San Antonio Breast Cancer Symposium
The San Antonio Breast Cancer Symposium's educational sessions, workshops, lectures, and poster presentations provide conference participants with the latest insights into breast cancer clinical findings and treatment pathways. Here are research highlights from the conference on treatment disparities, genetic considerations, risk factors, and more.
Comorbidities Negatively Impact Breast Cancer Survival
Missouri has a high breast cancer mortality rate, as well as high rates of type 2 diabetes, cardiovascular disease (CVD), and hypertension, which present more often in individuals who are poor, those living in rural areas, African Americans, and older adults. Women with comorbidities at the time of breast cancer diagnosis may have a worse prognosis, so researchers assessed survival disparities among these patient populations. According to the findings presented at the , comorbidities can negatively impact overall breast cancer survival.
Glutathione Plays a Role in Treatment-Related CINV
Chemotherapy-induced nausea and vomiting (CINV) can negatively affect nutritional intake, ability to work, and treatment adherence. Research suggests that younger age and female gender are the strongest predictors of CINV, but those may not be the only factors, particularly for delayed nausea, according to research findings presented at the San Antonio Breast Cancer Symposium on December 5, 2018.
Circulating Tumor Cells Predict Survival
Circulating tumor cells (CTCs) are identified in 20%–25% of patients with nonmetastatic breast cancer, and recent research suggests that detection of CTCs at five-year follow-up may predict late recurrence for nonmetastatic, estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2–) breast cancer. In a study presented at the , researchers from the University of Texas MD Anderson Cancer Center found that the presence of CTCs in patients with nonmetastatic breast cancer was associated with shortened relapse-free survival (RFS), regardless of the subtype.
Educational Workshop Improves Patient-Perceived Knowledge About Their Disease
Patient education can improve interactions with their healthcare team and provide coping mechanisms for the psychosocial effects of metastatic breast cancer, according to study findings presented at the .
Tailored Education Improves Patient Satisfaction and Comprehension
Throughout the course of treatment, patients with breast cancer receive a significant amounts of information from their healthcare team. Researchers at the University of Colorado School of Medicine assessed and revamped the educational materials from the facility’s Memorial Radiation Oncology Department to achieve a patient comprehension of key treatment-related concepts of 75%. They found that although some educational concepts remained unmemorable or improperly emphasized, overall trends in comprehension indicated that a patient-tailored approach led to better satisfaction and outcomes, according to the findings presented at the .
Trastuzumab Remains Standard HER2+ Breast Cancer Therapy Despite Cardiac Risks
Trastuzumab can improve disease-free survival (DFS) and overall survival (OS) in patients with human epidermal growth factor receptor 2-positive (HER2+) breast cancer. Although some studies suggest that short-term treatment (less than one year) may reduce cardiac toxicity and cost without compromising outcomes, the results of a new study presented at the disagree.
Study Identifies Novel Triplet Therapy for HR+/HER2+ Breast Cancer
Researchers from the University of Colorado Denver Young Women Breast Cancer Translational Program in Aurora identified a potential triplet combination for the treatment of hormone receptor-positive (HR+) human epidermal growth factor receptor 2-positive (HER2+) breast cancer: HER2-targeted small molecule inhibitor tucatinib, CDK4/6 inhibitor palbociclib, and selective estrogen receptor blocker fulvestrant. They presented the findings at the .
Highly Emetogenic Chemotherapy Still Contributes to Potentially Avoidable Adverse Events
The Centers for Medicare and Medicaid Services (CMS) implemented an oncology outcome measure to assess the quality of care and determine outpatient hospital payment (OP-35: Admissions and Emergency Department Visits for Patients Receiving Outpatient Chemotherapy). The measure assesses 30-day postchemotherapy rates of inpatient or emergency department (ED) events deemed “potentially avoidable” because of an association with any of the 10 CMS-defined toxicities: anemia, dehydration, diarrhea, fever, nausea, emesis, neutropenia, pain, pneumonia, or sepsis. Researchers sought to assess those events when linked to highly emetogenic chemotherapy (HEC) in patients treated with anthracycline plus cyclophosphamide (AC), carboplatin, or cisplatin. They presented the findings at the .
Social Support May Play a Role in Treatment Adherence
Many women discontinue adjuvant endocrine therapy (AET) because of adverse events (AEs), and only half remain adherent at five years. Researchers from the University of Southern California, Los Angeles, found that continued social support for those women may improve AET adherence. They presented the findings at the .
Socioeconomic Factors Predict Survival in Nonmetastatic Breast Cancer
Racial and regional disparities impact the incidence of, mortality from, and survival from breast cancer, but the role of other socioeconomic factors is unclear. Researchers from Fudan University in Shanghai, China, conducted a large study and found that marital status, insurance status, median household income, and residence also contribute to survival from nonmetastatic breast cancer. They presented the findings at the .
Breast MRI Protocol Improves Patient Care
Magnetic resonance imaging (MRI) can help diagnose breast cancer, but it is costly. Leadership at the University of Washington in Bellingham developed a protocol to improve the timeliness of care, moving the time of MRI prior to surgeon evaluation, and found that it led to enhanced patient care, eliminated delays in treatment, avoided unnecessary tests, shifted appropriate care to primary-care providers, and provided all necessary data prior to initial surgical consultation. They presented the findings at the .
Patients Rank the Importance of PRO Measures Differently
Patient-reported outcomes (PROs) can improve patient satisfaction and potentially impact survival. However, PRO data are not well-collected outside of the research setting. Researchers at the Yale School of Medicine in New Haven, CT, conducting qualitative study assessed the most personally relevant PROs in women with metastatic breast cancer and observed substantial variation in patient preferences. They presented the findings at the .
Time to Treatment Discontinuation Shorter in Patients Who Receive First-Line Palbociclib
Current treatment guidelines recommend sequential hormone therapy for patients with hormone receptor-positive (HR+) metastatic breast cancer who are not in visceral crisis and whose disease is not refractory to endocrine treatment. Second-line fulvestrant monotherapy is a treatment option for patients in whom disease progresses after first-line palbociclib. Researchers used real-world data to evaluate the time to treatment discontinuation (TTD) of second-line fulvestrant in patients with HR+ human epidermal growth factor receptor 2-negative (HER2–) metastatic breast cancer who did (n = 88) and did not (n = 100) receive first-line palbociclib and found it was shorter in patients who received palbociclib. They presented the findings at the .
Overall Survival From Breast Cancer Differs Based on Tumor Type and Location
Triple-negative breast cancer tumors are thought to be more immunogenic than other breast cancer subtypes, such as luminal A/B or human epidermal growth factor receptor 2-positive (HER2+) tumors. Among all breast cancers, tumors appear more commonly in the upper outer quadrant. However, it is not clear whether expression of immune response genes vary with tumor location among the different subtypes. Researchers assessed gene expression associated with immune response pathways to identify potential treatment targets and presented the findings at the .
Tumor Heterogeneity May Affect Outcomes in Patients With DCIS
Intratumor heterogeneity can lead to cancer progression, and tumors with the highest levels of heterogeneity may be more likely to progress. Researchers compared mutational loads from separate areas of pure ductal carcinoma in situ (DCIS) to genetic heterogeneity in DCIS lesions that coexist with invasive cancer and presented the findings at the .
On-Treatment Genetic Testing Improves Accuracy of Tumor Response Prediction
Genetic testing during treatment can improve accuracy of response and outcome prediction compared to other prognostic tests, according to results from a study assessing on-treatment changes in gene expression in patients receiving chemotherapy. Researchers from Oikonomidou O Institute of Genetics and Molecular Medicine in Edinburgh, United Kingdom, presented the findings at the .
Study Identifies Factors Associated With Long-Term Survival in Metastatic Breast Cancer
Few women with metastatic breast cancer live five years or longer, and predictors of long-term survival are not well understood. Researchers from the University of Pittsburgh Medical Center (UPMC) in Pennsylvania identified demographic- and disease-specific factors related to survival and presented their findings at the .
Asymptomatic Screening Can Improve Survival Rates in Patients With Recurrent Breast Cancer
Current guidelines recommend asymptomatic surveillance of breast cancer only for the detection of locoregional recurrences. Researchers from the Asan Medical Center in Seoul, Republic of Korea, conducted a retrospective 10-year survival analysis of a large cohort of patients with recurrent breast cancer to identify the impact of early detection on survival outcomes and presented the findings at the .
Screening Intervention Improves Access to Mammograms
Access to quality breast cancer screening and treatment may contribute to racial disparities outcomes. In 2016, researchers at the urban safety net Cook County Health and Hospitals System in Chicago, IL, implemented changes in mammography practices, which included installing digital machines at one of four sites, centralizing reading of images at a single site with radiologists specialized in mammography, and increasing care coordination such as enhanced patient outreach efforts. The efforts improved screening volume and cancer detection, according to the results presented at the .
Sexual Function Varies by Some Treatments in Breast Cancer Survivors
Surgical modality and receipt of chemotherapy or radiotherapy are not associated with sexual function, as measured by the Female Sexual Function Index (FSFI). Patients receiving endocrine therapy with an aromatase inhibitor had significantly lower sexual function scores than those who received no endocrine therapy or those on tamoxifen, said a group of U.S. researchers who presented their findings during a poster session on Saturday, December 10, at the San Antonio Breast Cancer Symposium.
Latinas With BRCA1 or 2 Mutations Are More Likely to Choose Surgery
The uptake of prophylactic surgeries among Latinas with germline BRCA mutations may be slightly lower than what has been reported in non-Hispanic whites but higher than in African Americans, a group of U.S. researchers said. They presented their findings on Saturday, December 10, during a poster session at the San Antonio Breast Cancer Symposium.
Supervised Exercise Reduces Fatigue in Patients With Breast Cancer
Exercise—preferably supervised—represents a viable intervention for prevention and treatment of fatigue among patients with breast cancer, a group of Australian, European, and U.S. researchers said. They presented their findings during a poster session on Saturday, December 9, during the San Antonio Breast Cancer Symposium.
Type 2 Diabetes May Increase Breast Cancer Mortality in Hispanic Women
The presence of type 2 diabetes mellitus at the time of breast cancer diagnosis has been suggested to adversely affect survival—independent of breast cancer stage, grade, and tumor phenotype—but few of those studies included people of Hispanic descent. Researchers from Johns Hopkins Bloomberg School of Public Health in Baltimore and the University of Louisville in Kentucky examined the association between self-reported diabetes history, breast cancer-specific and all-cause mortality among Hispanic and non-Hispanic white women diagnosed with breast cancer. They presented their results on Saturday, December 9, during a poster session at the San Antonio Breast Cancer Symposium.
Community Breast Physicians Network Study Supports Broader Testing
Ongoing and increasing evidence suggest that an equivalent rate of mutations may be found regardless of whether patients meet current testing criteria, according to a large group of community breast physicians. They presented their findings on Friday, December 8, during a poster session at the San Antonio Breast Cancer Symposium.
Exercise Is Beneficial in Metabolic Syndrome
Metabolic syndrome is associated with increased risk of cardiovascular disease, type 2 diabetes, and possibly cancer recurrence, and its occurrence is higher in breast cancer survivors than age-matched postmenopausal women. Now, a study on exercise has found that aerobic and resistance exercise intervention reduced metabolic syndrome in sedentary, overweight, and obese Hispanic breast cancer survivors. U.S. researchers presented their findings during a poster session on Friday, December 8, at the San Antonio Breast Cancer Symposium.
Disparities Remain in Breast Cancer Mortality Based on Health Insurance Status
Significantly higher rates of death are found in Medicaid and uninsured hospital admissions when compared to Medicare-enrolled admissions with breast cancer, suggesting that insurance status “appears to play a crucial role in patient outcomes.” Researchers with Drexel University in Philadelphia presented their findings on Friday, December 8, during a poster session at the San Antonio Breast Cancer Symposium.
Younger Age Equates to Unfavorable Subtypes, Higher Stage, and Worse Survival in BC
Patients with breast cancer who are younger than 40 years are likely to have unfavorable subtypes, higher stage, and lower overall survival and disease-free survival (DFS) as compared to their older counterparts, according to researchers at the Roswell Park Cancer Institute in Buffalo, NY. They presented their findings on Friday, December 8, during the San Antonio Breast Cancer Symposium.
Serum Vitamin D Linked to Inability to Achieve Pathologic Complete Response
Vitamin D deficiency is associated with the inability to reach pathologic complete response (pCR) in patients with breast cancer undergoing neoadjuvant systemic chemotherapy (NAC), and a trend for worse survival was seen in patients with triple negative tumors. Results from an analysis were presented on Thursday, December 7, during a poster session at the San Antonio Breast Cancer Symposium (SABCS).
Factors Increase Risk for Fibrosis After Whole Breast Radiation Therapy in Lateral Position
Whole breast radiation therapy in isocentric lateral decubitus position is well tolerated with good cosmesis and low rates of fibrosis, said a group that had previously confirmed the efficacy and safety of the technique. Researchers from the Institut Curie in Paris presented their results during a poster session on Thursday, December 7, at the San Antonio Breast Cancer Symposium.
PRAEGNANT Breast Cancer Registry Suggests Chemotherapy Offers Little Benefit
A group of German researchers attempting to identify predictors for a decision against an antihormonal treatment (AHT) were unable to show that patients benefited from chemotherapy. They presented their results on Thursday, December 7, during a poster session at the San Antonio Breast Cancer Symposium.
Enrichment of Mucin Gene Family Shown in Breast Cancer Diagnosed During Pregnancy
The first study on the mutational landscape of breast cancer diagnosed during pregnancy (BCP) using whole-genome sequencing found that BCP is associated with a higher number of putative driver mutations, including mutations in mucin genes. Researchers presented their findings on Thursday, December 7, during a poster session at the San Antonio Breast Cancer Symposium.
Combination Checkpoint Inhibition/Epigenetic Modulation Improves Survival in HER2-Positive Breast Cancer Models
Researchers from Johns Hopkins University in Baltimore have found that adding the histone deacetylase inhibitor entinostat (ENT) to checkpoint inhibition decreases tumor burden and improves survival in human epidermal growth factor receptor 2 (HER2)-positive breast cancer models. The findings were reported during the San Antonio Breast Cancer Symposium on Wednesday, December 6.
Blocking ER-Coregulator Signaling Enhances Palbociclib Therapy in ER-Positive Breast Cancer
The novel combination of estrogen receptor (ER) coregulator binding modulator (ERX-11) and palbociclib may delay, or even overcome, endocrine therapy resistance in women with ER-positive advanced breast cancer, according to a group of researchers from the University of Texas (UT) Healthcare System. They reported their findings during the San Antonio Breast Cancer Symposium on Wednesday, December 6.
Extended Adjuvant Bisphosphonate Treatment Does Not Improve DFS, OS in Early-Stage Breast Cancer
Women with high-risk, early-stage breast cancer see no improvement in disease-free survival (DFS) or overall survival (OS) after five years of adjuvant bisphosphonate treatment compared with just two years of treatment, according to SUCCESS A, a phase III study. European researchers presented these findings during the San Antonio Breast Cancer Symposium on Wednesday, December 6.
African American Women Continue to Experience Breast Cancer Disparities
Despite interventions to bridge the gap in cancer disparities between African American and white women, racial disparities in breast cancer mortality exist. The National Cancer Institute reported that African American women have a higher mortality rate from breast cancer as compared to Caucasian women (33.8 versus 25.0, respectively).
Aggressive Treatment Needed for Locoregional Recurrence in Patients With Breast Cancer
Researchers from Memorial Sloan Kettering Cancer Center in New York, NY, suggested that for women with locoregional recurrence (LRR) of breast cancer, contralateral axillary metastases should be treated aggressively for cure after excluding distant metastases. Challenges of and best practices for managing LRR was discussed at an education session during the San Antonio Breast Cancer Symposium on Tuesday, December 5.
Bilingual, Bicultural Patient Navigators May Reduce Disparities in Latinas With Breast Cancer
Researchers from the University of Texas (UT) Health San Antonio have found that providing Latinas with breast cancer with a bilingual, bicultural patient navigator can improve access to care and reduce treatment delays. The researchers presented their findings during the San Antonio Breast Cancer Symposium on Tuesday, December 5.
Antidepressant May Relieve Joint Pain From Aromatase Inhibitors
The antidepression drug duloxetine, which is approved to treat depression, anxiety, fibromyalgia, and diabetes nerve pain, may also relieve treatment-induced joint pain in breast cancer survivors receiving aromatase inhibitor therapy, according to the results of a study presented at the San Antonio Breast Cancer Symposium.