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Journal of Nuclear Medicine : Official... Feb 2016The diagnosis and management of breast cancer are undergoing a paradigm shift from a one-size-fits-all approach to an era of personalized medicine. Sophisticated... (Review)
Review
The diagnosis and management of breast cancer are undergoing a paradigm shift from a one-size-fits-all approach to an era of personalized medicine. Sophisticated diagnostics, including molecular imaging and genomic expression profiles, enable improved tumor characterization. These diagnostics, combined with newer surgical techniques and radiation therapies, result in a collaborative multidisciplinary approach to minimizing recurrence and reducing treatment-associated morbidity. This article reviews the diagnosis and treatment of breast cancer, including screening, staging, and multidisciplinary management.
Topics: Antineoplastic Agents; Breast Neoplasms; Disease Management; Female; Humans; Molecular Targeted Therapy; Neoplasm Recurrence, Local; Precision Medicine
PubMed: 26834110
DOI: 10.2967/jnumed.115.157834 -
Pathologica Apr 2022Phyllodes tumors (PT) are fibroepithelial neoplasms of the breast showing a peculiar leaf-like appearance. They account for 0.3 to 1% of all primary breast tumors and... (Review)
Review
Phyllodes tumors (PT) are fibroepithelial neoplasms of the breast showing a peculiar leaf-like appearance. They account for 0.3 to 1% of all primary breast tumors and 2.5% of all fibroepithelial breast tumors. PT are classified into benign, borderline and malignant based upon their stromal morphology with a distribution of 60%, 20%, and 20%, respectively. Malignant PT of the breast constitute an uncommon challenging group of fibroepithelial neoplasms. They have a relatively high tendency to recur, although distant metastasis is uncommon, and nearly exclusive to malignant PT. Adequate surgical resection remains the standard approach to achieve maximal local control. Giant malignant PT are rare and a pose a diagnostic dilemma for pathologists, especially when comprised of sarcomatous elements. This review highlights the morphological features of PT detected in cytology and histology specimens and discusses diagnostic pitfalls and differential diagnosis.
Topics: Breast; Breast Neoplasms; Female; Humans; Neoplasm Recurrence, Local; Neoplasms, Fibroepithelial; Phyllodes Tumor
PubMed: 35414723
DOI: 10.32074/1591-951X-754 -
Pediatric Blood & Cancer Dec 2018Breast cancer is the most common cancer of adolescents and young adult (AYA) women aged 15 to 39 years, accounting for 5.6% of all invasive breast cancer in women. In... (Review)
Review
Breast cancer is the most common cancer of adolescents and young adult (AYA) women aged 15 to 39 years, accounting for 5.6% of all invasive breast cancer in women. In comparison with older women, AYAs are more likely to have familial cancer predisposition genes, larger breast tumors, unfavorable biological characteristics, distant metastatic disease at diagnosis, and adverse outcome. Endocrine therapy and some chemotherapy recommendations differ between young and older women. AYAs require coordinated multidisciplinary care, treatment regimens that minimize late effects such as premature menopause and osteoporosis, and proactive management of psychological and sexual health during and after cancer treatment.
Topics: Adolescent; Adult; Breast Neoplasms; Female; Humans; Young Adult
PubMed: 30156052
DOI: 10.1002/pbc.27397 -
Breast Cancer (Tokyo, Japan) May 2022This systematic review aims to identify the effects of exercise interventions in patients with breast cancer (BCP) and survivors (BCS) on selected variables of physical... (Review)
Review
BACKGROUND
This systematic review aims to identify the effects of exercise interventions in patients with breast cancer (BCP) and survivors (BCS) on selected variables of physical fitness.
METHODS
A comprehensive literature search was conducted using Medline and Scopus. Randomized controlled trials with isolated exercise interventions in BCP and BCS women (< 5 years from therapy completion) were included. The risk of bias (RoB) assessment was conducted using the Cochrane RoB-2-tool. Variables regarding cardiorespiratory fitness (CRF), strength (ST), fatigue (F) and health-related quality of life (HRQoL) were discussed.
RESULTS
Of the 336 studies initially identified, 22 met all the inclusion criteria and were deemed eligible. RoB assessment indicated that the studies had predominantly "some concerns" or had "low RoB", with only 3 studies presenting a "high RoB". The mean duration and frequency of exercise interventions were 19 weeks and 3 sessions/week, performed at moderate intensity (65% VOmax and 66% 1RM, for aerobic and resistance-training interventions, respectively).
CONCLUSIONS
Exercise interventions seem to be a valuable strategy in BCP to avoid the decline of CRF, ST, F and HRQoL. Conversely, improved physical function among BCS is observed for the same variables. Resistance training and combined interventions seem to provide the most encouraging variations of the selected outcomes.
PROSPERO REGISTRATION ID
CRD42021237917.
Topics: Breast Neoplasms; Exercise; Exercise Therapy; Female; Humans; Physical Fitness; Quality of Life; Resistance Training; Survivors
PubMed: 35278203
DOI: 10.1007/s12282-022-01347-z -
Nature Reviews. Cancer Oct 2023The hormone receptor oestrogen receptor-α (ER) orchestrates physiological mammary gland development, breast carcinogenesis and the progression of breast tumours into... (Review)
Review
The hormone receptor oestrogen receptor-α (ER) orchestrates physiological mammary gland development, breast carcinogenesis and the progression of breast tumours into lethal, treatment-refractory systemic disease. Selective antagonism of ER signalling has been one of the most successful therapeutic approaches in oncology, benefiting patients as both a cancer preventative measure and a cancer treatment strategy. However, resistance to anti-oestrogen therapy is a major clinical challenge. Over the past decade, we have gained an understanding of how breast cancers evolve under the pressure of anti-oestrogen therapy. This is best depicted by the case of oestrogen-independent mutations in the gene encoding ER (ESR1), which are virtually absent in primary breast cancer but highly prevalent (20-40%) in anti-oestrogen-treated metastatic disease. These and other findings highlight the 'evolvability' of ER breast cancer and the need to understand molecular processes by which this evolution occurs. Recent development and approval of next-generation ER antagonists to target ESR1-mutant breast cancer underscores the clinical importance of this evolvability and sets a new paradigm for the treatment of ER breast cancers.
Topics: Humans; Female; Breast Neoplasms; Drug Resistance, Neoplasm; Estrogens; Signal Transduction
PubMed: 37500767
DOI: 10.1038/s41568-023-00604-3 -
The Oncologist May 2018Chemotherapy has been the historical mainstay of treatment for patients with breast cancer, with immunohistochemical markers and tumor characteristics driving treatment... (Review)
Review
PURPOSE
Chemotherapy has been the historical mainstay of treatment for patients with breast cancer, with immunohistochemical markers and tumor characteristics driving treatment decisions. The discovery of different intrinsic subtypes of breast cancer has advanced the understanding of breast cancer, with gene-based assays shedding further light on tumor behavior and response to treatment.
DESIGN
This review focuses on the landscape of the luminal A subtype, its definition based on immunohistochemistry (IHC) and gene assays, the prognostic and predictive value of these assays, guideline recommendations, and treatment implications.
RESULTS
Clinical studies of the prognostic value of gene-based and IHC-based assays in patients with luminal A-subtype breast cancers suggest a better prognosis for these patients compared with those with breast cancers of other subtypes.
CONCLUSION
In today's era of precision medicine, the best treatment regimen for patients with luminal A-subtype tumors is still undetermined, but available data raise the question whether chemotherapy can be omitted and endocrine therapy alone is sufficient for this patient population.
IMPLICATIONS FOR PRACTICE
Immunohistochemical markers have traditionally guided treatment decisions in breast cancer. However, advances in gene-expression profiling and availability of gene-based assays have launched these newer tests into everyday clinical practice. Luminal A-subtype tumors are a unique subset that may have favorable tumor biology. Properly defining this tumor subtype is important and may identify a subset of patients for whom endocrine therapy alone is sufficient.
Topics: Breast Neoplasms; Female; Humans; Immunohistochemistry
PubMed: 29472313
DOI: 10.1634/theoncologist.2017-0535 -
British Journal of Cancer Feb 2022Breast cancer accounts for 25% of the cancers in women worldwide. The most common subtype of breast cancer diagnosed is hormone receptor positive, which expresses the... (Review)
Review
Breast cancer accounts for 25% of the cancers in women worldwide. The most common subtype of breast cancer diagnosed is hormone receptor positive, which expresses the oestrogen receptor (ER). Targeting of the ER with endocrine therapy (ET) is the current standard of care for ER-positive (ER+) breast cancer, reducing the mortality by up to 40%. Resistance to ET, however, remains a major issue for ER + breast cancer, leading to recurrence and metastasis. One major driver of ET resistance is mutations in the ER gene (ESR1) leading to constitutive transcriptional activity and reduced ET sensitivity. These mutations are particularly detrimental in metastatic breast cancer (MBC) as they are present in as high as 36% of the patients. This review summarises the pre-clinical characterisation of ESR1 mutations and their association with clinical outcomes in MBC and primary disease. The clinically approved and investigational therapeutic options for ESR1 mutant breast cancer and the current clinical trials evaluating ESR1 mutations and ET resistance are also discussed. Finally, this review addresses pre-clinical models and multi-'omics' approaches for developing the next generation of therapeutics for ESR1 mutant and ET-resistant breast cancer.
Topics: Breast Neoplasms; Drug Resistance, Neoplasm; Estrogen Receptor alpha; Female; Humans; Molecular Targeted Therapy; Mutation; Neoplasm Metastasis
PubMed: 34621045
DOI: 10.1038/s41416-021-01564-x -
Pathologica Mar 2020The World Health Organization's new classification of breast tumors has just been published. This review aims to examine the morphological categorization of breast... (Review)
Review
The World Health Organization's new classification of breast tumors has just been published. This review aims to examine the morphological categorization of breast carcinomas which is still principally based on histological features and follows the traditions of histological typing. It gives a subjective and critical view on the WHO classifications and their changes over time, and describes the changes related to some of the most common or challenging breast carcinomas: in situ carcinomas, invasive breast carcinomas of no special type, lobular, cribriform, tubular, mucinous, papillary, metaplastic carcinomas and carcinomas with medullary pattern and those with apocrine differentiation are discussed in more details. Although the 5 edition of the classification is not perfect, it has advantages which are mentioned along with problematic issues of classifications.
Topics: Breast Neoplasms; Humans; Neoplasm Grading; Time Factors; World Health Organization
PubMed: 32202537
DOI: 10.32074/1591-951X-1-20 -
Polski Przeglad Chirurgiczny Dec 2020<br><b>Introduction:</b> Fibroadenomas are one of the most common benign tumors of the breast in the adolescent females accounting for about... (Review)
Review
<br><b>Introduction:</b> Fibroadenomas are one of the most common benign tumors of the breast in the adolescent females accounting for about 2/3<sup>rd</sup> of all the breast lumps and more than half of all the biopsied breast lesions. They come into being due to overgrowth of glandular tissue under the influence of hormonal changes that the girls undergo at the time of puberty. Due to the wide prevalence of fibroadenomas and the psychosocial morbidity associated with the finding of a breast mass, it is imperative for physicians treating adolescent patients to be thoroughly familiar and updated with this disease. <br><b>Aim:</b> The article aims at providing a brief review of the classification, presentation, diagnosis, and update on the management of breast fibroadenomas on the basis of recent literature.
Topics: Adolescent; Adolescent Health; Breast Neoplasms; Female; Fibroadenoma; Humans
PubMed: 33729177
DOI: 10.5604/01.3001.0014.5676 -
Breast Cancer Research : BCR Jan 2021Invasive lobular carcinoma (ILC) is the most common of the breast cancer special types, accounting for up to 15% of all breast cancer cases. ILCs are noted for their... (Review)
Review
Invasive lobular carcinoma (ILC) is the most common of the breast cancer special types, accounting for up to 15% of all breast cancer cases. ILCs are noted for their lack of E-cadherin function, which underpins their characteristic discohesive growth pattern, with cells arranged in single file and dispersed throughout the stroma. Typically, tumours are luminal in molecular subtype, being oestrogen and progesterone receptor positive, and HER2 negative. Since last reviewing the lobular literature (McCart Reed et al., Breast Cancer Res 17:12, 2015), there has been a considerable increase in research output focused on this tumour type, including studies into the pathology and management of disease, a high-resolution definition of the genomic landscape of tumours as well as the evolution of several potential therapeutic avenues. There abounds a huge amount of new data, which we will review herein.
Topics: Biomarkers, Tumor; Breast Neoplasms; Carcinoma, Lobular; Diagnosis, Differential; Disease Progression; Disease Susceptibility; Drug Resistance, Neoplasm; Female; Gene Expression; Genomics; Humans; Mutation; Neoplasm Grading; Neoplasm Staging; Phenotype; Prognosis; Tumor Microenvironment
PubMed: 33413533
DOI: 10.1186/s13058-020-01384-6