New research was presented at SABCS 2015, the San Antonio Breast Cancer Symposium, from December 8 to 12 in San Antonio. The features below highlight some of the studies that emerged from the conference.
A Group Intervention for Obesity Among Survivors
The Particulars: Previous research has indicated that obesity increases the risk for breast cancer and poor outcomes. Endocrine therapy for breast cancer can compound the issue because of side effects like musculoskeletal pain and weight gain. Structured group interventions for obese breast cancer patients who have an abnormal lipid metabolism may be effective for obesity during adjuvant endocrine therapy.
Data Breakdown: For a study, obese breast cancer survivors who were undergoing endocrine therapy participated in a structured group intervention for 3 weeks. The once-weekly intervention consisted of 15 minutes of nutrition education, a 30-minute group health coaching program, and a 45-minute group aerobic exercise. Participants were also asked to perform the same activities at home using an instructional DVD. When comparing measurements taken at baseline with those taken after the intervention, the researchers observed significant decreases in body weight, BMI, triglyceride levels, total cholesterol levels, and fatigue.
Take Home Pearls: Short-term structured interventions for obese women with breast cancer appear to effect behavioral changes that promote health. As a result, this can lead to favorable changes in obesity, triglyceride and cholesterol levels, and cancer-related fatigue.
Breast Cancer Treatment & Fertility
The Particulars: Data are lacking on the level of information that clinicians provide to women with breast cancer regarding how their treatments for cancer may impact fertility.
Data Breakdown: For a study, women with hormone receptor (HR)-negative breast cancer tumors completed a questionnaire on gynecologic concerns before and after their diagnosis and were asked about their perceptions on the impact of treatment for the disease on fertility. Less than 50% of patients reported being informed of the impact of breast cancer treatment on their fertility, and less than 25% were referred to a reproductive medicine specialist. More than one-third of patients involved in the study decided not to become pregnant. Of the 25% who wished to become pregnant, nearly half had not received information on the impact of treatment on fertility or on fertility preservation techniques.
Take Home Pearl: About half of women with HR-negative breast cancer appear to receive adequate information on the impact of anti-cancer treatment on fertility and other gynecologic consequences.
Psychological Morbidity in Breast Cancer
The Particulars: Improved treatment options, early detection, and younger age at diagnosis have contributed to the steady increase in the number of breast cancer survivors, according to prior research. However, few studies have assessed the long-term psychological outcomes following a cancer diagnosis and the determinants of these outcomes.
Data Breakdown: Study investigators assessed anxiety and depression among survivors of non-metastatic breast cancer who had completed treatment. At an average of nearly 3 years after a breast cancer diagnosis, clinically relevant levels of anxiety and depression were reported by 22.5% and 11.2% of patients, respectively.
Several factors were predictive for anxiety and depression, including:
- Older age.
- Higher endocrine symptoms.
- Reduced functional well-being.
Take Home Pearls: More than one-third of breast cancer survivors with non-metastatic disease appear to experience depression or anxiety. Several types of patients appear to be at greatest risk for psychological morbidity. Regular screening for anxiety and depression among breast cancer survivors may help identify those in need of psychological or psychiatric care.
Statins, Cancer Recurrence, & Mortality
The Particulars: Early clinical trials have shown that statins appear to be associated with a decreased risk of breast cancer. However, few studies have described the link between statin use and survival in those with breast cancer.
Data Breakdown: A meta-analysis of eight studies assessing the association of statins with recurrence-free survival (RFS) in patients with breast cancer found that statin use improved RFS when compared with no statin use (hazard ratio, 0.66). This benefit appeared to be confined to lipophilic statin use; hydrophilic statin use did not improve RFS. In an additional meta-analysis of five studies, researchers saw no significant association between statin use and breast cancer-specific survival or overall survival.
Take Home Pearl: Statin use appears to improve recurrence-free survival among patients with breast cancer but does not appear to reduce disease-specific or overall survival.
Long-Term Recurrence in Survivors
The Particulars: Invasive breast cancer tumors of 5 cm or less can be treated in a variety of ways, including breast conservation therapy (BCT) or modified radical mastectomy (MRM). A National Cancer Institute (NCI) study randomized 237 women with pathologically confirmed invasive breast tumors of 5 cm or less to receive BCT or MRM between 1979 and 1987. Outcomes were evaluated through 25 years follow-up for most participants, but risk factors for delayed cancer recurrence at 30 years have not been explored.
Data Breakdown: For a study, researchers conducted a chart review of all patients in the aforementioned NCI study who had a new cancer diagnosis 25 to 30 years after their original breast cancer diagnosis (7.4% of patients). Among those who experienced disease recurrence during this period, 71.4% had received prior BCT. However, 33.3% of these cases were non-breast cancer in origin.
Take Home Pearls: A significant proportion of women with a history of early-stage breast cancer appear to be at risk for late cancer recurrence. Yearly monitoring with mammography and physical examinations are suggested for this patient population.