Skip to main content

Research Repository

Advanced Search

When the World Throws You a Curve Ball: Lessons Learned in Breast Cancer Management

Obeng-Gyasi, Samilia; Coles, Charlotte E.; Jones, Jade; Sacks, Ruth; Lightowlers, Sara; Bliss, Judith M.; Brunt, A. Murray; Haviland, Joanne S.; Kirby, Anna M.; Kalinsky, Kevin

Authors

Samilia Obeng-Gyasi

Charlotte E. Coles

Jade Jones

Ruth Sacks

Sara Lightowlers

Judith M. Bliss

Joanne S. Haviland

Anna M. Kirby

Kevin Kalinsky



Abstract

In the care of patients with operable breast cancer, there has been a shift toward increasing use of neoadjuvant therapy. There are benefits to neoadjuvant therapy, such as monitoring for response, as well as an increased rate of breast conservation and reduction of potential morbidity associated with breast surgery, including axillary management. Among patients with highly proliferative tumors, such as HER2-positive or triple-negative breast cancer, those with residual disease are at higher risk of recurrence, which informs the recommended systemic therapy in the adjuvant setting. For instance, in patients with residual disease after neoadjuvant chemotherapy and HER2-targeted therapy, there is a role for adjuvant trastuzumab emtansine for those with residual disease at the time of surgery. The same holds true regarding the role of adjuvant capecitabine in patients with residual disease after neoadjuvant chemotherapy. With the added complexities of treating patients in the era of the COVID-19 outbreak, additional considerations are critical, including initiation of surgery within an appropriate time from completion of neoadjuvant therapy. National consensus guidelines on time to surgery must be developed to improve measurement and comparison across systems. In addition, there is emerging radiation treatment management research addressing a number of factors, including hypofractionation, role of proton beam therapy, safe omission of radiotherapy, and preoperative radiotherapy with or without drug combination. In this article, the multidisciplinary approach of treating patients with operable breast cancer is highlighted, with updates and future considerations described.

Citation

Obeng-Gyasi, S., Coles, C. E., Jones, J., Sacks, R., Lightowlers, S., Bliss, J. M., …Kalinsky, K. (2021). When the World Throws You a Curve Ball: Lessons Learned in Breast Cancer Management. American Society of Clinical Oncology educational book, 41(41), e79-e89. https://doi.org/10.1200/edbk_320691

Journal Article Type Article
Acceptance Date Mar 12, 2021
Online Publication Date May 6, 2021
Publication Date 2021-06
Journal American Society of Clinical Oncology Educational Book
Publisher American Society of Clinical Oncology
Peer Reviewed Peer Reviewed
Volume 41
Issue 41
Pages e79-e89
DOI https://doi.org/10.1200/edbk_320691
Keywords General Medicine
Publisher URL https://ascopubs.org/doi/10.1200/EDBK_320691