP, Chikhlikar PR, Ghosh
N, Trivedi TI. Ann Surg Oncol. 2000 May;7(4):305-11.
The
prognostic value of proliferation indices: a study with in vivo
bromodeoxyuridine and Ki-67. Goodson
WH, Moore DH, Ljung BM, Chew K, Mayall B, Smith HS, Waldman FM.
Breast Cancer Res Treat. 2000 Jan;59(2):113-23.
Prognostic
value of histologic grade and proliferative activity in axillary
node-positive breast cancer: results from the Eastern Cooperative
Oncology Group Companion Study, EST 4189. Simpson
JF, Gray R, Dressler LG, Cobau CD, Falkson CI, Gilchrist KW, Pandya
KJ, Page DL, Robert NJ. J Clin Oncol. 2000 May;18(10):2059-69.
Primary
node negative breast cancer in BRCA1 mutation carriers has a poor
outcome. Foulkes
WD, Chappuis PO, Wong N, Brunet JS, Vesprini D, Rozen F, Yuan ZQ,
Pollak MN, Kuperstein G, Narod SA, Begin LR. Ann Oncol. 2000
Mar;11(3):307-13.
Prognostic
value of vascular endothelial growth factor in breast cancer. Gasparini
G. Oncologist. 2000;5 Suppl 1:37-44.
Prognostic
value of p53 for local failure in mastectomy-treated breast cancer
patients. Zellars
RC, Hilsenbeck SG, Clark GM, Allred DC, Herman TS, Chamness GC,
Elledge RM. J Clin Oncol. 2000 May;18(9):1906-13.
Role
of isolated locoregional recurrence of breast cancer: results of
four prospective studies. Schmoor
C, Sauerbrei W, Bastert G, Schumacher M. J Clin Oncol. 2000
Apr;18(8):1696-708.
Hot
spot microvessel density and the mitotic activity index are strong
additional prognostic indicators in invasive breast cancer. de
Jong JS, van Diest PJ, Baak JP.Histopathology. 2000 Apr;36(4):306-12.
Assessment
of HER2 status in breast cancer: why, when and how? Dowsett
M, Cooke T, Ellis I, Gullick WJ, Gusterson B, Mallon E, Walker R.
Eur J Cancer. 2000 Jan;36(2):170-6.
c-erbB-4
protein expression in human breast cancer. Kew
TY, Bell JA, Pinder SE, Denley H, Srinivasan R, Gullick WJ, Nicholson
RI, Blamey RW, Ellis IO. Br J Cancer. 2000 Mar;82(6):1163-70.
Tumor
microvessel density and prognosis in node-negative breast cancer. Medri
L, Nanni O, Volpi A, Scarpi E, Dubini A, Riccobon A, Becciolini
A, Bianchi S, Amadori D. Int
J Cancer. 2000 Jan 20;89(1):74-80.
p53
and vascular-endothelial-growth-factor (VEGF) expression predicts
outcome in 833 patients with primary breast carcinoma. Linderholm
B, Lindh B, Tavelin B, Grankvist K, Henriksson R. Int J Cancer .
2000 Jan 20;89(1):51-62.
A
prospective trial of midwest breast cancer patients: a p53 gene
mutation is the most important predictor of adverse outcome. Blaszyk
H, Hartmann A, Cunningham JM, Schaid D, Wold LE, Kovach JS, Sommer
SS. Int J Cancer. 2000 Jan 20;89(1):32-8.
Do
we need prognostic factors in nodal-negative breast cancer? Arbiter.
Hayes DF.Eur
J Cancer. 2000 Feb;36(3):302-6. No Abstract.
Do
we need better prognostic factors in nodal-negative breast cancer? Kaufmann M, Scharl A. Eur J Cancer. 2000 Feb;36(3):298-301.
No Abstract.
Do
we need better prognostic factors in node-negative breast cancer?
Pro:. Thomssen C, Janicke F. Eur J Cancer. 2000 Feb;36(3):293-8.
No Abstract.
Mutant
p53 protein overexpression in women with ipsilateral breast tumor
recurrence following lumpectomy and radiation therapy. Turner
BC, Gumbs AA, Carbone CJ, Carter D, Glazer PM, Haffty BG. Cancer.
2000 Mar 1;88(5):1091-8.
Factors
influencing the effect of age on prognosis in breast cancer: population
based study. Kroman
N, Jensen MB, Wohlfahrt J, Mouridsen HT, Andersen PK, Melbye M.
BMJ. 2000 Feb 19;320(7233):474-8.
Cytokeratin-positive
cells in the bone marrow and survival of patients with stage I,
II, or III breast cancer. Braun
S, Pantel K, Muller P, Janni W, Hepp F, Kentenich CR, Gastroph S,
Wischnik A, Dimpfl T, Kindermann G, Riethmuller G, Schlimok G. N
Engl J Med. 2000 Feb 24;342(8):525-33.
The
prognostic value of p53 and c-erb B-2 immunostaining is overrated
for patients with lymph node negative breast carcinoma: a multivariate
analysis of prognostic factors in 613 patients with a follow-up
of 14-30 years. Reed
W, Hannisdal E, Boehler PJ, Gundersen S, Host H, Marthin J. Cancer.
2000 Feb 15;88(4):804-13.
Plasma
D-dimer levels in operable breast cancer patients correlate with
clinical stage and axillary lymph node status. Blackwell
K, Haroon Z, Broadwater G, Berry D, Harris L, Iglehart JD, Dewhirst
M, Greenberg C. J Clin Oncol. 2000 Feb;18(3):600-8.
Clinical
progression of breast cancer malignant behavior: what to expect
and when to expect it. Heimann
R, Hellman S. J Clin Oncol. 2000 Feb;18(3):591-9.
Factors
predicting for efficacy and safety of docetaxel in a compassionate-use
cohort of 825 heavily pretreated advanced breast cancer patients. Alexandre
J, Bleuzen P, Bonneterre J, Sutherland W, Misset JL, Guastalla J,
Viens P, Faivre S, Chahine A, Spielman M, Bensmaine A, Marty M,
Mahjoubi M, Cvitkovic E. J Clin Oncol. 2000 Feb;18(3):562-73.
Screen-detected
breast cancers have a lower mitotic activity index. Groenendijk
RP, Bult P, Tewarie L, Peer PG, van der Sluis RF, Ruers TJ, Wobbes
T. Br J Cancer. 2000 Jan;82(2):381-4.
Number
of apoptotic cells as a prognostic marker in invasive breast cancer. de
Jong JS, van Diest PJ, Baak JP. Br J Cancer. 2000 Jan;82(2):368-73.
Vascular
grading of angiogenesis: prognostic significance in breast cancer. Hansen
S, Grabau DA, Sorensen FB, Bak M, Vach W, Rose C. Br J Cancer.
2000 Jan;82(2):339-47.
A
high number of tumor free axillary lymph nodes from patients with
lymph node negative breast carcinoma is associated with poor outcome. Camp
RL, Rimm EB, Rimm DL. Cancer. 2000 Jan 1;88(1):108-13.
Relevant
Clinical Trials:
Phase
III Randomized Study of Doxorubicin and Cyclophosphamide Followed
by Paclitaxel With or Without Trastuzumab (Herceptin) in Women With
Node Positive Breast Cancer That Overexpresses HER2
Phase
III Randomized Study of Doxorubicin Plus Cyclophosphamide Followed
by Paclitaxel With or Without Trastuzumab (Herceptin) in Patients
With HER-2 Overexpressing Breast Cancer
Phase
III Randomized Study of Trastuzumab (Herceptin) Alone Followed By
Paclitaxel Plus Trastuzumab Versus Upfront Combination of Trastuzumab
and Paclitaxel in Women With HER2 Overexpressing Metastatic Breast
Cancer
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