Samilia Obeng-Gyasi
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
Charlotte E. Coles
Jade Jones
Ruth Sacks
Sara Lightowlers
Judith M. Bliss
Professor Adrian Brunt m.brunt@keele.ac.uk
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 |
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