San Antonio in Texas, has the distinct honor of hosting the largest gathering of breast cancer professionals, patient advocates, and several others every year. It is the San Antonio Breast Cancer Symposium or SABCS. I just returned and was very happy to learn of new research, and also network with breast oncology colleagues.
Out of several posters and oral presentations I encountered, a few stood out in my mind. I’d like to share these as I believe, they are important for breast cancer patients, survivors, and their family members to know about.
We still don’t know how long to give anti-estrogen pills for estrogen receptor (ER) positive non-stage IV breast cancer. Should it be 5 or 10 years, 7.5 or 10 years? Can some individuals get away with only 5 years? Is there an accurate method to tell who can? There are still many uncertainties so one needs to have a detailed discussion with their oncologist.
For stage IV breast cancer, we have increasing understanding of why anti-estrogen pills stop working at some point. It looks like genetic mutations may occur over time, that alter the estrogen receptor such that usual pills stop working. This is at least one mechanism that may be at play. Understanding resistance pathways is crucial since that allows us to figure out ways to overcome such resistance. New medication combinations are being studied.
Adding estrogen-blockade does not help much for stage 2 and 3 ER/PR and HER2 positive breast cancer treated with chemo before surgery. We have known for a while that giving herceptin and chemotherapy before surgery can make the cancer melt away. In order words, we get to surgery, take out the lump, and the pathologist finds that all cancer cells have died. This is a very great thing when it happens since the cancer is much less likely to grow back. Please note that whether to give chemotherapy before versus after surgery, is a complicated discussion you need to have with your oncologist.
We know that when the cancer is ER/PR and HER2 positive, this complete cancer death (aka pathologic complete response) is less likely than if HER2 positive and ER/PR negative. The update is that a study called NSABP B52 showed that adding anti-estrogen pills before surgery to target the ER/PR positive part, does not change anything. This is disappointing and we hope the researchers can figure out how to proceed from here.
Immunotherapy is moving on in breast cancer research. Perhaps you’ve watched Opdivo® commercials on TV. Maybe you remember President Jimmy Carter’s melanoma treated with Keytruda®. These are medicines that work against cancer by activating the immune system to help in the fight. They are being increasingly studied in breast cancer, especially a potentially aggressive type called triple negative breast cancer.
Fat intake, energy balance and waist circumference may have a relation with risk of death after breast cancer diagnosis. >/= 36.8% dietary fat intake and >88cm waist circumference were detrimental in women under 70, in a trial reported by RT Chlebowski and colleagues. The take home point is yes, dieting and exercise to maintain a healthy weight is good for your health even after a breast cancer diagnosis.
Also be sure to search for #sabcs16, #sabcs2016, #sabcs, and #bcsm on Twitter and other social media. Do you have any other thoughts, or want to share your experience? Please feel free to leave a comment below. Do hover over the right bottom to subscribe to my blog for free updates related to cancer, blood disorders, and books.
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