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https://www.readbyqxmd.com/read/26255746/neoadjuvant-endocrine-therapy-patient-selection-treatment-duration-and-surrogate-endpoints
#1
Belinda Yeo, Mitch Dowsett
Neoadjuvant endocrine treatment has become of increasing interest for downstaging primary ER+ breast cancers as it has become clear that the pathologic complete response rate of luminal tumours to chemotherapy is much lower than that of non-luminal and differs little from that to endocrine therapy. There is much more experience in postmenopausal than premenopausal women. Aromatase inhibitors are generally the agent of choice. Responses are lower in those with the low levels of ER. While duration of endocrine treatment in clinical trials has usually been standardized at around three to four months it is clear that volume reductions continue to occur beyond that time in a large proportion of cases and routine clinical practice is often to treat to maximum response...
November 2015: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/25523063/additional-us-or-dbt-after-digital-mammography-which-one-is-the-best-combination
#2
Arlette Elizalde, Luis Pina, Jon Etxano, Pedro Slon, Romina Zalazar, Meylin Caballeros
BACKGROUND: Digital mammography (DM) is widespread used for the detection of breast cancer, but its sensitivity drops in dense breasts. It is well known that additional breast ultrasound (US) and digital breast tomosynthesis (DBT) increase the sensitivity of DM. However, to our knowledge, there are no articles comparing the role of both additional techniques. PURPOSE: To assess the diagnostic performance of DM and the different combinations of DM + additional DBT and DM + additional US in an enriched sample of patients...
January 2016: Acta Radiologica
https://www.readbyqxmd.com/read/21555689/randomized-phase-ii-neoadjuvant-comparison-between-letrozole-anastrozole-and-exemestane-for-postmenopausal-women-with-estrogen-receptor-rich-stage-2-to-3-breast-cancer-clinical-and-biomarker-outcomes-and-predictive-value-of-the-baseline-pam50-based-intrinsic
#3
RANDOMIZED CONTROLLED TRIAL
Matthew J Ellis, Vera J Suman, Jeremy Hoog, Li Lin, Jacqueline Snider, Aleix Prat, Joel S Parker, Jingqin Luo, Katherine DeSchryver, D Craig Allred, Laura J Esserman, Gary W Unzeitig, Julie Margenthaler, Gildy V Babiera, P Kelly Marcom, Joseph M Guenther, Mark A Watson, Marilyn Leitch, Kelly Hunt, John A Olson
PURPOSE: Preoperative aromatase inhibitor (AI) treatment promotes breast-conserving surgery (BCS) for estrogen receptor (ER)-positive breast cancer. To study this treatment option, responses to three AIs were compared in a randomized phase II neoadjuvant trial designed to select agents for phase III investigations. PATIENTS AND METHODS: Three hundred seventy-seven postmenopausal women with clinical stage II to III ER-positive (Allred score 6-8) breast cancer were randomly assigned to receive neoadjuvant exemestane, letrozole, or anastrozole...
June 10, 2011: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/21231986/ki67-index-changes-pathological-response-and-clinical-benefits-in-primary-breast-cancer-patients-treated-with-24-weeks-of-aromatase-inhibition
#4
Masakazu Toi, Shigehira Saji, Norikazu Masuda, Katsumasa Kuroi, Nobuaki Sato, Hiroyuki Takei, Yutaka Yamamoto, Shinji Ohno, Hiroko Yamashita, Kazufumi Hisamatsu, Kenjiro Aogi, Hiroji Iwata, Masahiro Takada, Takayuki Ueno, Shigetoyo Saji, Niramol Chanplakorn, Takashi Suzuki, Hironobu Sasano
Aromatase inhibitor shows efficacy for hormone receptor positive postmenopausal breast cancer. We evaluated the activity of 24 weeks of aromatase inhibition with exemestane for primary breast cancer in a neoadjuvant setting. Patients with stage II/IIIA invasive breast cancer with estrogen receptor (ER) and/or progesterone receptor (PgR)-positive status were eligible. Primary endpoints were objective response rate (ORR) and safety. A steroidal aromatase inhibitor exemestane of 25 mg/day was administered for 16 weeks with an 8-week extension...
April 2011: Cancer Science
https://www.readbyqxmd.com/read/19542732/-future-prospects-of-neoadjuvant-endocrine-therapy-in-postmenopausal-breast-cancer
#5
Masakazu Toi, Hironobu Sasano, Matthew J Ellis
Third-generation aromatase inhibitors(AIs)have recently overtaken tamoxifen(TAM)to play a key role in the adjuvant treatment of post-menopausal hormone receptor-positive breast cancer patients. The accumulating evidence of neoadjuvant chemotherapy is now contributing to growing interest in neoadjuvant endocrine therapy using AIs. Recent research has revealed that administration of AIs 3-4 months prior to surgery is more effective than TAM in terms of the clinical response rate and the breast-conserving surgical procedure rate...
June 2009: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/19323294/predicting-endocrine-therapy-responsiveness-in-breast-cancer
#6
REVIEW
Cynthia X Ma, Cesar G Sanchez, Matthew J Ellis
Endocrine therapy is one of the most effective treatment strategies for breast cancer. However, in the adjuvant setting, up to 40% to 50% of patients with estrogen receptor (ER)-positive breast cancers relapse despite these interventions. Although ER and HER2 analysis has increased our ability to predict which patients will benefit from endocrine therapy, further improvement is needed, most specifically for patients with ER-positive, HER2-negative disease. Recent advances in genomic technology have made it possible to classify breast cancers into risk categories with significant prognostic implications...
February 2009: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/18812550/outcome-prediction-for-estrogen-receptor-positive-breast-cancer-based-on-postneoadjuvant-endocrine-therapy-tumor-characteristics
#7
COMPARATIVE STUDY
Matthew J Ellis, Yu Tao, Jingqin Luo, Roger A'Hern, Dean B Evans, Ajay S Bhatnagar, Hilary A Chaudri Ross, Alexander von Kameke, William R Miller, Ian Smith, Wolfgang Eiermann, Mitch Dowsett
BACKGROUND: Understanding how tumor response is related to relapse risk would help clinicians make decisions about additional treatment options for patients who have received neoadjuvant endocrine treatment for estrogen receptor-positive (ER+) breast cancer. METHODS: Tumors from 228 postmenopausal women with confirmed ER+ stage 2 and 3 breast cancers in the P024 neoadjuvant endocrine therapy trial, which compared letrozole and tamoxifen for 4 months before surgery, were analyzed for posttreatment ER status, Ki67 proliferation index, histological grade, pathological tumor size, node status, and treatment response...
October 1, 2008: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/17260098/serum-prolactin-levels-are-positively-associated-with-mammographic-density-in-postmenopausal-women
#8
Gail A Greendale, Mei-Hua Huang, Giske Ursin, Sue Ingles, Frank Stanczyk, Carolyn Crandall, Gail A Laughlin, Elizabeth Barrett-Connor, Arun Karlamangla
BACKGROUND: Prolactin is a polypeptide hormone that promotes normal breast proliferation and differentiation, but it is also implicated in the development and growth of mammary tumors. Mammographic density is a strong, independent predictor of breast cancer and, therefore, a potential surrogate indicator of breast cancer risk. METHODS: To test the hypothesis that serum prolactin is positively related to mammographic density, we conducted a cross-sectional analysis of baseline data from the Postmenopausal Estrogen/Progestin Interventions (PEPI) Mammographic Density Study...
November 2007: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/16410685/sequential-treatment-with-exemestane-and-non-steroidal-aromatase-inhibitors-in-advanced-breast-cancer
#9
Gianfilippo Bertelli, Ornella Garrone, Marco Merlano, Marcella Occelli, Laura Bertolotti, Federico Castiglione, Fiorella Pepi, Ornella Fusco, Lucia Del Mastro, Robert C F Leonard
BACKGROUND: The steroidal aromatase inactivator exemestane has demonstrated activity after prior failure of non-steroidal aromatase inhibitors (including third-generation inhibitors letrozole and anastrozole) in postmenopausal women with advanced breast cancer. If exemestane is used as first anti-aromatase agent, however, it is unclear whether patients can still benefit from letrozole or anastrozole after progression. PATIENTS AND METHODS: Postmenopausal patients with advanced, hormone receptor-positive or -unknown breast cancer were eligible for this study...
2005: Oncology
https://www.readbyqxmd.com/read/16280044/positive-association-between-mammographic-breast-density-and-bone-mineral-density-in-the-postmenopausal-estrogen-progestin-interventions-study
#10
Carolyn Crandall, Shana Palla, Beth A Reboussin, Giske Ursin, Gail A Greendale
INTRODUCTION: Mammographic breast density is a strong independent risk factor for breast cancer. We hypothesized that demonstration of an association between mammographic breast density and bone mineral density (BMD) would suggest a unifying underlying mechanism influencing both breast density and BMD. METHODS: In a cross-sectional analysis of baseline data from the Postmenopausal Estrogen/Progestin Interventions Study (PEPI), participants were aged 45 to 64 years and were at least 1 year postmenopausal...
2005: Breast Cancer Research: BCR
https://www.readbyqxmd.com/read/16177147/the-association-of-endogenous-sex-steroids-and-sex-steroid-binding-proteins-with-mammographic-density-results-from-the-postmenopausal-estrogen-progestin-interventions-mammographic-density-study
#11
Gail A Greendale, Shana L Palla, Giske Ursin, Gail A Laughlin, Carolyn Crandall, Malcolm C Pike, Beth A Reboussin
Mammographic density is an independent risk factor for breast cancer. In postmenopausal women, higher levels of endogenous sex steroids are associated with an increased risk of breast cancer. Limited prior data suggest that endogenous sex steroids either are not associated (total estradiol and progesterone) or are negatively associated (free estradiol) with higher mammographic density. To analyze the associations between endogenous sex steroids and mammographic density, the authors conducted a 1998-2005 cross-sectional analysis of baseline clinical trial data from the Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial for US women who had not used hormone therapy for at least 3...
November 1, 2005: American Journal of Epidemiology
https://www.readbyqxmd.com/read/16112948/the-role-of-mammographic-density-in-evaluating-changes-in-breast-cancer-risk
#12
REVIEW
Malcolm C Pike
The Women's Health Initiative (WHI) study showed that postmenopausal continuous combined estrogen-progestogen therapy (EPT) significantly increases the risk of breast cancer, thus confirming the results from large epidemiological studies. These results were predicted approximately 15 years previously based on the epidemiology of breast cancer and the relationship of ovarian hormone levels to breast cell proliferation. However, the prediction had little effect on prescribing habits due to its theoretical nature...
July 2005: Gynecological Endocrinology
https://www.readbyqxmd.com/read/15254051/post-treatment-change-in-serum-estrone-predicts-mammographic-percent-density-changes-in-women-who-received-combination-estrogen-and-progestin-in-the-postmenopausal-estrogen-progestin-interventions-pepi-trial
#13
RANDOMIZED CONTROLLED TRIAL
Giske Ursin, Shana L Palla, Beth A Reboussin, Stacey Slone, Carol Wasilauskas, Malcolm C Pike, Gail A Greendale
PURPOSE: Postmenopausal estrogen and progestin therapy (EPT) increases mammographic percent density and breast cancer risk substantially more than does estrogen therapy alone. We determined whether increases in serum estrone as a function of treatment predict increases in mammographic percent density. METHODS: We measured mammographic percent density and serum estrone levels in participants in the Postmenopausal Estrogen/Progestin Interventions Trial who were randomly assigned to receive conjugated equine estrogens (CEE) 0...
July 15, 2004: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/11108873/progestins-and-menopause-epidemiological-studies-of-risks-of-endometrial-and-breast-cancer
#14
M C Pike, R K Ross
Estrogen replacement therapy (ERT) increases a woman's risk of developing endometrial cancer approximately 120% for each 5 years of use. ERT increases a woman's risk of developing breast cancer approximately 10% for each 5 years of use. To reduce the greatly increased endometrial cancer risk, progestins have been added to ERT (estrogen-progestin replacement therapy; EPRT) for between 5 and 15 days (usually 7 or 10 days) per month in a sequential fashion (sequential EPRT; SEPRT) or with each dose of ERT (continuous-combined EPRT; CEPRT)...
October 2000: Steroids
https://www.readbyqxmd.com/read/10068383/effects-of-estrogen-and-estrogen-progestin-on-mammographic-parenchymal-density-postmenopausal-estrogen-progestin-interventions-pepi-investigators
#15
RANDOMIZED CONTROLLED TRIAL
G A Greendale, B A Reboussin, A Sie, H R Singh, L K Olson, O Gatewood, L W Bassett, C Wasilauskas, T Bush, E Barrett-Connor
BACKGROUND: In longitudinal studies, greater mammographic density is associated with an increased risk for breast cancer. OBJECTIVE: To assess differences between placebo, estrogen, and three estrogen-progestin regimens on change in mammographic density. DESIGN: Subset analysis of a 3-year, multicenter, double-blind, randomized, placebo-controlled trial. SETTING: Seven ambulatory study centers. PARTICIPANTS: 307 of the 875 women in the Postmenopausal Estrogen/Progestin Interventions Trial...
February 16, 1999: Annals of Internal Medicine
https://www.readbyqxmd.com/read/9606612/megatrials-of-hormonal-replacement-therapy
#16
REVIEW
B G Wren
Despite the fact that estrogen replacement therapy has been demonstrated to be of great value to postmenopausal women, many patients are still reluctant to use it. This is primarily because of fears that sex hormone therapy increases the risk of developing uterine and breast cancer. Because retrospective epidemiological studies have failed to clarify the issue for breast cancer, ambitious prospective trials have been initiated to determine the role of hormones in the development of breast cancer and cardiovascular disease...
May 1998: Drugs & Aging
https://www.readbyqxmd.com/read/8837542/prevention-and-management-of-osteoporosis-consensus-statements-from-the-scientific-advisory-board-of-the-osteoporosis-society-of-canada-3-effects-of-ovarian-hormone-therapy-on-skeletal-and-extraskeletal-tissues-in-women
#17
REVIEW
R G Josse
OBJECTIVE: To present recent evidence on the use of ovarian hormone therapy (OHT) for osteoporosis and outline safe and effective regimens. OPTIONS: Estrogen alone, estrogen and progestins, progestins alone; various treatment regimens. OUTCOMES: Fracture and loss of bone mineral density in osteoporosis; increased bone mass, prevention of fractures and improved quality of life associated with OHT. EVIDENCE: Relevant clinical studies and reports, including the Nurses' Health Study and the Post-menopausal Estrogen/Progestin Interventions (PEPI) Trial, were studied with emphasis on recent prospective, randomized, controlled trials...
October 1, 1996: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/8260184/breast-conserving-treatment-of-early-breast-cancer-results-in-a-common-clinical-trial
#18
L Pirtoli, A Bellezza, F Pepi, E Tucci, M Crociani, A M Crastolla, M Farzad, M Bindi
Results of large prospective trials, often based on selected series and optimal treatment techniques, indicate that breast conserving therapy is appropriate for most patients with early breast cancer. Questions remain regarding the therapeutic outcome in common practice. We report on a series of 206 consecutive, unselected patients treated with current radiotherapy procedures. The Kaplan-Meier evaluation showed 5- and 8-year survival rates (93%, 91%), distant disease-free survival rates (87%, 85%) and local relapse-free survival rates (90%, 88%) that were comparable to those of the conservative arms in reported randomised trials and to the data from retrospective studies reported by authoritative institutions...
1993: Acta Oncologica
https://www.readbyqxmd.com/read/6840008/-monitoring-of-cardiac-function-during-doxorubicin-therapy-in-metastasized-breast-cancer-measuring-systolic-time-interval
#19
R Lenzhofer, R Dudczak, C Dittrich, G Gumhold, K Moser, K H Spitzy
Assessment of systolic time interval represents an uncomplicated, sufficiently precise and cheap possibility in clinical practice of cardiac monitoring during treatment with doxorubicin (adriamycin) if the ratio between pre-ejection period interval (PEPI) and left ventricular ejection time interval (LVETI) ("Weissler index") for evaluation of left ventricular cardiac function is used. In an investigation of 352 female patients with metastatic carcinoma of the breast statistically ascertained dose-response relationships could be established as regards electrocardiographic disorders of repolarisation and the systolic time interval (P less than 0...
May 20, 1983: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/6630285/acute-cardiac-toxicity-in-patients-after-doxorubicin-treatment-and-the-effect-of-combined-tocopherol-and-nifedipine-pretreatment
#20
R Lenzhofer, U Ganzinger, H Rameis, K Moser
In two groups of female patients with metastatic breast cancer who had all been pretreated with doxorubicin (350 mg/m2), acute cardiac effects following i.v. doxorubicin bolus injection (60 mg/m2) were recorded on the basis of systolic time intervals (STI). In six patients who received doxorubicin only the ratio between the heart-beat-corrected preejection period and left ventricular ejection time (PEPI:LVETI) as well as the PEP index were found to be significantly increased with a peak at 6 h following drug infusion (P less than 0...
1983: Journal of Cancer Research and Clinical Oncology
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