Missouri has a high breast cancer mortality rate, as well as high rates of type 2 diabetes, cardiovascular disease (CVD), and hypertension, which present more often in individuals who are poor, those living in rural areas, African Americans, and older adults. Women with comorbidities at the time of breast cancer diagnosis may have a worse prognosis, so researchers assessed survival disparities among these patient populations. According to the findings presented at the San Antonio Breast Cancer Symposium on December 5, 2018, comorbidities can negatively impact overall breast cancer survival.

Chemotherapy-induced nausea and vomiting (CINV) can negatively affect nutritional intake, ability to work, and treatment adherence. Research suggests that younger age and female gender are the strongest predictors of CINV, but those may not be the only factors, particularly for delayed nausea, according to research findings presented at the San Antonio Breast Cancer Symposium on December 5, 2018.

Circulating tumor cells (CTCs) are identified in 20%–25% of patients with nonmetastatic breast cancer, and recent research suggests that detection of CTCs at five-year follow-up may predict late recurrence for nonmetastatic, estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2–) breast cancer. In a study presented at the San Antonio Breast Cancer Symposium on December 6, 2018, researchers from the University of Texas MD Anderson Cancer Center found that the presence of CTCs in patients with nonmetastatic breast cancer was associated with shortened relapse-free survival (RFS), regardless of the subtype.

Patient education can improve interactions with their healthcare team and provide coping mechanisms for the psychosocial effects of metastatic breast cancer, according to study findings presented at the San Antonio Breast Cancer Symposium on December 8, 2018.

Throughout the course of treatment, patients with breast cancer receive a significant amounts of information from their healthcare team. Researchers at the University of Colorado School of Medicine assessed and revamped the educational materials from the facility’s Memorial Radiation Oncology Department to achieve a patient comprehension of key treatment-related concepts of 75%. They found that although some educational concepts remained unmemorable or improperly emphasized, overall trends in comprehension indicated that a patient-tailored approach led to better satisfaction and outcomes, according to the findings presented at the San Antonio Breast Cancer Symposium on December 8, 2018.

Trastuzumab can improve disease-free survival (DFS) and overall survival (OS) in patients with human epidermal growth factor receptor 2-positive (HER2+) breast cancer. Although some studies suggest that short-term treatment (less than one year) may reduce cardiac toxicity and cost without compromising outcomes, the results of a new study presented at the San Antonio Breast Cancer Symposium on December 8, 2018, disagree.

Researchers from the University of Colorado Denver Young Women Breast Cancer Translational Program in Aurora identified a potential triplet combination for the treatment of hormone receptor-positive (HR+) human epidermal growth factor receptor 2-positive (HER2+) breast cancer: HER2-targeted small molecule inhibitor tucatinib, CDK4/6 inhibitor palbociclib, and selective estrogen receptor blocker fulvestrant. They presented the findings at the San Antonio Breast Cancer Symposium on December 7, 2018.

The Centers for Medicare and Medicaid Services (CMS) implemented an oncology outcome measure to assess the quality of care and determine outpatient hospital payment (OP-35: Admissions and Emergency Department Visits for Patients Receiving Outpatient Chemotherapy). The measure assesses 30-day postchemotherapy rates of inpatient or emergency department (ED) events deemed “potentially avoidable” because of an association with any of the 10 CMS-defined toxicities: anemia, dehydration, diarrhea, fever, nausea, emesis, neutropenia, pain, pneumonia, or sepsis. Researchers sought to assess those events when linked to highly emetogenic chemotherapy (HEC) in patients treated with anthracycline plus cyclophosphamide (AC), carboplatin, or cisplatin. They presented the findings at the San Antonio Breast Cancer Symposium on December 7, 2018.

Many women discontinue adjuvant endocrine therapy (AET) because of adverse events (AEs), and only half remain adherent at five years. Researchers from the University of Southern California, Los Angeles, found that continued social support for those women may improve AET adherence. They presented the findings at the San Antonio Breast Cancer Symposium on December 7, 2018.

Racial and regional disparities impact the incidence of, mortality from, and survival from breast cancer, but the role of other socioeconomic factors is unclear. Researchers from Fudan University in Shanghai, China, conducted a large study and found that marital status, insurance status, median household income, and residence also contribute to survival from nonmetastatic breast cancer. They presented the findings at the San Antonio Breast Cancer Symposium on December 7, 2018.

Magnetic resonance imaging (MRI) can help diagnose breast cancer, but it is costly. Leadership at the University of Washington in Bellingham developed a protocol to improve the timeliness of care, moving the time of MRI prior to surgeon evaluation, and found that it led to enhanced patient care, eliminated delays in treatment, avoided unnecessary tests, shifted appropriate care to primary-care providers, and provided all necessary data prior to initial surgical consultation. They presented the findings at the San Antonio Breast Cancer Symposium on December 7, 2018.

Patient-reported outcomes (PROs) can improve patient satisfaction and potentially impact survival. However, PRO data are not well-collected outside of the research setting. Researchers at the Yale School of Medicine in New Haven, CT, conducting qualitative study assessed the most personally relevant PROs in women with metastatic breast cancer and observed substantial variation in patient preferences. They presented the findings at the San Antonio Breast Cancer Symposium on December 7, 2018.

Current treatment guidelines recommend sequential hormone therapy for patients with hormone receptor-positive (HR+) metastatic breast cancer who are not in visceral crisis and whose disease is not refractory to endocrine treatment. Second-line fulvestrant monotherapy is a treatment option for patients in whom disease progresses after first-line palbociclib. Researchers used real-world data to evaluate the time to treatment discontinuation (TTD) of second-line fulvestrant in patients with HR+ human epidermal growth factor receptor 2-negative (HER2–) metastatic breast cancer who did (n = 88) and did not (n = 100) receive first-line palbociclib and found it was shorter in patients who received palbociclib. They presented the findings at the San Antonio Breast Cancer Symposium on December 7, 2018.

Triple-negative breast cancer tumors are thought to be more immunogenic than other breast cancer subtypes, such as luminal A/B or human epidermal growth factor receptor 2-positive (HER2+) tumors. Among all breast cancers, tumors appear more commonly in the upper outer quadrant. However, it is not clear whether expression of immune response genes vary with tumor location among the different subtypes. Researchers assessed gene expression associated with immune response pathways to identify potential treatment targets and presented the findings at the San Antonio Breast Cancer Symposium on December 6, 2018.

Intratumor heterogeneity can lead to cancer progression, and tumors with the highest levels of heterogeneity may be more likely to progress. Researchers compared mutational loads from separate areas of pure ductal carcinoma in situ (DCIS) to genetic heterogeneity in DCIS lesions that coexist with invasive cancer and presented the findings at the San Antonio Breast Cancer Symposium on December 6, 2018.

Genetic testing during treatment can improve accuracy of response and outcome prediction compared to other prognostic tests, according to results from a study assessing on-treatment changes in gene expression in patients receiving chemotherapy. Researchers from Oikonomidou O Institute of Genetics and Molecular Medicine in Edinburgh, United Kingdom, presented the findings at the San Antonio Breast Cancer Symposium on December 6, 2018.

Few women with metastatic breast cancer live five years or longer, and predictors of long-term survival are not well understood. Researchers from the University of Pittsburgh Medical Center (UPMC) in Pennsylvania identified demographic- and disease-specific factors related to survival and presented their findings at the San Antonio Breast Cancer Symposium on December 6, 2018.

Current guidelines recommend asymptomatic surveillance of breast cancer only for the detection of locoregional recurrences. Researchers from the Asan Medical Center in Seoul, Republic of Korea, conducted a retrospective 10-year survival analysis of a large cohort of patients with recurrent breast cancer to identify the impact of early detection on survival outcomes and presented the findings at the San Antonio Breast Cancer Symposium on December 5, 2018.

Access to quality breast cancer screening and treatment may contribute to racial disparities outcomes. In 2016, researchers at the urban safety net Cook County Health and Hospitals System in Chicago, IL, implemented changes in mammography practices, which included installing digital machines at one of four sites, centralizing reading of images at a single site with radiologists specialized in mammography, and increasing care coordination such as enhanced patient outreach efforts. The efforts improved screening volume and cancer detection, according to the results presented at the San Antonio Breast Cancer Symposium on December 5, 2018.

Surgical modality and receipt of chemotherapy or radiotherapy are not associated with sexual function, as measured by the Female Sexual Function Index (FSFI). Patients receiving endocrine therapy with an aromatase inhibitor had significantly lower sexual function scores than those who received no endocrine therapy or those on tamoxifen, said a group of U.S. researchers who presented their findings during a poster session on Saturday, December 10, at the San Antonio Breast Cancer Symposium.

The uptake of prophylactic surgeries among Latinas with germline BRCA mutations may be slightly lower than what has been reported in non-Hispanic whites but higher than in African Americans, a group of U.S. researchers said. They presented their findings on Saturday, December 10, during a poster session at the San Antonio Breast Cancer Symposium.

Exercise—preferably supervised—represents a viable intervention for prevention and treatment of fatigue among patients with breast cancer, a group of Australian, European, and U.S. researchers said. They presented their findings during a poster session on Saturday, December 9, during the San Antonio Breast Cancer Symposium.

The presence of type 2 diabetes mellitus at the time of breast cancer diagnosis has been suggested to adversely affect survival—independent of breast cancer stage, grade, and tumor phenotype—but few of those studies included people of Hispanic descent. Researchers from Johns Hopkins Bloomberg School of Public Health in Baltimore and the University of Louisville in Kentucky examined the association between self-reported diabetes history, breast cancer-specific and all-cause mortality among Hispanic and non-Hispanic white women diagnosed with breast cancer. They presented their results on Saturday, December 9, during a poster session at the San Antonio Breast Cancer Symposium.

Ongoing and increasing evidence suggest that an equivalent rate of mutations may be found regardless of whether patients meet current testing criteria, according to a large group of community breast physicians. They presented their findings on Friday, December 8, during a poster session at the San Antonio Breast Cancer Symposium.

Metabolic syndrome is associated with increased risk of cardiovascular disease, type 2 diabetes, and possibly cancer recurrence, and its occurrence is higher in breast cancer survivors than age-matched postmenopausal women. Now, a study on exercise has found that aerobic and resistance exercise intervention reduced metabolic syndrome in sedentary, overweight, and obese Hispanic breast cancer survivors. U.S. researchers presented their findings during a poster session on Friday, December 8, at the San Antonio Breast Cancer Symposium.

Significantly higher rates of death are found in Medicaid and uninsured hospital admissions when compared to Medicare-enrolled admissions with breast cancer, suggesting that insurance status “appears to play a crucial role in patient outcomes.” Researchers with Drexel University in Philadelphia presented their findings on Friday, December 8, during a poster session at the San Antonio Breast Cancer Symposium.

Patients with breast cancer who are younger than 40 years are likely to have unfavorable subtypes, higher stage, and lower overall survival and disease-free survival (DFS) as compared to their older counterparts, according to researchers at the Roswell Park Cancer Institute in Buffalo, NY. They presented their findings on Friday, December 8, during the San Antonio Breast Cancer Symposium. 

Vitamin D deficiency is associated with the inability to reach pathologic complete response (pCR) in patients with breast cancer undergoing neoadjuvant systemic chemotherapy (NAC), and a trend for worse survival was seen in patients with triple negative tumors. Results from an analysis were presented on Thursday, December 7, during a poster session at the San Antonio Breast Cancer Symposium (SABCS).

Whole breast radiation therapy in isocentric lateral decubitus position is well tolerated with good cosmesis and low rates of fibrosis, said a group that had previously confirmed the efficacy and safety of the technique. Researchers from the Institut Curie in Paris presented their results during a poster session on Thursday, December 7, at the San Antonio Breast Cancer Symposium.

A group of German researchers attempting to identify predictors for a decision against an antihormonal treatment (AHT) were unable to show that patients benefited from chemotherapy. They presented their results on Thursday, December 7, during a poster session at the San Antonio Breast Cancer Symposium.

The first study on the mutational landscape of breast cancer diagnosed during pregnancy (BCP) using whole-genome sequencing found that BCP is associated with a higher number of putative driver mutations, including mutations in mucin genes. Researchers presented their findings on Thursday, December 7, during a poster session at the San Antonio Breast Cancer Symposium.

Researchers from Johns Hopkins University in Baltimore have found that adding the histone deacetylase inhibitor entinostat (ENT) to checkpoint inhibition decreases tumor burden and improves survival in human epidermal growth factor receptor 2 (HER2)-positive breast cancer models. The findings were reported during the San Antonio Breast Cancer Symposium on Wednesday, December 6.

The novel combination of estrogen receptor (ER) coregulator binding modulator (ERX-11) and palbociclib may delay, or even overcome, endocrine therapy resistance in women with ER-positive advanced breast cancer, according to a group of researchers from the University of Texas (UT) Healthcare System. They reported their findings during the San Antonio Breast Cancer Symposium on Wednesday, December 6.

Women with high-risk, early-stage breast cancer see no improvement in disease-free survival (DFS) or overall survival (OS) after five years of adjuvant bisphosphonate treatment compared with just two years of treatment, according to SUCCESS A, a phase III study. European researchers presented these findings during the San Antonio Breast Cancer Symposium on Wednesday, December 6.

Despite interventions to bridge the gap in cancer disparities between African American and white women, racial disparities in breast cancer mortality exist. The National Cancer Institute reported that African American women have a higher mortality rate from breast cancer as compared to Caucasian women (33.8 versus 25.0, respectively).

Researchers from Memorial Sloan Kettering Cancer Center in New York, NY, suggested that for women with locoregional recurrence (LRR) of breast cancer, contralateral axillary metastases should be treated aggressively for cure after excluding distant metastases. Challenges of and best practices for managing LRR was discussed at an education session during the San Antonio Breast Cancer Symposium on Tuesday, December 5.

Researchers from the University of Texas (UT) Health San Antonio have found that providing Latinas with breast cancer with a bilingual, bicultural patient navigator can improve access to care and reduce treatment delays. The researchers presented their findings during the San Antonio Breast Cancer Symposium on Tuesday, December 5.

Targeted and endocrine therapy combination results in concordant, superior progression-free survival (PFS), suggesting similar mechanisms of targetable endocrine resistance between metastatic sites, according to a meta-analysis by researchers with the Albacete University Hospital in Spain presented on Saturday, December 10, during the San Antonio Breast Cancer Symposium.

Older adults with a breast cancer diagnosis often undergo surgery, but fewer than 50% have adjuvant treatment with endocrine therapy, radiation therapy, or chemotherapy, according to findings from researchers with Morton Plant Mease Hospitals in Clearwater, FL, presented on Friday, December 9, at the San Antonio Breast Cancer Symposium.

Whether body mass index (BMI) is associated with an increased risk of breast cancer is dependent on age and is not altered by menopausal status or by genetic factors, according to an analysis of 11,700 participants (5,400 families) already enrolled in the Breast Cancer Family Registry (in North America and Australia) and the Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer (in Australia). The international group of researchers presented their findings on Friday, December 9, at the San Antonio Breast Cancer Symposium.

The more researchers learn about breast cancer susceptibility genes, the more personalized treatment can become, said Fergus J. Couch, PhD, who presented the AACR Outstanding Investigator Award for Breast Cancer Research on Friday, December 9, during the San Antonio Breast Cancer Symposium. Women with one or more first-degree female relatives with a history of breast cancer have a two-fold increased risk of developing breast cancer, and those risks continue to escalate with the number of affected family members and whether those family members were diagnosed at a young age or with bilateral disease.

No delays in treatment initiation occur in adolescent and young adult (AYA) women with breast cancer in urban settings, and there does not seem to be any significant differences between African American or other races in terms of treatment initiation.

In the United States, adriamycin/cyclophosphamide/paclitaxel/trastuzumab (ACTH) and docetaxel/carboplatin/trastuzumab (TCH) have been widely adopted as systemic adjuvant therapy of human epidermal growth factor receptor 2-positive (HER2+) breast cancer and remain the standard of care for many women with early-stage HER2+ disease. However, no head-to-head comparison of these regimens has been conducted in a clinical trial, and current clinical trial data have limited generalizability because of the exclusion of older women and the low representation of minorities and those with significant comorbidities. Researchers at the University of North Carolina, Chapel Hill, presented their new head-to-head results on Friday, December 9, during the San Antonio Breast Cancer Symposium.

MicroRNAs are important regulators of cellular function and are associated with aging and cancer, but not much is known about chemotherapy’s on them. Recently, a group of European researchers found that adjuvant chemotherapy does not significantly boost aging progression in older adults with breast cancer. They presented on Friday, December 9, during the San Antonio Breast Cancer Symposium about the predictive role of microRNAs in determining the decline in functionality and quality of life, toxicity, and unexpected hospitalization during or after chemotherapy.

Scientists and those treating breast cancers already know a deleterious mutation in BRCA1 or BRCA2 greatly increases the lifetime risk of developing breast cancer, but until recently it remained unclear whether a correlation between lifestyle and breast cancer existed. A group of Irish researchers has now found unhealthy lifestyles may be a significant contributing factor to the increased penetrance of BRCA1 and BRCA2 mutations. They presented their results on Thursday, December 8, during the San Antonio Breast Cancer Symposium.

Breast cancers contain cells that act and behave in a similar manner to stem cells, and these cancer stem cells (CSCs) bring about metastasis and contribute to treatment resistance.

More than 25% of patients with locally advanced breast cancer (LABC) will relapse during their first five years after treatment, but Canadian researchers have developed a viable list of five risk factors that may predict relapse after neoadjuvant therapy. The University of Ottawa researchers presented the results of their analyses on Thursday, December 8, during the San Antonio Breast Cancer Symposium, noting that several other groups have also researched prediction tools.

If circulating tumor DNA (ctDNA) can be detected in an adjuvant setting after both surgery and chemotherapy for early-stage breast cancer, patients are at high risk of early relapse, according to a proof-of-principle study. Researchers with the Institute of Cancer Research in London presented their results of their longer follow-up series on Wednesday, December 7, during the San Antonio Breast Cancer Symposium.