On July 18, 2018, the U.S. Food and Drug Administration (FDA) expanded the indication for ribociclib (Kisqali) in combination with an aromatase inhibitor for pre/perimenopausal women with HR-positive, HER2-negative advanced or metastatic breast cancer, as initial endocrine-based therapy.

Mrs. Jones is a 66-year-old postmenopausal woman who developed left breast pain and a palpable mass. A mammogram and ultrasound showed a 4.6 cm mass with an enlarged axillary node. A core biopsy revealed invasive ductal carcinoma that is estrogen receptor positive, progesterone receptor positive, and HER2 negative. Positron-emission tomography and computed tomography scans revealed metastatic disease.

It’s been a long time coming, but the Childhood Cancer Survivorship, Treatment, Access and Research (STAR) Act was finally signed into law on June 6 by President Trump. The act focuses on advancing pediatric cancer research and treatments along with improving screening programs and supporting patients into survivorship. As with many issues in the U.S. capital, the issue had two sides: many healthcare professionals see it as a win to support childhood cancer survivors, but it raised concerns for others about potential coverage issues.

Which Breast Cancers Benefit from Treatment With Cyclin-Dependent Kinase 4/6 Inhibitor Treatment?

A. Newly diagnosed DCIS  

B. Metastatic, triple negative  

C. Premenopausal, neoadjavant  

D. ER+ metastatic

Although all cancers have a genetic basis, a subset result from an inherited (i.e., germline) mutation that puts a person at increased risk for certain cancers. Unfortunately, the signs of hereditary cancer are often overlooked or misunderstood. Here’s what oncology nurses need to know about BRCA mutations, one of the more common mutations you’ll see in practice.

Which of the following is gene that may play a role in tumor resistance to chemotherapy?

A. NRAS

B. APC

C. p53

D. VHL

An international survey of 86 genetic testing labs showed inconsistent protocols and standards for analyzing the BRCA1 or 2 cancer susceptibility genes and their variations. The results were reported in NPJ Genomic Medicine.

Test your oncology knowledge with ONS. Which of the following is a risk factor for developing breast cancer? 

1. Women who are gravida 3 para 2
2. Mild to moderate alcohol use
3. Absence of the BRCA1 or BRCA2 mutation
4. Going through menopause prior to age 55

Women who receive chemotherapy or radiation therapy treatments for breast cancer are more likely to have high levels of DNA damage and reduced activity of an enzyme involved in chromosome healing than those who receive only surgery for breast cancer, according to the results of a study published in NPJ Breast Cancer.

Identifying genetically predisposed women with breast cancer who could benefit from risk assessment and genetic counseling is an important competency for oncology nurses. However, a recent study published in the Journal of Clinical Oncology (JCO) reported that fewer than 50% of newly diagnosed patients with breast cancer who should have been given formal genetic counseling actually received the appropriate genetic testing.

Lymphedema, the chronic swelling of a limb resulting from fluid accumulation, is a common sequela of surgery or radiation treatment for breast cancer. Nearly 90% of women who develop lymphedema do so within three years of treatment. Survivors commonly report physical and emotional distress, limitations to daily activities in fear of exacerbating lymphedema, and body image issues because of an abnormally enlarged limb.

On February 26, 2018, the U.S. Food and Drug Administration (FDA) approved abemaciclib (Verzenio™) in combination with an aromatase inhibitor as initial endocrine-based therapy for postmenopausal women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 HER2-negative advanced or metastatic breast cancer.

On January 12, 2018, the U.S. Food and Drug Administration (FDA) granted regular approval to olaparib tablets, a poly (ADP-ribose) polymerase (PARP) inhibitor, for the treatment of patients with deleterious or suspected deleterious germline BRCA-mutated (gBRCAm), HER2-negative metastatic breast cancer who have been treated with chemotherapy either in the neoadjuvant, adjuvant, or metastatic setting.

Many women face a lack of information and understanding after their breast cancer diagnoses. Currently, women have more treatment options than ever before, and patients have the ability to review the latest findings to identify the option that fits best for their lives.

Research has shown that women aged 65 and older who have breast cancer experience higher rates of heart failure compared to their age-matched counterparts, ranging from 29% of women with breast cancer who received no chemotherapy to 38% of women who received treatment with anthracyclines. However, little is known about the association between heart failure and long-term survival in older women with breast cancer, and it is unclear how the relative contribution of heart failure to mortality risk varies by breast cancer stage.

On December 1, 2017, the U.S. Food and Drug Administration approved Ogivri (trastuzumab-dkst) as a biosimilar to Herceptin (trastuzumab) for the treatment of patients with HER2-overexpressing breast or metastatic stomach cancer (gastric or gastroesophageal junction adenocarcinoma).

Meditation is a healing practice that involves focusing attention, regulating breathing, and developing a nonjudgmental awareness of one’s thoughts and feelings. It aims to improve emotional regulation and overall well-being. Data from the 2012 National Health Interview Survey indicate that 18 million adults and 927,000 children practice meditation. Meditation encompasses repeating words with phonetic significance as in mantram meditation; paying attention or continually returning to the present moment as in mindfulness meditation; or practicing specific movements as in tai chi and qigong.   

As Breast Cancer Awareness Month begins this week, we’ll start seeing pink awareness efforts everywhere. Pink products will line the shelves at stores, awareness and fundraising ads will showcase celebrities wearing pink ribbons, and high school, collegiate, and even professional athletes will adorn their uniforms with pink, some even articulating a specific person or family member affected by breast cancer for whom they’re dedicating their athletic efforts.

On September 28, 2017, the U.S. Food and Drug Administration approved abemaciclib in combination with fulvestrant for women with HR-positive, HER2-negative advanced or metastatic breast cancer with disease progression following endocrine therapy.

Researchers have discovered a protein that may lead to a new way to prevent resistance and improve outcomes for patients whose cancers have a BRCA2 mutation. The findings were reported in Molecular Cell.

Breast cancer risk peaks when a patient is in her 40s for BRCA1 mutations and in her 50s for BRCA2 mutations, according to the results of a new study published in JAMA.

Alongside congressional representatives Debbie Wasserman Schultz and Susan Brooks, ONS and other organizations are lobbying for support of the Protecting Access to Lifesaving Screenings (PALS) Act. This legislation would push insurance companies—along with the Veterans Health Administration—to provide access and coverage to breast cancer screenings for women aged 40–49.

Hot flashes, also known as hot flushes, are marked by periods of sudden, intense feelings of warmth that begin at the chest and radiate to the neck and face, along with flushing, sweating, and heart palpitations, lasting several seconds to minutes. Compared to healthy postmenopausal women, breast cancer patients and survivors are prone to experiencing more severe and longer-lasting hot flashes. A bothersome symptom, hot flashes can occur anytime during a 24-hour period, but those occurring at night are most troubling because they interfere with sleep. Sleep deprivation negatively impacts daytime functioning as well as pain, fatigue, depression, and anxiety levels, diminishing quality of life significantly.

Nearly half of patients treated for early-stage breast cancer report at least one severe side effect, according to the results of a study published in Cancer.

On March 31, 2017, the U.S. Food and Drug Administration (FDA) granted regular approval to palbociclib for the treatment of hormone receptor (HR)‑positive, human epidermal growth factor receptor 2 (HER2)‑negative advanced or metastatic breast cancer in combination with an aromatase inhibitor as initial endocrine based therapy in postmenopausal women.

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.

On March 13, 2017, the U.S. Food and Drug Administration (FDA) approved ribociclib (KISQALI^®, Novartis Pharmaceuticals Corp.), a cyclin-dependent kinase 4/6 inhibitor, in combination with an aromatase inhibitor as initial endocrine-based therapy for the treatment of postmenopausal women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer.

Researchers conducting the largest study to date on screening mammography outcomes have found no evidence to support stopping mammography screenings at a certain age. The findings were presented at the 2016 Radiological Society of North America annual meeting.