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Topic: Breaking Research News from sources other than breastcancer.org

Forum: Clinical Trials, Research News, Podcasts, and Study Results —

Share your research articles, interpretations and experiences here. Let us know how these studies affect you and your decisions.

Posted on: Nov 20, 2017 10:31PM - edited Nov 20, 2017 10:35PM by Lumpie

Lumpie wrote:

I watch for research news on breast cancer, treatments, etc., and frequently see interesting articles. There is a topic on BCO called "Breaking Research News from Breastcancer.org." One of the moderators suggested that another topic might be appropriate for posting links and synopses of reports on research found elsewhere. So here it is! Please post links to reports on research form reliable sources. Thanks for sharing!

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Posts 961 - 990 (1,263 total)

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Apr 4, 2019 12:31PM Hopeful82014 wrote:

https://www.cancernetwork.com/her2-positive-breast-cancer/trail-solution-trastuzumab-resistance-her2-breast-cancer

Dx IDC
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Apr 4, 2019 09:57PM Lumpie wrote:

Persons Living With Incurable Cancer a Growing, Neglected Group

People with metastatic cancer are living longer, thanks to better treatments, including immunotherapies and tyrosine kinase inhibitors (TKIs), yet few studies have addressed the nonbiomedical needs and challenges of this rapidly growing population.

"Unfortunately, the research community has failed to study and address the psychological, social, spiritual, and financial impact of living for years with incurable cancer,"

The article refers readers to

Time to Study Metastatic-Cancer Survivorship

https://www.nejm.org/doi/full/10.1056/NEJMp1901103

and to MBC Connect: https://www.mbcconnect.org/

https://www.medscape.com/viewarticle/911355?src=wn...


"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Apr 5, 2019 04:38PM Karenfizedbo15 wrote:

nice one Lumpie...Hope is vital and you find us that!

Surgery 9/7/2007 Lymph node removal: Underarm/Axillary; Mastectomy: Right; Reconstruction (right): Latissimus dorsi flap Dx 4/2018, IDC, Right, Stage IV, metastasized to lungs, 1/17 nodes, ER+/PR+, HER2-
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Apr 5, 2019 08:14PM Lumpie wrote:

Some of you may be interested in this conference:

(MRS is Metastatic Research Society)

Register today for the METAvivor/MRS Metastatic Cancer Stakeholder Engagement Conference on June 7 and 8, 2019 at the University of North Carolina, Lineberger Cancer Center in Chapel Hill, NC. The conference is from 8:00 am - 4:00 pm on June 7 and 8:00 am - 2:30 pm on June 8, 2019. Once registered, click here to book your room at the Courtyard by Marriott Chapel Hill. Click Here To Register.

Engagement Conference Room Block

Courtyard Chapel Hill for $129 USD per night
Room Block Start Date: Thursday, June 6, 2019
Room Block End Date: Saturday, June 8, 2019
Last Day to Book: Monday, May 6, 2019

Book your group rate for Engagement Conference Room Block

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Apr 8, 2019 08:21AM Lumpie wrote:

Do Breast Cancer Patients Skip Follow-Up? Over 20% stopped seeing cancer docs 5 years after diagnosis

Follow-up guidelines vary widely among national organizations for patients with early-stage breast cancer treated with curative intent. The study sought to evaluate the patterns and predictors of provider follow-up care within the first 5 years after diagnosis.

Twenty-one percent of patients with early-stage breast cancer discontinued seeing any oncology provider over the 5 years after diagnosis. Coordination of follow-up care between oncology specialists may reduce discontinuation rates and increase clinical efficiency.

https://www.medpagetoday.com/hematologyoncology/breastcancer/79043?xid=nl_mpt_DHE_2019-04-08&eun=g1278169d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202019-04-08&utm_term=NL_Daily_DHE_Active

https://ascopubs.org/doi/abs/10.1200/JOP.18.00229

DOI: 10.1200/JOP.18.00229 Journal of Oncology Practice 15, no. 1 (January 1 2019) e1-e9.


"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Apr 8, 2019 08:50AM Lumpie wrote:

FDA: Breast Density Must Be Reported to Women During Mammograms

Proposed rule would also tighten FDA regulation of mammogram facilities

WEDNESDAY, March 27, 2019 (HealthDay News) -- Women with dense breasts who get mammograms must be told of their higher risk for breast cancer under new rules proposed Wednesday by the U.S. Food and Drug Administration.

The FDA proposal would also tighten its regulation of mammogram facilities, giving the agency the power to notify patients if problems are found at a center so that repeat mammograms can be done at another certified center.

https://www.practiceupdate.com/C/81637/56?elsca1=emc_enews_topic-alert


"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Apr 9, 2019 07:53AM - edited Apr 9, 2019 07:54AM by Lumpie

ACP Wrangles Diverging Breast Ca Screening Guidelines
Guidance for average-risk women draws rebuke

Women ages 50 to 74 at average risk for breast cancer should undergo screening mammography every other year, according to the latest guidance from the American College of Physicians (ACP), recommendations that were met with immediate pushback from the radiology community.

Additional guidance statements emphasized women at average risk for breast cancer should not be screened. For example, average-risk women ages 40 to 49 should discuss the potential risks and benefits of undergoing mammography with their physicians, with the understanding that the potential harms outweigh the benefits in most women of this age.

Women ages 75 or older, or those with a life expectancy of 10 years or less, should discontinue breast cancer screening.

Finally, they said, among average-risk women of all ages, clinical breast examination (CBE) should not be used to screen for breast cancer. Instead, the 5 to 10 minutes this exam takes should be "devoted to healthcare interventions of greater proven net benefit."

The ACP considers women with dense breast tissue on mammography and no other risk factors to be at average risk.

In a joint statement, the American College of Radiology and Society of Breast Imaging warned that ACP's new recommendations could "result in up to 10,000 additional, and unnecessary, breast cancer deaths in the United States each year,"

https://www.medpagetoday.com/hematologyoncology/breastcancer/79085?xid=nl_mpt_DHE_2019-04-09&eun=g1278169d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202019-04-09&utm_term=NL_Daily_DHE_Active

https://annals.org/aim/fullarticle/2730520/screening-breast-cancer-average-risk-women-guidance-statement-from-american

DOI: 10.7326/M18-2147

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Apr 9, 2019 08:29AM Beaverntx wrote:

Fortunately for me my PCP looks at these kind of recommendations as being based on "herd mentality" and treats his patients as individuals. Had I not had my annual mammogram at age 77 who knows how long it would have taken that tumor near my chest wall to make itself evident in some nasty way? I would much rather have a biopsy with negative findings (been there, done that) than have no idea what is going on in my body that is treatable if known. My rant for the day!

Diagnosed at age 77-- Oncotype 17, dealing with this bump in the road of life!!🎆 Dx 1/24/2018, IDC, Right, 2cm, Stage IB, Grade 3, 0/9 nodes, ER+/PR+, HER2- (IHC) Dx 1/30/2018, DCIS, Right, <1cm, Stage 0 Surgery 1/30/2018 Lumpectomy: Right; Lymph node removal: Right, Sentinel Radiation Therapy 3/11/2018 Whole-breast: Breast Surgery 6/15/2018 Prophylactic ovary removal Hormonal Therapy 6/19/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Apr 9, 2019 10:19AM marijen wrote:

Beaverntx I think 75 is the cutoff age for the death panel.

Free fatty acids appear to rewire cells to promote obesity-related breast cancer
Date:
March 13, 2019
Source:
University of Illinois at Urbana-Champaign
Summary:
Free fatty acids in the blood are linked with higher rates of estrogen-receptor positive breast cancer in obese postmenopausal women, according to a new study.
https://www.sciencedaily.com/releases/2019/03/1903...

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Apr 9, 2019 11:02AM Sara536 wrote:

Yikes!

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Apr 9, 2019 01:39PM Salamandra wrote:

Well since my cancer was diagnosed by clinical breast examination two years before I would have started getting mammograms, I'm glad that my gynecologist was not following that protocol.

How about extending the amount of time that insurance companies permit doctors to spend with their patients, so they can actually get both a breast exam and other beneficial health interventions?!?

Dx at 39. 1.8cm. Oncotype 9. Dx 9/19/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (FISH) Surgery 10/17/2018 Lumpectomy; Lymph node removal: Sentinel Radiation Therapy 12/2/2018 Whole-breast: Breast Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Apr 9, 2019 03:20PM Beaverntx wrote:

Salamandra, great idea. Used to be the case but with the increasing voice of the "bean counters" focus has changed from the patient to the bottom line!

Diagnosed at age 77-- Oncotype 17, dealing with this bump in the road of life!!🎆 Dx 1/24/2018, IDC, Right, 2cm, Stage IB, Grade 3, 0/9 nodes, ER+/PR+, HER2- (IHC) Dx 1/30/2018, DCIS, Right, <1cm, Stage 0 Surgery 1/30/2018 Lumpectomy: Right; Lymph node removal: Right, Sentinel Radiation Therapy 3/11/2018 Whole-breast: Breast Surgery 6/15/2018 Prophylactic ovary removal Hormonal Therapy 6/19/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Apr 9, 2019 07:46PM MinusTwo wrote:

I have old-fashioned, standard medicare with a medigap policy. I have not had any problem seeing any docs whenever I want. Nor have I had any problem getting any testing. My docs don't rush me and take time to answer all my questions. However I do have friends who are on the Medicare HMO (Advantage) plans and have problems like everyone is describing.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Apr 9, 2019 08:16PM Lumpie wrote:

I get it that "over-diagnosis" has its problems but I have also noticed that no one who has been Dx'd with cancer ... even if it wasn't found by mammogram or practitioner exam... says "gee, it's too bad there's so much screening." I think that if you pole the public, they prefer to have more screening, not less. I am sure we have all noticed the "executive physicals" that some health care systems offer.... for a fee not covered by insurance. What are those? Extra screening! Is it strictly rational? Maybe not. Thing is, a certain percentage of us would rather be alive and vigilant than dead and rational. (And there's my rant for the day, too!)

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Apr 9, 2019 11:47PM Kanga_Roo wrote:

An “up lifting” story

https://life.shared.com/18-yo-invents-bra-that-detects-breast-cancer-to-ensure-other-women-dont-suffer-like-his-mother?utm_source=share&utm_medium=ios_app

Dx 1/24/2018, IDC, Left, 5cm, Stage IV, metastasized to liver, ER+/PR+, HER2- (IHC) Hormonal Therapy 2/11/2018 Femara (letrozole) Targeted Therapy 2/15/2018 Kisqali
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Apr 10, 2019 06:41AM GreekNinja wrote:

Off the shelf immunotherapy research being conducted. The future is full of hope. Let's all stick around for it.

www.medicalnewstoday.com/artic...

Dx 8/18/2016, IDC, Right, 2cm, Stage IIIA, Grade 2, 6/11 nodes, ER+/PR+, HER2- Chemotherapy 9/26/2016 AC + T (Taxol) Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Apr 12, 2019 04:11PM - edited Apr 12, 2019 04:11PM by Lumpie

Genetic Testing Lags in Breast, Ovarian Ca
Contributors include physician, patient, financial factors

Rates of genetic testing for breast or ovarian cancer remained well below levels associated with current clinical guidelines, according to a large retrospective analysis.

Medical records showed that a fourth of patients with breast cancer and about a third of those with ovarian cancer had genetic test results. Testing rates varied by factors unrelated to genetic risk, such as race and insurance status. Among the patients tested, 8-15% had at least one pathogenic variant that warranted a change in care... testing rates <100% for women younger than age 45 with breast cancer are "suboptimal" and that "a 30% genetic testing rate for patients with ovarian cancer is inadequate." [Patients] may not understand that a positive result may impact their own future cancer screening or ovarian cancer treatment options. 24.1% of the patients with breast cancer and 30.9% of the patients with ovarian cancer had undergone genetic testing. Only 2% of patients with breast cancer were tested for all 11 genes designated by current clinical guidelines as susceptibility genes.

https://www.medpagetoday.com/genetics/genetictesting/79173?xid=nl_mpt_DHE_2019-04-12&eun=g1278169d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202019-04-12&utm_term=NL_Daily_DHE_Active

Primary Source Journal of Clinical Oncology

Source Reference: Kurian AW, et al "Genetic testing and results in a population-based cohort of breast cancer patients and ovarian cancer patients" J Clin Oncol 2019; DOI: 10.1200/JCO.18.01854.

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Apr 12, 2019 04:20PM Lumpie wrote:

Elucent Medical Receives FDA Clearance for Innovation for Breast Tumor Removal Procedures

EnVisio Surgical Navigation System and SmartClip Soft Tissue Marker provide alternative for painful and costly localization procedures

Elucent Medical announced that it has received U.S. Food and Drug Administration (FDA) 510(k) clearance for the clinical use of the company's EnVisio™ Surgical Navigation System. Elucent Medical's permanently implantable wireless SmartClip™ Soft Tissue Marker provides an alternative localization procedure. The SmartClip™ is used by surgeons with the company's EnVisio™ Navigation System to identify the location of the malignancy and to wirelessly navigate to it in real-time 3-D. The system can uniquely identify three different SmartClip™ Soft Tissue Markers – allowing physicians to effectively mark difficult lesions and navigate distances, depths, and directions... Elucent Medical is offering a ...solution that addresses a key challenge for breast surgeons: how to easily find the location of a malignant biopsy during surgery, especially in tissue that lacks anatomical landmarks.

https://www.businesswire.com/news/home/20190411005251/en/Elucent-Medical-Receives-FDA-Clearance-Innovation-Breast

www.elucentmedical.com

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Apr 12, 2019 05:37PM Nkb wrote:

Lumpie- I heard a talk with a panel of MOs who said that they can't get authorization for the genetic testing for many patients especially if they are under 60 years old. The prices have come way down so maybe if the insurance refuses- patients could pay for it themselves.

Dx 1/2012, ILC, Stage IIIC, Grade 2, ER+/PR+, HER2- Surgery 2/3/2012 Lymph node removal: Left, Right, Underarm/Axillary; Mastectomy: Left, Right Chemotherapy 2/27/2012 AC + T (Taxol) Radiation Therapy 9/10/2012 Hormonal Therapy 10/21/2012 Arimidex (anastrozole) Dx 5/2017, Stage IV, metastasized to bone/other, ER+/PR-, HER2- Targeted Therapy 6/1/2017 Ibrance (palbociclib) Hormonal Therapy 6/1/2017 Faslodex (fulvestrant) Hormonal Therapy 3/13/2019 Aromasin (exemestane) Targeted Therapy 3/13/2019 Afinitor (everolimus)
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Apr 12, 2019 08:41PM MountainMia wrote:

Nkb, my genetic testing was billed at about $4500 from the lab (independent of my hospital) and about $300 from my hospital for the counselor and the blood draw. I don't know how much it is other places, but it would be a stretch to cover that by myself.

The rain comes and the rain goes, but the mountain remains. I am the mountain.
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Apr 12, 2019 10:28PM Nkb wrote:

mountain Mia- that sounds like the prices for when I had the tests also- tho my insurance covered it- these MOs are saying that it is getting closer to $250-750 for the 11 or 13 tests that are the most important. Hope it is true.

Dx 1/2012, ILC, Stage IIIC, Grade 2, ER+/PR+, HER2- Surgery 2/3/2012 Lymph node removal: Left, Right, Underarm/Axillary; Mastectomy: Left, Right Chemotherapy 2/27/2012 AC + T (Taxol) Radiation Therapy 9/10/2012 Hormonal Therapy 10/21/2012 Arimidex (anastrozole) Dx 5/2017, Stage IV, metastasized to bone/other, ER+/PR-, HER2- Targeted Therapy 6/1/2017 Ibrance (palbociclib) Hormonal Therapy 6/1/2017 Faslodex (fulvestrant) Hormonal Therapy 3/13/2019 Aromasin (exemestane) Targeted Therapy 3/13/2019 Afinitor (everolimus)
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Apr 13, 2019 11:20AM Lumpie wrote:

Effect of Radiotherapy After Breast-Conserving Surgery Depending on the Presence of TILs
  • The purpose of this study was to analyze the association of tumor-infiltrating lymphocytes (TILs) with the effect of postoperative radiotherapy (RT) on ipsilateral breast tumor recurrence (IBTR) in a large randomized trial of 936 patients with stage I/II breast cancer. The authors found that high TIL values were associated with a reduced risk of IBTR (HR, 0.61; P=.033). The interaction between RT and TILs was not found to be statistically significant (P=.317).
  • High TIL values within the primary tumor may be associated with a reduced risk for IBTR. The authors further conclude that patients with low TIL values may experience a greater benefit from RT with regard to reduced risk of IBTR.
https://www.practiceupdate.com/C/81899/56?elsca1=emc_enews_topic-alert
https://ascopubs.org/doi/10.1200/JCO.18.02157
DOI: 10.1200/JCO.18.02157 Journal of Clinical Oncology
Published online April 02, 2019.
"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Apr 13, 2019 11:32AM - edited Apr 13, 2019 11:33AM by Lumpie

My insurer would not pay for genetic testing either. We found a lab that would do it for around $400 "cash" paid by me/the patient without doing the insurer's paperwork. Some labs offer "patient assistance programs" for those who either do not have insurance or whose insurance will not cover the testing. It is worthwhile to ask. Sometimes these programs depend on your household income. You will still have to have an order from your physician and you they may want you to agree ahead of time that you will pay a fixed price and that they will not file insurance paperwork. It is interesting that they seem to be discussing this testing as "standard of care" but that insurers are not paying for it. Unfortunately, it seems like it often takes a while before the insurers catch up to actually paying for standard of care.

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Apr 13, 2019 12:17PM illimae wrote:

What genetic testing are you referring too, like BRACA and other mutations or something more specific?

Diagnosed at 41 Stage IV De Novo Dx 11/16/2016, IDC, Left, 5cm, Stage IV, metastasized to bone, Grade 3, 3/13 nodes, ER+/PR-, HER2+ (IHC) Chemotherapy 1/2/2017 Abraxane (albumin-bound or nab-paclitaxel) Targeted Therapy 1/2/2017 Herceptin (trastuzumab) Targeted Therapy 1/2/2017 Perjeta (pertuzumab) Surgery 6/26/2017 Lumpectomy: Left; Lymph node removal: Underarm/Axillary Radiation Therapy 8/10/2017 Breast, Lymph nodes Dx 10/5/2017, IDC, Left, Stage IV, metastasized to brain Radiation Therapy 10/20/2017 External: Brain Radiation Therapy 4/18/2018 External: Brain Radiation Therapy 5/23/2019 External: Brain Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Apr 13, 2019 12:59PM Lumpie wrote:

illimae, Basically, yes. There are a lot of labs that offer testing. And your physician will recommend the testing that seems most appropriate. Some labs offer a breast cancer specific panel that screens for risk for hereditary breast cancer risk only. A lab may also offer a multi-cancer panel that screens for elevated risk for multiple types of cancer. BRCA genes would almost certainly be included in either of those but it's always wise to double check. Of course, our knowledge of genetics and causality continues to evolve, so these tests may change over time as researchers learn more. As that knowledge evolves, you may be able to get updated results or you may need to be retested. Keeping in mind that this is just one lab/just one example, if you want to read up on the tests available by looking at a lab's website, here are a couple of links to a lab I know some practitioners to use:

Breast cancer panel {interestingly, this indicates that it is for ER+, HER2− early-stage breast cancer patients only}

https://myriad.com/products-services/breast-cancer/endopredict/

Multiple hereditary cancers:

https://myriad.com/products-services/hereditary-cancers/myrisk-hereditary-cancer/

Some of the web pages have videos. It can actually be quite educational if you are interested in genetics.

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Apr 13, 2019 02:15PM illimae wrote:

Thanks for clarifying. I was tested almost immediately at MDA since I was stage IV de novo at 41 with strong family history (mom and maternal aunt). Results were negative but the genetic counselor believed there’s something in a combination of genes not currently known. It was covered by my insurance since I was under 45, I only paid the $100 copay. Interesting stuff, thanks!

Diagnosed at 41 Stage IV De Novo Dx 11/16/2016, IDC, Left, 5cm, Stage IV, metastasized to bone, Grade 3, 3/13 nodes, ER+/PR-, HER2+ (IHC) Chemotherapy 1/2/2017 Abraxane (albumin-bound or nab-paclitaxel) Targeted Therapy 1/2/2017 Herceptin (trastuzumab) Targeted Therapy 1/2/2017 Perjeta (pertuzumab) Surgery 6/26/2017 Lumpectomy: Left; Lymph node removal: Underarm/Axillary Radiation Therapy 8/10/2017 Breast, Lymph nodes Dx 10/5/2017, IDC, Left, Stage IV, metastasized to brain Radiation Therapy 10/20/2017 External: Brain Radiation Therapy 4/18/2018 External: Brain Radiation Therapy 5/23/2019 External: Brain Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Apr 15, 2019 09:41AM Lumpie wrote:

On the TRAIL of a Solution to Trastuzumab Resistance in HER2+ Breast Cancer

A genomic and proteomic analysis of HER2-positive breast cancer cell lines that are resistant to trastuzumab found a deregulation of the cell death pathway known as TRAIL (tumor necrosis factor–related apoptosis-inducing ligand). The finding presents the possibility of targeting this pathway as a way to lessen the impact of trastuzumab resistance in HER2-positive breast cancer.

https://www.cancernetwork.com/her2-positive-breast-cancer/trail-solution-trastuzumab-resistance-her2-breast-cancer

https://www.sciencedirect.com/science/article/pii/S0304383519301983

https://doi.org/10.1016/j.canlet.2019.03.042

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Apr 15, 2019 10:05AM Lumpie wrote:

Organ Transplant Disability Bias Gets Second Look Under Trump

The Office for Civil Rights (OCR) in the U.S. Department of Health and Human Services (HHS) is reportedly considering written guidance warning health care providers that denying organ transplants based solely on disability violates the ADA.

https://news.bloomberglaw.com/health-law-and-business/organ-transplant-disability-bias-gets-second-look-under-trump

{This would seem to raise some interesting questions about the possibility of transplant for oligo-metastatic disease.}

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Apr 16, 2019 01:03AM Lanne2389 wrote:

as I recall, my genetic tests covered about 15 variables. Even with a strong family history (mom and both her sisters, who each had recurrences), the tests did not find any links. My insurer- Aetna- covered the tests. I think the hospital told me they will check results again in 5 years if new tests are available.

I find it unconscionable that some insurers won’t cover genetic testing and/or that the standard of care depends on where you live.

Lanne

Lanne Dx 11/20/2016, IDC, Right, 3cm, Stage IIB, Grade 1, 3/17 nodes, ER+/PR+, HER2- (FISH) Chemotherapy 1/2/2017 AC + T (Taxol) Surgery 6/13/2017 Lymph node removal: Right, Sentinel, Underarm/Axillary; Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Radiation Therapy 8/7/2017 Whole-breast: Lymph nodes, Chest wall Hormonal Therapy 9/14/2017 Femara (letrozole) Surgery 7/16/2018 Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Apr 16, 2019 07:04AM lala1 wrote:

When I was diagnosed in 2012 I was tested for BRAC through Myriad which was negative. At the time, insurance didn't cover it so I paid $4000 for the testing. Took me forever to pay it off!! Well, now I've just gotten my mammogram results letter (all good!) and the letter says genetic testing is now strongly recommended for anyone having had BC. I called the breast center where I had my testing done because I wasn't sure if my original testing was all that was needed or if there was more. The counselor there said Myriad is now offering additional testing to anyone who only had BRAC done. It covers about 30 more genes that are looked at for other ties to BC and insurance should cover it. Apparently guidelines recommend the latest testing be done for all BC patients. So I've called my BS and they are supposed to be sending a referral to the breast center so I can go in for a blood draw to get the extra tests done.

Mentor smooth round high profile memory gel implants 600cc (Left); Allergan 10 Moderate Profile 120cc (Right) ; Oncotype 15 Dx 11/27/2012, IDC, 2cm, Stage IIA, Grade 3, 0/5 nodes, ER+/PR+, HER2- Surgery 12/13/2012 Mastectomy: Left Hormonal Therapy 2/1/2013 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 3/26/2013 Reconstruction (left): Silicone implant Surgery 6/25/2014 Reconstruction (left): Nipple reconstruction Surgery 1/20/2015 Prophylactic ovary removal

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