Less Treatment May Be Fine for Some Women With Breast Cancer – Everyday Health
Posted: December 11, 2020 at 9:55 am
It may be possible for some postmenopausal women to avoid some breast cancer treatment without compromising survival, according to two new studies presented at the San Antonio Breast Cancer Symposium (SABCS), hosted by UT Health San Antonio, the American Association for Cancer Research, and the Dan L. Duncan Comprehensive Cancer Center at Baylor College of Medicine.
The meeting was held virtually December 8 to 11.
One study found that postmenopausal women with early-stage breast cancer who were at low risk of recurrence can skip chemotherapy after surgery. The other found that older patients may be able to skip radiation therapy following breast-conserving surgery.
The studies reflect a resolve in the oncology field to avoid overtreatment of disease, sparing patients from some of the side effects that can accompany treatments like chemotherapy and radiation.
Were looking to move beyond a one-size-fits-all approach, said the presenting author of the first study, Kevin Kalinsky, MD, director of the Glenn Family Breast Center at Winship Cancer Institute of Emory University. This is another step forward in trying to achieve precision medicine.
Dr. Kalinskys study followed women with hormone receptor-positive (HR positive), HER2-negative breast cancer the most common form of breast cancer for about five years following treatment.
The 5,083 study participants had early-stage lymph node-positive cancer (meaning the cancer had spread to one to three lymph nodes) and a recurrence score of 25 or lower.
Breast cancer recurrence scores are based on the presence of 16 cancer-related genes and can range from 0 to 100.
All the study participants received endocrine therapy following surgery, while about half were randomly assigned to receive chemotherapy as well.
The study, which was organized by the SWOG Cancer Research Network and is called RxPONDER, found that while additional chemotherapy improved disease-free survival rates by about 5 percent for premenopausal women, postmenopausal patients gained no added benefit.
This will save tens of thousands of women the time, expense, and potentially harmful side effects that can be associated with chemo infusions, Kalinsky said.
Questions remain about whether chemotherapy has different biological effects based on menopausal status, or simply exerts its effect by shutting down ovarian function.
In the second study, known as PRIME II, researchers found that older patients with HR-positive breast cancer may be able to skip radiation treatment after breast-conserving surgery.
The study enrolled 1,326 women ages 65 and older who had HR-positive breast cancer that had not spread. All of the women had breast-conserving surgery and received hormone therapy. Half of the study participants were assigned to also receive radiation therapy after surgery.
Previous research has suggested a higher risk of cancer recurrence among patients who do not receive radiation therapy. However, the new study found no significant differences in survival, metastasis (disease spread), or new breast cancers among the two groups after five years of follow-up.
The study is important because many postmenopausal women are diagnosed with less-aggressive breast cancers but still receive whole-breast radiation therapy following breast-conserving surgery.
Over half the patients diagnosed with breast cancer in developed countries are over the age of 65 years, said Ian Kunkler, MBBCh, a professor of clinical oncology at the Western General Hospital at the University of Edinburgh in Scotland. We were interested in determining whether older patients with low-risk breast cancer could be spared radiation therapy.
We found that omitting postoperative radiation therapy did not compromise survival or increase the risk of distant metastasis, Dr. Kunkler said. Based on these results, we believe that omission of radiation therapy after breast-conserving surgery should be an option for older patients with localized, HR-positive breast cancer who are receiving adjuvant hormone therapy and meet certain clinico-pathological criteria.
The study findings may not be applicable to patients with high-grade tumors or tumors larger than 3 centimeters, he said, because there were only a few patients with grade-three tumors in the study.
RELATED: Everyday Healths Building a Breast Cancer Community Twitter Chat: Heres What You Missed
A fresh analysis of the landmark phase 3 monarchE clinical trial showed adding Verzenio (abemaciclib) to endocrine therapy significantly benefits patients with high-risk, lymph-node positive, early-stage breast cancer thats classified as HR-positive, HER2-negative.
Many patients with HR-positive, HER2-negative early-stage disease will not experience a recurrence of cancer with endocrine therapy alone, said the study presenter, Priya Rastogi, MD, associate professor in the department of medicine at the University of Pittsburgh and medical director of the National Surgical Adjuvant Breast and Bowel Project (NSABP) Foundation.
But about 20 percent of patients will experience a recurrence of the disease within 10 years of their initial diagnosis. These recurrences are typically diagnosed as incurable metastatic breast cancer, she said.
An earlier release of data from the trial, which includes 5,637 patients, showed the addition of Verzenio to endocrine therapy curbed the risk of invasive disease recurrent by about 25 percent. The new data, which followed patients for longer, showed that those who received Verzenio experienced a 28.7 percent reduced risk of invasive disease.
Since some women experience relapse several years after their initial treatment, it will be important to gather long-term data on the treatment regimen, said SABCS codirector C. Kent Osborne, MD, professor in the department of medicine, hematology, and oncology at Baylor College of Medicine in Houston. Dr. Osborne was not involved in the study.
The study will continue with a longer-term assessment of overall survival rates among the two groups.
RELATED: New Treatment for Aggressive Breast Cancer Announced at ESMO 2020
Women with breast cancer who undergo radiation therapy may have side effects that go unreported or unnoticed by healthcare providers, according to a study from the University of Michigan.
The study was comprised of 9,868 patients with breast cancer who were treated with radiation therapy. Researchers compared the patients reports of side effects with those assessed by their physicians.
The study showed physicians tended to under-recognize pain severity as well as itching (pruritus), swelling, and fatigue. Among the 5,510 patients who reported at least one substantial symptom during radiation therapy, 53.2 percent had under-recognition of at least one of the four symptoms.
Recognition of symptoms is necessary for appropriate supportive care, said Reshma Jagsi, MD, DPhil, the Newman Family Professor and deputy chair of the department of radiation oncology and director of the Center for Bioethics and Social Sciences in Medicine at the University of Michigan in Ann Arbor.
This work reveals that [physicians] systematically miss substantial symptoms in certain patients, including patients who are younger or of Black or other race.
The study points to the need for physicians to improve the way they assess side effects in patients, said SABCS codirector Virginia Kaklamani, MD, a professor of medicine in the division of hematology and medical oncology, University of Texas Health Sciences Center in San Antonio. Dr. Kaklamani was not involved in the study.
Its really quite surprising to me that in 30 percent of cases there was under-recognition compared to what patients are reporting, she said. We need to do a better job.
I think the key here is improving physician-patient communication, she said. That involves a spectrum of potential interventions which begins with addressing our own unintentional biases.
RELATED: Closing the Gap in Breast Cancer Care and Support for Black Women
Read the original post:
Less Treatment May Be Fine for Some Women With Breast Cancer - Everyday Health
- What Is a Hormone Doctor? | eHow [Last Updated On: May 4th, 2015] [Originally Added On: May 4th, 2015]
- Learn About Hormone Replacement Therapy [Last Updated On: May 4th, 2015] [Originally Added On: May 4th, 2015]
- Bioidentical Hormone Doctors, Thyroid Disorders, Lyme ... [Last Updated On: May 4th, 2015] [Originally Added On: May 4th, 2015]
- Natural Bioidentical Hormone Replacement Therapy (HRT ... [Last Updated On: May 4th, 2015] [Originally Added On: May 4th, 2015]
- What Is a Hormone Doctor? | eHow StemCell Doctors [Last Updated On: June 4th, 2015] [Originally Added On: June 4th, 2015]
- Hormone Replacement Therapy in NYC | NYC Hormone ... [Last Updated On: June 24th, 2015] [Originally Added On: June 24th, 2015]
- Endocrinology - Wikipedia, the free encyclopedia [Last Updated On: September 21st, 2015] [Originally Added On: September 21st, 2015]
- AAG Health - Hormone Replacement Therapy | HGH & Testosterone [Last Updated On: September 25th, 2015] [Originally Added On: September 25th, 2015]
- Denver Bioidentical Hormone Therapy Clinic - Biovive Medicine [Last Updated On: September 25th, 2015] [Originally Added On: September 25th, 2015]
- Naturopathic Doctor Phoenix | Weight Loss Clinic ... [Last Updated On: September 25th, 2015] [Originally Added On: September 25th, 2015]
- What is an Endocrinologist? What does an Endocrinologist ... [Last Updated On: September 25th, 2015] [Originally Added On: September 25th, 2015]
- HRT | Hormone Replacement Therapy | Testosterone [Last Updated On: September 25th, 2015] [Originally Added On: September 25th, 2015]
- Endocrine disease - Wikipedia, the free encyclopedia [Last Updated On: September 29th, 2015] [Originally Added On: September 29th, 2015]
- Hormone Replacement Therapy - Ideal Physician Weight Loss [Last Updated On: October 21st, 2015] [Originally Added On: October 21st, 2015]
- Hormone Replacement | Fred Bloem, MD Holistic Physician ... [Last Updated On: October 24th, 2015] [Originally Added On: October 24th, 2015]
- How to Find a Bioidentical Hormone Doctor [Last Updated On: November 1st, 2015] [Originally Added On: November 1st, 2015]
- Neal Rouzier, MD The Hormone Doctor [Last Updated On: January 27th, 2016] [Originally Added On: January 27th, 2016]
- Hypothyroidism Diagnosis, Symptoms, and Treatment [Last Updated On: February 2nd, 2016] [Originally Added On: February 2nd, 2016]
- A Natural Progesterone Cream by Resonance Direct [Last Updated On: March 1st, 2016] [Originally Added On: March 1st, 2016]
- Network Of Doctors - Renew Man [Last Updated On: March 21st, 2016] [Originally Added On: March 21st, 2016]
- Dr. Komer, MD - Your Temporary Index [Last Updated On: March 25th, 2016] [Originally Added On: March 25th, 2016]
- Dr. Komer The Komer Clinics - Treatment, Education ... [Last Updated On: March 28th, 2016] [Originally Added On: March 28th, 2016]
- Atlantic Age Management - New Jersey Hormone Doctor ... [Last Updated On: April 3rd, 2016] [Originally Added On: April 3rd, 2016]
- Growth Hormone Treatment [Last Updated On: April 8th, 2016] [Originally Added On: April 8th, 2016]
- Information on Thyroid Disorders | Hormone Health Network [Last Updated On: May 11th, 2016] [Originally Added On: May 11th, 2016]
- Transgender hormone therapy Clinic [Last Updated On: June 8th, 2016] [Originally Added On: June 8th, 2016]
- DIM for Hormone Balance - Healthy by Nature [Last Updated On: June 30th, 2016] [Originally Added On: June 30th, 2016]
- MedHelp - Health community, health information, medical ... [Last Updated On: July 2nd, 2016] [Originally Added On: July 2nd, 2016]
- Hormone Replacement Therapy - WebMD [Last Updated On: July 23rd, 2016] [Originally Added On: July 23rd, 2016]
- Hormone Replacement Therapy Boca Raton - Hormone Doctor ... [Last Updated On: July 23rd, 2016] [Originally Added On: July 23rd, 2016]
- How to Balance Hormones Naturally | Wellness Mama [Last Updated On: July 24th, 2016] [Originally Added On: July 24th, 2016]
- Integrative Medicine Denver | Hormone Replacement Therapy [Last Updated On: August 28th, 2016] [Originally Added On: August 28th, 2016]
- HGH.com - Natural Human Growth Hormone Supplements [Last Updated On: September 5th, 2016] [Originally Added On: September 5th, 2016]
- The Physician Assistant Life - Essay [Last Updated On: September 24th, 2016] [Originally Added On: September 24th, 2016]
- Man vs. Estrogen: It's Not Just A Woman Thing! | Seasons ... [Last Updated On: September 28th, 2016] [Originally Added On: September 28th, 2016]
- Bioidentical Hormones: Dr. John R. Lee's Three Rules for BHRT [Last Updated On: October 5th, 2016] [Originally Added On: October 5th, 2016]
- Endocrinology - Wikipedia [Last Updated On: October 25th, 2016] [Originally Added On: October 25th, 2016]
- TODAY Video - Latest TODAY show clips, news & video ... [Last Updated On: November 11th, 2016] [Originally Added On: November 11th, 2016]
- Hormonal Imbalance Anxiety a Precursor to Other Health ... [Last Updated On: December 7th, 2016] [Originally Added On: December 7th, 2016]
- DIM for Hormone Balance - blog.healthybynaturehwc.com [Last Updated On: December 7th, 2016] [Originally Added On: December 7th, 2016]
- Medicine - Wikipedia [Last Updated On: January 8th, 2017] [Originally Added On: January 8th, 2017]
- Steroid - Wikipedia [Last Updated On: January 8th, 2017] [Originally Added On: January 8th, 2017]
- Thyroid Disease Manager : Diagnosis and Treatment of Graves [Last Updated On: January 13th, 2017] [Originally Added On: January 13th, 2017]
- Dr. Brian Irwin: BPH is a common but uncomfortable disorder - Conway Daily Sun [Last Updated On: February 8th, 2017] [Originally Added On: February 8th, 2017]
- Hospital adds doctors at Dove's Landing - Oroville Mercury Register [Last Updated On: February 8th, 2017] [Originally Added On: February 8th, 2017]
- Veracyte (VCYT) Enters Agreement with Quest Diagnostics (DGX) to Expand Patient Access to GEC - StreetInsider.com [Last Updated On: February 8th, 2017] [Originally Added On: February 8th, 2017]
- Dear Dr. Roach: Elevated calcium level may signal excess hormone - Herald & Review [Last Updated On: February 8th, 2017] [Originally Added On: February 8th, 2017]
- Endocrine disease - Wikipedia [Last Updated On: February 8th, 2017] [Originally Added On: February 8th, 2017]
- What causes infertility and how can it be treated? - WRDW-TV [Last Updated On: February 8th, 2017] [Originally Added On: February 8th, 2017]
- Doctor's Tip: What is the safest cookware? - Glenwood Springs Post Independent [Last Updated On: February 10th, 2017] [Originally Added On: February 10th, 2017]
- Nonbinary students confront surgery challenges - Yale Daily News (blog) [Last Updated On: February 10th, 2017] [Originally Added On: February 10th, 2017]
- Human Growth Hormone - Rejuvalife Vitality Institute [Last Updated On: February 10th, 2017] [Originally Added On: February 10th, 2017]
- Shed pounds to lower the risk - Times of India [Last Updated On: February 11th, 2017] [Originally Added On: February 11th, 2017]
- Colorado House panel rejects three GOP abortion bills - The Denver Post [Last Updated On: February 11th, 2017] [Originally Added On: February 11th, 2017]
- Dems defeat anti-choice bills - Pueblo Chieftain [Last Updated On: February 11th, 2017] [Originally Added On: February 11th, 2017]
- People get test results, have more tests done at Live Healthy 2017 Health Fair - Grand Island Independent [Last Updated On: February 12th, 2017] [Originally Added On: February 12th, 2017]
- Physicians' Education Resource Plans Most Impactful Miami ... - PR Web (press release) [Last Updated On: February 13th, 2017] [Originally Added On: February 13th, 2017]
- Windsor doctor penalized for 'reckless' narcotics prescribing - Windsor Star [Last Updated On: February 13th, 2017] [Originally Added On: February 13th, 2017]
- 'Bathroom Bill' is discrimination - Emporia Gazette [Last Updated On: February 13th, 2017] [Originally Added On: February 13th, 2017]
- What's in store: Chronos - bestofneworleans.com [Last Updated On: February 13th, 2017] [Originally Added On: February 13th, 2017]
- A lot of blood, for no reason? Common, costly clot test has few benefits - Knowridge Science Report [Last Updated On: February 15th, 2017] [Originally Added On: February 15th, 2017]
- Ask the Doctor: Dizziness, Graves' disease, herbal remedies - WNDU-TV [Last Updated On: February 15th, 2017] [Originally Added On: February 15th, 2017]
- The Thyroid Problem: How you can identify thyroid issues and free your health - Black Hills Pioneer [Last Updated On: February 15th, 2017] [Originally Added On: February 15th, 2017]
- 5 Reasons Real Women Chart Their Menstrual Cycle - Verily [Last Updated On: February 15th, 2017] [Originally Added On: February 15th, 2017]
- Holistic Medicine Doctor in Dever, Colorado | BioViveMD [Last Updated On: February 15th, 2017] [Originally Added On: February 15th, 2017]
- With health care repeal looming, women turn to IUDs and other long-term birth control - Kansas City Star [Last Updated On: February 17th, 2017] [Originally Added On: February 17th, 2017]
- Older women reduce their endometrial cancer risk with weight loss - Fox News [Last Updated On: February 17th, 2017] [Originally Added On: February 17th, 2017]
- Chief justice cheers turnout at Longview off-site session - Longview News-Journal [Last Updated On: February 18th, 2017] [Originally Added On: February 18th, 2017]
- What's It Like Getting Health Care As A Black Transgender Person? - BuzzFeed News [Last Updated On: February 19th, 2017] [Originally Added On: February 19th, 2017]
- The Secret Behind Trump's Flowing Locks - eParisExtra.com (blog) [Last Updated On: February 20th, 2017] [Originally Added On: February 20th, 2017]
- Family pushes bill expanding medical training in schools - WBIR.com [Last Updated On: February 20th, 2017] [Originally Added On: February 20th, 2017]
- Quick fix: Zeman turns last-place Pescara around in 3 days - The Republic [Last Updated On: February 20th, 2017] [Originally Added On: February 20th, 2017]
- Major study finds testosterone therapy is no fountain of youth - Philly.com [Last Updated On: February 21st, 2017] [Originally Added On: February 21st, 2017]
- Perth doctor Amish Dwarka Singh guilty over weight loss, bodybuilding prescriptions - ABC Online [Last Updated On: February 23rd, 2017] [Originally Added On: February 23rd, 2017]
- Introducing Bio-Identical Hormone Replacement Therapy at Young Medical Spa in Center Valley and Lansdale ... - PR Web (press release) [Last Updated On: March 6th, 2017] [Originally Added On: March 6th, 2017]
- Is testosterone-replacement therapy good or bad? One man suffering from low levels searches for answers. - Men's Fitness [Last Updated On: March 6th, 2017] [Originally Added On: March 6th, 2017]
- Area doctor to launch book on women's health during menopause - Southgate News Herald [Last Updated On: March 6th, 2017] [Originally Added On: March 6th, 2017]
- Obesity May Raise Girls' Risk of Asthma, Allergies - WebMD [Last Updated On: March 6th, 2017] [Originally Added On: March 6th, 2017]
- Doc: Pill's hormone regulation benefits women with PCOS - The Detroit News [Last Updated On: March 6th, 2017] [Originally Added On: March 6th, 2017]
- USMLE Step 1: Postpartum amenorrhea and hormone levels - American Medical Association (blog) [Last Updated On: March 6th, 2017] [Originally Added On: March 6th, 2017]