American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Breast cancer treatment innovations tempered by screening shortfalls

OCTOBER 26, 2017
Clinical Congress Daily Highlights, Thursday Edition

Great strides have been made in understanding, detecting and treating breast cancer, but much more remains to be done. This year, more than 250,000 new cases will be diagnosed and more than 40,000 women will die of breast cancer.

Three studies presented this week offer intriguing new ways to treat and study breast cancer — while a fourth suggests that substantial progress can also be made by improving compliance with screening recommendations.

A team led by Julia L. Jin, Weill Cornell Medical College, New York, NY, Cornell University, Ithaca, NY, and Hospital for Special Surgery, New York, NY, developed a novel three-dimensional vascularized and stiffened collagen platform for the study of metastasis. When seeded with a breast cancer cell line, the cells migrated through into the vasculature, moving significantly farther than cells in unstiffened collagen. The authors concluded that this approach overcomes the limitations of previous models and can be used in the study of breast cancer signaling pathways. It may also provide an effective platform for high-throughput analysis of patient-specific tumor cells.

Shrikant Anant, PhD, University of Kansas Medical Center, Kansas City, KS, and colleagues found that two compounds, celastrol and triptolide, suppress triple negative breast cancer (TNBC) cell growth in cell lines, as well as patient derived cells. The compounds interfere with the heat-shock protein Hsp90, which fosters breast cancer progression and treatment resistance. Patients with TNBC have an especially poor prognosis due to the cancer’s high frequency of metastasis.

In patients with localized, early-stage breast cancers, researchers led by Takayuki Kinoshita, MD, PhD, National Cancer Center Hospital, Tokyo, Japan, found that radiofrequency ablation (RFA) is a promising minimally invasive and cosmetically acceptable alternative to surgery. In this Phase I study, localized tumors with a maximum diameter of 2 cm were treated with RFA. Of the 57 patients who completed the RFA and underwent diagnostic imaging and needle biopsy after 3 months, seven were suspected of incomplete RFA and underwent surgical resection; in a later follow up, one patient was diagnosed with contralateral breast cancer.

Screening is essential to catching cancer at its earliest, most treatable stages. Yet Vance Y. Sohn, MD, FACS, Madigan Army Medical Center, Tacoma, WA, and colleagues found poor compliance in patients at high risk for the development of breast cancer even in an equal access, no-cost medical system. The researchers offered MRI screening/surveillance to 1,057 women deemed by the Tyler-Cuzik Breast Cancer Risk Assessment Model to have a 20 percent or greater risk of developing breast cancer. The authors found that although patients at higher risk were more likely to undergo MRI screening, even a greater than 40 percent lifetime risk did not ensure uniform adherence to screening.

Additional Information:
The four Scientific Forum studies presented at the 2017 Clinical Congress  of the American College of Surgeons in San Diego, CA were: Effects of Hsp90 Inhibitors on Patient Derived Triple Negative Breast Cancer Cells: BRCA 1 as a Therapeutic Target for TNBC; Poor Compliance in Screening Breast MRI in High-Risk Women in an Equal Access System; Radiofrequency Ablation for Early-Stage Breast Cancer: Results from 5 Years of Follow-Up in a Prospective Multicenter Study; Modeling Breast Cancer Metastasis in a Novel Three-Dimensional Biomimetic Platform. Program, webcast and audio information is available online at FACS.org/clincon2017.

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