Calling all TNs
Comments
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No Heidi, I don't know Cheryl. Maybe I should look her up and ride with her this spring!
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Good Grief Claire... where is this at?! I'm in Ohio and we got ice, but honestly the highways are dry and wet now.
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Heidi etc: So glad you raised this. I admit it - I kinda resent other people's good health. It bugs me that close friends of ours smoke and drink way too excess and so far are very healthy - not that I wish them ill at all, I just want to shake them and say, "take care of yourself, don't take your health for so friicking granted..." Maybe I'm grieving my lost former "life." I get angry when a circle of women I know go on and on about the shape of their boobs, or the state of their hair - I don't expect people to walk on eggshells around me and edit what they say, but it seems insensitive. Maybe I just wish the life lesson I learned about what's truly important would be learned by them through osmosis or something... I would like to have that power or something... but I guess you gotta live (through) it to get it.0
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cc - connecticut - i've never seen this much snow -roofs are collapsing, school is cancelled
its been a nightmare - ice and sleet due tonight
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Heidi - remember you are just as healthy as those others. We have cancer, but we are nevertheless healthy as a horse, I know I am and I am sure you are too. That is why I don't understand what the hell Cancer is, when I feel so good. Believe me it is the weather which is making everyone feel blue. Over here in California, the weather is absolutely, breathtakenly beautiful today, so I feel like my old self. There is no cancer on my mind, it is as if I am just dealing with medical appointments. So hang in there for just a bit longer, Spring will bring tons of joy again. It is just a disease, just like other diseases, let it pass on. Our bodies are resilient and it will fight this just as fights virusus and bacteria.
Kelben - fight it girl, no matter how many times it comes. Have a no care attitude. I know I am doing that now, to fu*k with the damn disease. Honestly, I have a lot of swear words in my vocabulary nowadays, and I am loving it.
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I'm hoping my recurring funk is weather related but I also appear to have sprained a rib muscle doing barnwork, my knee is acting up again (after riding the past two days--- I will probably elect to do the surgery) and my neck is chronically stiff with almost zero range-of-motion to the left.
So, my former super athletic, "I am invincible" self is being put sorely to the test. That and a few other personal issues I won't go into. I hate the "new" me because, well, I feel... old.
It has to get better when sailing season comes around again because I am like Ratty in Wind in the Willows: a real water rat.
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Magnetic Resonance Imaging Response Monitoring of Breast Cancer During Neoadjuvant Chemotherapy: Relevance of Breast Cancer Subtype
J Clin Oncol. 2011 Jan 10;[Epub Ahead of Print], CE Loo, ME Straver, S Rodenhuis, SH Muller, J Wesseling, MJ Vrancken Peeters, KG Gilhuijs
This study looked at patient response to neoadjuvant chemotherapy as monitored by MRI; response can be interpreted only if the cancer subtype is known as MRI changes are predictive in triple-negative and...
TAKE-HOME MESSAGEThis study looked at patient response to neoadjuvant chemotherapy as monitored by MRI; response can be interpreted only if the cancer subtype is known as MRI changes are predictive in triple-negative and HER2-positive subtypes only.SUMMARYOncologySTAT Editorial TeamBreast cancer is a heterogeneous disease. Subtypes differ in treatment outcome based, in part, on hormone receptor (estrogen receptor [ER]; progesterone receptor [PR]) and human epidermal growth factor receptor 2 (HER2) status. Subtypes may be classified as triple-negative (ER, PR, and HER2 negative), HER2-positive (ER and PR positive or negative), and ER-positive (HER2 negative, PR positive or negative). Chemotherapy response varies within these subtypes; therefore, monitoring may identify nonresponding tumors. Dynamic contrast-enhanced magnetic resonance imaging (MRI) differentiates between residual tumor and nonvascularized therapy-induced fibrosis, and may be used to identify residual tumor after completion of neoadjuvant chemotherapy. This study evaluated the differences among breast cancer subtypes on MRI markers for disease response to neoadjuvant chemotherapy. Patients were offered neoadjuvant chemotherapy if they had pathologically proven invasive breast cancer > 3 cm and/or ≥ one tumor-positive lymph node. Patients were included who received two MRI examinations, one before and a second during neoadjuvant chemotherapy, and who underwent surgery after neoadjuvant chemotherapy. Excluded were patients with HER2-positive breast cancer who did not receive trastuzumab. Patients with HER2-negative tumors received six courses of cyclophosphamide and doxorubicin every 2 weeks; some patients received six courses of capecitabine and docetaxel or doxorubicin and docetaxel. Chemotherapy regimens were switched if no or little response was noted after three courses. Patients with HER2-positive tumors received trastuzumab plus paclitaxel and carboplatin (8-week course) followed by trastuzumab, paclitaxel, and carboplatin (two 8-week courses) or trastuzumab plus fluorouracil, epirubicin, and cyclophosphamide (4 courses). Patients underwent mastectomy or breast-conserving therapy following chemotherapy. MRI with gadolinium-containing contrast medium on a T1 sequence was performed using a 1.5-T or 3.0-T scanner before and during neoadjuvant chemotherapy. MRI interpretation was blinded.A total of 188 patients were included. Most patients (55%) had ER-positive/HER2-negative tumors; the remaining patients had triple-negative (25%) or HER2-positive (20%) tumors. Residual tumor was found in 93%, 66%, and 60% of patients with ER-positive/HER2-negative, triple-negative, and HER2-positive tumors, respectively (p < .001).Triple-negative tumors were more likely to be a unifocal mass on MRI at baseline (57%) than HER2-positive (18%) or ER-positive/HER2-negative tumors (33%; p = .001), while HER2-positive tumors were more likely to be multifocal on MRI at baseline (53%) than the triple-negative (32%) or ER-positive tumors (30%; p = .02). During neoadjuvant chemotherapy, triple-negative tumors regressed as a shrinking mass on MRI significantly more often than the other subtypes (p < .001). On multiple logistic regression analysis of residual disease on MRI, significant factors included breast cancer subtype, late enhancement during neoadjuvant chemotherapy, and pattern of reduction between baseline and neoadjuvant chemotherapy. These factors were significant for triple-negative (r = 0.605; p < .001) and HER2-positive tumors (r = 0.426; p < .01) but not for ER-positive/HER2-negative tumors (r = 0.074; p = .458). On multivariate analysis, no markers showed significant associations with residual disease or breast cancer response index (BRI) in the ER-positive/HER2-negative group. In the triple-negative and HER2-positive groups, the only significant factor on multivariate analysis was the change in largest tumor diameter at late enhancement between baseline MRI and MRI during neoadjuvant chemotherapy (area under the receiver operating characteristic curve, 0.76; p < .001).The ability of MRI to identify response to neoadjuvant chemotherapy differed among subtypes; MRI changes were predictive of pathology outcome in the triple-negative and HER-2 positive groups, but not in the ER-positive/HER2-negative group.0 -
Sorry if this is a repeat. I just Copy/Paste stuff as it reaches my Inbox. I don't always read it anymore. Information overload, I guess.
Incidence and Outcome of BRCA Mutations in Unselected Patients With Triple Receptor-Negative Breast Cancer
Clin Cancer Res. 2011 Jan 13;[Epub Ahead of Print], AM Gonzalez-Angulo, KM Timms, S Liu, H Chen, J Litton, J Potter, JS Lanchbury, KA Stemke-Hale, B Hennessy, BK Arun, GN Hortobagyi, K-A Do, GB Mills, F Meric-Bernstam
Nearly 20% of an unselected cohort of patients with triple-negative breast cancer carried the BRCA mutation, and they had a significantly lower risk of relapse compared with patients with the wild-type...
TAKE-HOME MESSAGENearly 20% of an unselected cohort of patients with triple-negative breast cancer carried the BRCA mutation, and they had a significantly lower risk of relapse compared with patients with the wild-type gene.SUMMARYOncologySTAT Editorial TeamTriple-negative breast cancer (TNBC) is defined as breast cancer that is estrogen-receptor negative, progesterone-receptor negative, and human epidermal growth factor receptor 2 (HER2-)–negative. It accounts for only 15% to 20% of breast cancers but causes a disproportionate number of deaths from the disease. Gonzalez-Angulo et al investigated the incidence of germline and somatic BRCA1/2 deleterious mutations in an unselected group of patients with TNBC, and determined the prognostic significance of carrying a mutation. The researchers identified 77 patients from the M.D. Anderson Breast Cancer Management System database who had definitive surgery for invasive TNBC between 1997 and 2006, and who had both tumor and normal tissue available. Mutations in tumor and normal tissue were classified as germline mutations, while mutations in tumor but not in normal tissue were classified as somatic mutations. Median patient age was 51 years (range, 27–83 years).BRCA sequencing showed that 15 of the 77 patients (19.5%) had a deleterious BRCA mutation: 12 in BRCA1 (1 somatic) and 3 in BRCA2. The BRCA mutation carriers tended to be younger than patients with wild-type BRCA. Nuclear grade, histology, and pathology stage were not significantly associated with mutation status. All patients save one received adjuvant chemotherapy.At a median follow-up of 43 months, the BRCA mutation carriers had significantly better relapse-free survival (RFS). Five-year RFS estimates were 86.2% for patients with BRCA mutations vs 51.7% for patients with wild-type BRCA (P = .031). Five-year overall survival (OS) estimates were also higher in the BRCA mutation carriers but did not reach significance (73.3% vs 52.8%, respectively; P = .225). After adjusting for other patient characteristics, RFS remained significantly better for the mutation carriers compared with those with the wild-type gene (hazard ratio [HR] 0.19; P = .016).Despite the incidence of deleterious BRCA mutations in the patients with TNBC in this study, less than half (43%) of the study patients were referred for genetic counseling. Six mutation carriers and the patient with a somatic BRCA1 mutation were not referred because they were perceived to be at low risk due to older age or lack of first-degree relatives with breast or ovarian cancer. In some cases, referrals were not made due to problems with reimbursement.The authors also cited recent work at M.D. Anderson comparing the cost effectiveness of different BRCA testing strategies for women under age 50 with breast cancer. The results showed that testing those with TNBC was the most cost-effective strategy.As a result of the current study findings and the cost-effectiveness study, the authors recommended that physicians discuss genetic counseling with their patients with TNBC.The investigators also noted that information on BRCA status is increasingly important in selecting therapies, especially with poly (ADP-ribose) polymerase-1 (PARP1) inhibitors, which have shown efficacy as monotherapy in clinical studies of women with germline BRCA mutations. BRCA testing of patients with TNBC would likely identify a number of patients who could benefit from PARP inhibitor therapy who would not have been tested using current BRCA testing strategies based on family history.The results of this small investigation warrant further study to determine whether BRCA status is, in fact, prognostic in patients with TNBC, or whether it predicted benefit from the systemic therapies used in this patient cohort.Abstract
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Here's another. Tell me when you guys get sick of reading this stuff.
Prospective Comparison of Switches in Biomarker Status Between Primary and Recurrent Breast Cancer: The Breast Recurrence In Tissues Study (BRITS)
Breast Cancer Research. 2010 Nov 8;12(6):1-9, A Thompson, L Jordan, P Quinlan, E Anderson, A Skene, J Dewar, C Purdie
Abstract
This large prospective trial confirms that biopsies should be performed in women with relapsed breast cancer since hormone or HER2 receptor status may change between primary and locoregional or metastatic...
Introduction: Immunohistochemistry of primary breast cancer is routinely used to guide changes in therapy at the time of relapse. Retrospective reviews suggest that the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor type 2 (HER2) receptor may differ between the primary and loco-regional recurrence or distant metastases. The Breast Recurrence In Tissues Study (BRITS) was a large, multicentre, prospective study to examine changes in ER, PR and HER2.
Methods: Matched primary and recurrent breast cancer tissue samples were prospectively collected from 205 women attending 20 institutions. Central laboratory immunohistochemical analysis of core biopsies and tissue microarrays of ER and PR using the Allred and Quickscore methods and HER2 (confirmed by fluorescence in situ hybridisation (FISH) for HER2 2+) were performed.
Results: From 205 consenting women, 18 (8.8%) did not have recurrent disease on biopsy, 35 were ineligible, 13 had insufficient paired tissue and 2 were excluded for safety reasons. Paired samples from 137 women, mean age 62.6 years (range 27-87 years), 83/137 (60.6%) postmenopausal with a median 92.2 months (range 5-327 months) from primary to recurrence and 88 (64.2%) as locoregional recurrence were successfully analysed. A switch in receptor status, in either direction, by Allred score, was identified for ER in 14 patients (10.2%; P = 0.983 Wilcoxon sign rank test), PR in 34 (24.8%; P = 0.003 Wilcoxon sign rank test) and HER2 in 4 (2.9%; P = 0.074 Wilcoxon sign rank test). There was no difference between locoregional or distant recurrence in the proportion who switched. The switch in receptor status led to a change in the subsequent treatment plan for 24 patients (17.5%).
Conclusions: This prospective study confirms retrospective evidence that the management of relapsed breast cancer should include confirmatory tissue sampling and identify switches of ER, PR or HER2 which change therapeutic management for one in six patients.
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It may be just me, but just when I think "they" have come up with something that sounds really good, someone else comes up with a trial that debunks it.
Heidi this is the worst time of year and if I was well enough and if I had enough money, I would be going somewhere warm for a couple of weeks .... to find myself.
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I think I am suffering from SAD for the first time in my life. Normally I don't get "down" in winter. That's why I thought it might be fun to try and get together in DC for some of the gals that are in striking distance once spring finally gets here.
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Let's start planning it - when- where
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http://dc.about.com/cs/familyactivities/a/CherryBlossom.htm
Check this out. Give me feedback. I'll start the wheels in motion...
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it would have to be a weekend for me
april 8-10?
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Goodness Claire- I thought we had alot of snow. We are currently getting hammered. 40 mile an hour winds and about 10-12" if snow with more to come. Interstate 70 between kansas City and St. Louis (250 miles) is shut down due to no visibility. I am about 40 mile south of Kansas City. This is the worst I've seen!
Tiffany
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That's bad even by Canadian standards.
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Events during those dates: (April 8,9,10)
Sugarloaf Craft Festival
April 8-10, 2011. Montgomery County Fairgrounds, Gaithersburg, MD. Enjoy a wide selection of contemporary crafts and fine art at this popular festival.
Parade of the National Cherry Blossom Festival
April 9, 2011, 10 a.m. See wonderful entertainment for the whole family including decorated floats, gigantic colorful helium balloons, marching bands, clowns, horses, antique cars, military and celebrity performances, and more.
Sakura Matsuri Japanese Street Festival
April 9, 2011, 11 a.m.-6 p.m. The huge Japanese street party includes live entertainment, food, arts, games and a Ginza Marketplace.0 -
We are having nasty weather here in Ohio too..oh please..where is SPRING? ok..how about just no more ICE!
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Yep..just googled Titan and breast cancer..and up pops our TN thread...
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Titan- doesn't that piss you off? I had a very bad experience with someone finding me online a few years back (you know) so I freak when I see this happen. I thought our posts were not subject to search engine findings?
At least you had to add the BC info. Mine just popped up under my former username.
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Mine popped up when I googled my whole name!!!! Lots of them too!
Edited to read - Mistake - not under my real name - my user name. But it's all out there- ugh!
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Please forgive me for not catching up, but I just want to say I'd love a DC meet up if I'm feeling good. I'm only a day away.
Time to crawl back to my heartburn from hell hole. I am taking 4x the Prilosec dosage, plus 2x the Zantac dosage, and Carafate in between with little relief (Onc gave me the dosages). Tomorrow I'm pushing the GI for a fast appointment as long as we stay snow free Thur/Fri.
18 inches over two days here, 3 feet on the ground.
Lovelyface, curse away. This f-ing sucks.
HeidiToo- your pictures are so amazing. They made me smile. Which isn't easy these days, so thank you.
Here's hoping a GI can help me, cause I can't take another friggin month of this.0 -
Heidi, Love the pink, pirate elephant.0
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His name is MacFry--- a combining of two names from some raccoons I rehabbed (long story) Big Mac & SmallFry. We take him everywhere, sort of like Flat Stanly (only fatter).
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Hi everyone, I hope you are all having a nice day. We're just bracing ourselves for the huge snowstorm that's supposed to start around midnight tonight. DC in the spring would be fun. Not sure if I could wing it but I sure would like to try. I flew to Balitmore really cheap from Buffalo a couple of years ago so it might be doable.
In the spirit of Heidi's pirate talk, here's something funny you can try. If you're on Facebook, scroll to the very bottom and you'll see "Facebook copyright 2011" and language (English in my case)...click on the link and all the availble languages will pop up. Choose "English" and a little drop down arrow will appear...click on it and choose "English (Pirate) and your Facebook account will turn to Pirate language. It's quite funny.
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MacFry, love it!
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Sugar- you made my day! I did it! AARGH!0
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Laurajane - I just wanted to let you know that I had only a partial response to AC, roughly 50%. Knowing what happened with you, I pushed for a MRI, and my doctor added the Carbo, which I've responded to very well. I truly hope the Carbo with Gezar works as well for you!
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Heidi: I so love when you post pictures of your horses, the beach, the boat, the water and McFry!
Sugar: Argh, matey, I love the pirate stuff!
Laurajane: The icestorm sounds beautiful, but cold!
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MBJ: I'd much rather be in cali right now! I'm in Ohio too... in our area, 45000 are without power now. My lights have flickered several times, went out for a second, came back on. Several counties around me are under a level 3 emergency, which means you're not supposed to be out unless you are emergency personnel... or you could be ticketed. LA would be a mess with ice! We have family in San Dimas. Gosh, I'd hate to see the highway there with any amount of snow or ice. But I must admit, if the sun comes out after this ice storm, it will look like a crystal kingdom... simply indescribable and gorgeous. We're expected to get snow on top of this mess tomorrow. I'd much rather have snow than ice, but snow on top of ice?? Bad news.0
