Triple Negative Metastatic Breast Cancer

Triple negative (TNBC) metastatic breast cancer is a heterogeneous disease, chemotherapy remains the mainstay of treatment, however, new treatments based on identifying molecular subtypes, stratifying TNBC based on gene expression assays with subsequent specific targeted therapy is an area of intense clinical research. In this post, I will review our current standard clinical practice and explore ongoing and future clinical directions.

Metastatic TNBC is very heterogenous, and while Basal type is most common, it only account for nearly 80% of all cases.

 

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Breast Cancer Neoadjuvant Therapy Part 2/3

Neoadjuvant therapy was discussed in a prior post, in this post I will discuss the following items

  • Patient evaluation throughout neoadjuvant therapy.
  • Treatment modalities in neoadjuvant therapy.
  • Special patient subgroups.
  • Management of the axilla.

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Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer

The standard of care for evaluating the axilla in breast cancer is sentinel lymph node biopsy. For patients who happen to have positive lymph node involvement by sentinel lymph node biopsy, additional treatment of the axilla is necessary. Proceeding with total axillary lymph node dissection (ALND)while effective is associated with significant morbidity and may not be needed in all patients with positive sentinel lymph node biopsy. The AMAROS trial came to provide a needed answer, ” Can axillary radiation therapy to the axilla in a specific subset of patients with positive sentinel lymph node be done in place of ALND?”

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Advances in the treatment of advanced estrogen receptor positive breast cancer

Luminal estrogen receptor positive HER-2 negative breast cancer is the common type of breast cancer, accounting for 70%  of all breast cancer. Endocrine therapy of estrogen receptor positive HER2 negative advanced breast cancer is very effective, however, many patients will have disease recurrence as a result of endocrine therapy emerging resistance. In this post, I will review our recent understanding of resistance mechanisms how this understanding translating into new therapies.

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