scholarly journals Inflammatory breast cancer defined: proposed common diagnostic criteria to guide treatment and research

2022 ◽  
Author(s):  
R. Jagsi ◽  
G. Mason ◽  
B. A. Overmoyer ◽  
W. A. Woodward ◽  
S. Badve ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Inflammatory Breast Cancer ◽  
Validation Studies ◽  
Scoring System ◽  
Clinical Care ◽  
Basic Research ◽  
Imaging Features ◽  
Imaging Characteristics ◽  
Quantitative Scoring

Abstract Purpose Inflammatory breast cancer is a deadly and aggressive type of breast cancer. A key challenge relates to the need for a more detailed, formal, objective definition of IBC, the lack of which compromises clinical care, hampers the conduct of clinical trials, and hinders the search for IBC-specific biomarkers and treatments because of the heterogeneity of patients considered to have IBC. Methods Susan G. Komen, the Inflammatory Breast Cancer Research Foundation, and the Milburn Foundation convened patient advocates, clinicians, and researchers to review the state of IBC and to propose initiatives to advance the field. After literature review of the defining clinical, pathologic, and imaging characteristics of IBC, the experts developed a novel quantitative scoring system for diagnosis. Results The experts identified through consensus several “defining characteristics” of IBC, including factors related to timing of onset and specific symptoms. These reflect common pathophysiologic changes, sometimes detectable on biopsy in the form of dermal lymphovascular tumor emboli and often reflected in imaging findings. Based on the importance and extent of these characteristics, the experts developed a scoring scale that yields a continuous score from 0 to 48 and proposed cut-points for categorization that can be tested in subsequent validation studies. Conclusion To move beyond subjective ‘clinical diagnosis’ of IBC, we propose a quantitative scoring system to define IBC, based on clinical, pathologic, and imaging features. This system is intended to predict outcome and biology, guide treatment decisions and inclusion in clinical trials, and increase diagnostic accuracy to aid basic research; future validation studies are necessary to evaluate its performance.

An update on inflammatory breast cancer

2011 ◽  
Vol 2 (2) ◽  
pp. 73
Author(s):  
P. Thapaliya ◽  
N. J. Karlin
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Radiation Therapy ◽  
Inflammatory Breast Cancer ◽  
Treatment Modalities ◽  
Molecular Pathways ◽  
Disease Treatment ◽  
Fatal Disease ◽  
Edge Information ◽  
Oncologic Therapy

Inflammatory breast cancer is one of the most aggressive forms of breast cancer. Once considered to be a uniformly fatal disease, treatment of this entity has evolved significantly over the last two decades. In this article, we review the epidemiology, pathology, biologic underpinnings, radiologic advances, and treatment modalities for inflammatory breast cancer. Updates in surgical therapy, medical oncologic therapy and radiation therapy are reviewed. Emphasis is on cutting edge information regarding inflammatory breast cancer. The management of inflammatory breast cancer is best served by a multidisciplinary team. Continued research into molecular pathways and potential targets is imperative. Future clinical trials should include evaluation of conventional therapy with targeted therapies.

scholarly journals Review of Metaplastic Carcinoma of the Breast: Imaging Findings and Pathologic Features

2012 ◽  
Vol 2 ◽  
pp. 21 ◽  
Author(s):  
Rebecca Leddy ◽  
Abid Irshad ◽  
Tihana Rumboldt ◽  
Abbie Cluver ◽  
Amy Campbell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Invasive Ductal Carcinoma ◽  
Breast Imaging ◽  
Ductal Carcinoma ◽  
Metaplastic Carcinoma ◽  
Imaging Features ◽  
Benign Lesions ◽  
Imaging Characteristics ◽  
Pathology Classification ◽  
Pathologic Features

Metaplastic carcinoma (MPC), an uncommon but often aggressive breast cancer, can be challenging to differentiate from other types of breast cancer and even benign lesions based on the imaging appearance. It has a variable pathology classification system. These types of tumors are generally rapidly growing palpable masses. MPCs on imaging can present with imaging features similar to invasive ductal carcinoma and probably even benign lesions. The purpose of this article is to review MPC of the breast including the pathology subtypes, imaging features, and imaging pathology correlations. By understanding the clinical picture, pathology, and overlap in imaging characteristics of MPC with invasive ductal carcinoma and probably benign lesions can assist in diagnosing these difficult malignancies.

scholarly journals OTHR-09. Accelerating Research for Breast Cancer Brain Metastasis and Leptomeningeal Disease through Patient-led Collaborations

2021 ◽  
Vol 3 (Supplement_3) ◽  
pp. iii16-iii16
Author(s):  
Christine Hodgdon ◽  
Laurie Campbell
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Metastatic Breast ◽  
Basic Research ◽  
Leptomeningeal Disease ◽  
Eligibility Criteria ◽  
Cns Metastasis ◽  
Breast Cancer Brain Metastasis

Abstract Patient-driven Initiative of the Metastatic Breast Cancer (MBC) Alliance The Breast Cancer Brain Metastasis (BCBM) Initiative: Marina Kaplan Project launched in June 2020 as an official project of the MBC Alliance which includes 32 nonprofits, 12 industry partners, and 30 individual patient advocates. The Marina Project has grown to include 35members with representation from industry, research institutions, and individual patients. Nearly one-third of the group is comprised of patients living with brain metastases or leptomeningeal disease (LMD). Disparities for Patients Living with BCBM & LMD In the US, approximately 200,000 new cases of brain metastases are diagnosed each year[1]. Approximately 10–15% of patients with MBC will develop brain metastases, and may be as high as 30–50% for certain subtypes[2]. A diagnosis of central nervous system (CNS) metastasis often accelerates an already incurable diagnosis. CNS metastasis are difficult to image and detect, tend to have poorer prognoses with lower overall survival, and are treated with invasive therapies which can have lasting side effects. Furthermore, most clinical trials exclude patients with CNS metastasis which further hinders research. Values and Objectives The overarching goal of this initiative is to accelerate the scope and breadth of evidence-based CNS metastasis research by targeting entities conducting clinical trials and collaborating with them to do the following: (i) Increase the quality and quantity of basic research; (ii) Increase the number of clinical trials in areas where research is lacking; (iii) Diversify the type of clinical trial interventions; (iv) Eliminate restrictive eligibility criteria in clinical trials; (v) Incorporate clinically meaningful trial endpoints [1] Eichler, April F et al. The biology of brain metastases-translation to new therapies. Nature reviews. Clinical oncology vol. 8,6 (2011): 344–56. doi: 10.1038/nrclinonc.2011.58 [2] Brosnan EM, Anders CK. Understanding patterns of brain metastasis in breast cancer and designing rational therapeutic strategies. Ann Transl Med. 2018;6(9):163. doi: 10.21037/atm.2018.04.35

How American oncologists treat breast cancer: an assessment of the influence of clinical trials.

1991 ◽  
Vol 9 (1) ◽  
pp. 7-16 ◽  
Author(s):  
D Belanger ◽  
M Moore ◽  
I Tannock
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Estrogen Receptor ◽  
Postmenopausal Woman ◽  
Adjuvant Chemotherapy ◽  
Inflammatory Breast Cancer ◽  
Primary Breast Cancer ◽  
Node Negative ◽  
Node Negative Breast Cancer ◽  
Estrogen Receptor Negative

The present study was designed to assess the preferred methods of treatment of breast cancer by American oncologists, and the impact of clinical trials on their practice. We mailed 465 questionnaires to surgical, radiation, or medical oncologists. The questionnaire described five hypothetic patients with breast cancer, and respondents were asked to select their preferred treatment for each patient. For primary breast cancer, most physicians would offer the choice of local excision followed by radiation therapy or modified radical mastectomy. About 80% of physicians would prescribe adjuvant chemotherapy for a premenopausal woman with estrogen receptor-negative, axillary node negative breast cancer, and for a postmenopausal woman with estrogen receptor-negative, node-positive disease. This policy was favored by male and female physicians of each specialty. Almost all respondents would treat a young woman with inflammatory breast cancer with initial chemotherapy followed by radiation and/or surgery, and about 60% would recommend chemotherapy to a postmenopausal patient with estrogen receptor-negative disease and minimally symptomatic bone metastases. Clinical trials have compared treatment strategies that could be applied to patients described in our questionnaire. Preferred treatments for primary breast cancer, and for inflammatory breast cancer are supported by the results of clinical trials. Recommendation of adjuvant chemotherapy for node-negative breast cancer is not based on a consistent demonstration of improvement in survival, although randomized trials with short follow-up have shown delay to recurrence. Recommendation of adjuvant chemotherapy for a postmenopausal woman with node-positive breast cancer is contrary to the results of large randomized controlled trials (and to a meta-analysis), which have shown that this policy does not lead to improved survival. Our report suggests that even large randomized clinical trials may have a minimal impact on practice if their results run counter to belief in the value of the treatment.

INNV-02. ACCELERATING RESEARCH FOR BREAST CANCER BRAIN METASTASIS AND LEPTOMENINGEAL DISEASE THROUGH PATIENT-LED COLLABORATIONS

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi105-vi105
Author(s):  
Christine Hodgdon
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Metastatic Breast ◽  
Basic Research ◽  
Leptomeningeal Disease ◽  
Eligibility Criteria ◽  
Cns Metastasis ◽  
Breast Cancer Brain Metastasis

Abstract PATIENT-DRIVEN INITIATIVE OF THE METASTATIC BREAST CANCER (MBC) ALLIANCE The Breast Cancer Brain Metastasis (BCBM) Initiative: Marina Kaplan Project launched in June 2020 as an official project of the MBC Alliance which includes 32 nonprofits, 12 industry partners, and 30 individual patient advocates. The project has grown to include 35 members with representation from industry, research institutions, and individual patients. Nearly one-third of the group is comprised of patients living with brain metastases or LMD. DISPARITIES FOR PATIENTS LIVING WITH BCBM & LMD In the US, approximately 200,000 new cases of brain metastases are diagnosed each year.1 Approximately 10-15% of patients with MBC will develop brain metastases, and may be as high as 30-50% for certain subtypes.2 A diagnosis of central nervous system (CNS) metastasis often accelerates an already incurable diagnosis. CNS metastasis are difficult to image and detect, tend to have poorer prognoses with lower overall survival, and are treated with invasive therapies which can have lasting side effects. Furthermore, most clinical trials exclude patients with CNS metastasis which further hinders research. VALUES & OBJECTIVES The overarching goal of this initiative is to accelerate the scope and breadth of evidence-based CNS metastasis research by targeting entities conducting clinical trials and collaborating with them to do the following: (1) Increase the quality and quantity of basic research; (2) increase the number of clinical trials in areas where research is lacking; (3) diversify the type of clinical trial interventions; (4) eliminate restrictive eligibility criteria in clinical trials; (5) Incorporate clinically meaningful trial endpoints. References Eichler, April F et al. The biology of brain metastases-translation to new therapies. Nat Rev. Clinical oncology vol. 8,6 (2011): 344-56. doi: 10.1038/nrclinonc.2011.58 Brosnan EM, Anders CK. Understanding patterns of brain metastasis in breast cancer and designing rational therapeutic strategies. Ann Transl Med. 2018;6(9):163. doi: 10.21037/atm.2018.04.35

scholarly journals Predicting Molecular Subtypes of Breast Cancer with Mammography and Ultrasound Findings: Introduction of Sono-Mammometry Score

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Sana Shaikh ◽  
Afshan Rasheed
Keyword(s):  
Breast Cancer ◽  
Immunohistochemical Analysis ◽  
Molecular Classification ◽  
Benign Tumors ◽  
Imaging Features ◽  
Breast Cancers ◽  
Breast Cancer Imaging ◽  
Resource Limited ◽  
Imaging Characteristics

We studied the correlation of sonographic and digital mammographic features with molecular classification of breast cancer. Imaging features from 313 patients with preliminary ultrasound and digital mammogram between November 2017 and May 2020 were compared with histopathology and immunohistochemical analysis for the prediction of molecular classification of breast cancer. We also devised a score called “sono-mammometry” score consisting of few simple imaging features which can easily be performed in outpatient settings. We studied that non-triple-negative breast cancers are predominantly hypoechoic and strongly correlate with the presence of irregular spiculated margins along with peripheral echogenic halo, posterior shadowing, and microcalcifications, while there is considerable variation in imaging features of TNBC as some of its imaging features overlap with those of typical benign tumors. Although imaging characteristics are helpful in the prediction of molecular classification, the prognostication value of these imaging features is still weak. There is considerable variation in imaging features which warrants vigilance towards improved diagnostic performance. To help better understand these features, our sono-mammometry score can serve as straightforward test which is assumed to be functional and productive in resource-limited settings.

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