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Medscape
4 days ago
- Health
- Medscape
Fast Five Quiz: Assessing Early Breast Cancer
Breast cancer screening, prevention, and management decisions are made on the basis of several factors related to family history, patient history, and, if a diagnosis of breast cancer is made, tumor type. Upon diagnosis, the determination of risk for recurrence and prognosis, as well as patient disease stage, health, and preferences, informs management strategies regarding neoadjuvant treatment, breast-conserving surgery, the type of radiation therapy used, if any, and whether adjuvant treatment should be initiated. Do you know the key aspects of risk assessment and their implications in early breast cancer? Test your knowledge with this quick quiz. Although all breast cancer types might recur despite early diagnosis and treatment, those defined as triple-negative breast cancer are considered high-risk for recurrence. Patients with this subtype usually have a significant risk for disease recurrence. Hormone receptor (HR)-positive tumors, which express estrogen receptors (ERs) and/or progesterone receptors (PRs), are generally defined as luminal-like, typically less aggressive, and having a more favorable prognosis. HER2-positive breast tumors are biologically aggressive tumors, but recurrence outcomes have dramatically improved with anti-HER2-targeted therapies. Learn more about breast cancer risk factors. On average, individuals harboring a germline BRCA1 mutation have up to a 72% risk of developing breast cancer by age 80 years; for those with a germline BRCA2 mutation, the risk is up to 69%. Because of the high lifetime risk for breast cancer in individuals with germline BRCA mutations, both US and European guidelines recommend considering prophylactic surgery, such as double mastectomy. Learn more about BRCA1 and BRCA2 mutations. According to the European Society for Medical Oncology, decisions about adding chemotherapy to adjuvant endocrine therapy are individualized on the basis of patient and disease factors, including results of genomic assays. Data have shown that most cases of small ER-positive, PR-positive, HER2-negative, or node-negative breast cancer generally have a good prognosis with endocrine therapy alone and usually do not require adjuvant chemotherapy. Although assessment of response to neoadjuvant endocrine therapy or chemotherapy is generally used in the setting of locally advanced breast cancer (particularly when the size and/or location of the tumor preclude breast-conserving surgery), patients with very small, early, HER2-negative, HR-positive cancer types are usually treated with surgery first, followed by radiation therapy and consideration of adjuvant therapy with an endocrine regimen, chemotherapy, or both. Ki-67 is an indirect measure of cell proliferation. Although a high Ki-67 score is often considered a marker for a poorer prognosis in early breast cancer, it cannot predict the benefit of chemotherapy as a single measure owing to many limitations. Learn more about breast cancer treatments. The risk for recurrence of a HER2-positive tumor is generally dependent on tumor size, the presence of positive axillary lymph nodes, tumor grade, and other histologic and patient factors. Before the development of effective anti-HER2 therapies, such as trastuzumab, novel anti-HER2 TKIs, or antibody-drug conjugates, HER2 positivity was associated with poor prognosis. The degree of HER2 positivity (ie, immunohistochemistry [IHC] 2+/fluorescence in situ hybridization amplified vs IHC 3+) is generally not correlated with recurrence risk, although it might be associated with greater responsiveness to anti-HER2-targeted therapies. Patients with early-stage, HER2-positive tumors with clinically positive lymph nodes are usually candidates for neoadjuvant systemic treatment with chemotherapy and pertuzumab plus trastuzumab. Age alone usually does not indicate if a patient may be considered for neoadjuvant systemic treatment, but data have shown that younger age (≤ 50 years) has been linked to disease recurrence in this population "across all treatments." The number of live births before age 40 years alone usually does not indicate if a patient may be considered for neoadjuvant systemic treatment as well. Learn more about family history and genetic risk factors for breast cancer. A diagnostic companion test for germline BRCA status is needed to select patients for PARP inhibitors in many countries. Such status can help determine how certain patients will respond to this treatment, as patients with germline BRCA mutations tend to have heightened sensitivity to PARP inhibitors and other DNA-damaging agents. Further, detecting these mutations in select patients and treating them with PARP inhibitors has been shown to improve progression-free and distant-disease-free survival, and they have become "a crucial treatment for breast cancer with BRCA mutations." For example, in 2022, the European Medicines Agency and the US FDA approved adjuvant olaparib, a PARP inhibitor, for the treatment of patients with deleterious or suspected deleterious germline BRCA mutation and a diagnosis of HER2-negative, high-risk, early-stage breast cancer treated with neoadjuvant or adjuvant chemotherapy. Ki-67 measurement, MRI findings alone, and a diagnostic companion test for ERBB2 (HER2) are usually not required when selecting adjuvant therapy with a PARP inhibitor in this setting. Learn more about PARP inhibitors for breast cancer. Editor's Note: This article was created using several editorial tools, including generative AI models, as part of the process. Human review and editing of this content were performed prior to publication.
Campaign ME
17-07-2025
- Business
- Campaign ME
Edelman UAE makes key leadership appointments
Edelman has announced new leadership appointments across its UAE team in an effort to reinforce its specialist capabilities in Health, Crisis & Risk, and Brand. These internal moves promotions aim to reflect Edelman's ongoing investment in integrated, sector-led communications and the strength of its senior talent across the region. Lauren Brush has assumed the role of Head of Health, bringing a track record of advising high-profile global stakeholders, including the Saudi Ministry of Health and leading U.S.-based medical associations. Her work spans pandemic response, BRCA testing, and the launch of the UAE's first-ever telemedicine portal. Already a key advisor on Edelman's partnership with M42 and its expansive portfolio, Brush will now lead the development of the firm's health offer in the region, helping clients navigate an increasingly high-impact and rapidly shifting sector. Chase Burns has been appointed Head of Crisis & Risk, expanding his role within Edelman's Corporate Practice. He currently leads the work for the Abu Dhabi Investment Office (ADIO), Hub71 and ATRC. With more than 15 years of experience both in-house and advising clients through high-stakes, reputationally sensitive situations across aviation, advanced technology and sovereign investment, Burns has overseen responses to aircraft groundings, geopolitical attacks, and pandemic-related disruptions. As scrutiny intensifies and exposure to misinformation and disinformation, operational disruption, and geopolitical risks grows, Burns will lead the development of Edelman's integrated crisis and risk advisory services in the region, helping clients anticipate, navigate and recover from complex situations, while also representing the region within Edelman's global crisis leadership team. Lastly, Deepanshi Tandon has been appointed Head of Brand for Edelman UAE. In her role, she will lead the Brand practice, building on Edelman's expertise in creating earned-first, trusted brands that drive influence and shape culture. She brings more than 15 years of experience and has led several global brands across markets and sectors, spearheading strategic, creative, and culturally resonant work. Tandon currently leads work for clients such as PepsiCo and Nissan Middle East and has played a central role in shaping brand reputation strategies and leading integrated, multi-channel campaigns that drive cultural relevance and impact. On the appointments, Omar Qirem, CEO, Edelman Middle East, said: 'These leadership updates reflect both our investment in specialist talent and our commitment to developing leadership from within. Lauren, Chase and Deepanshi bring a powerful combination of subject matter expertise, client trust, and integrated thinking that will be instrumental to our next chapter of growth in the region.' The global communications firm operates wholly owned offices in Abu Dhabi, Dubai, and Riyadh as part of Edelman's broader Middle East network.
Forbes
09-07-2025
- Health
- Forbes
Here's What Every Woman Should Know About Their Risk Of Breast Cancer
Breast cancer surgery scars by partial mastectomy. Breast cancer rates are rising across the United States, with most diagnoses occurring without a clear, predictable explanation. An estimated 85–90% of cases are sporadic, meaning they result from factors such as environmental exposures rather than a known inherited genetic mutation or strong family history. The lack of identifiable causes in most cases is concerning given that nearly 370,000 people will be diagnosed with breast cancer this year in the United States. The American Cancer Society estimates that 42,000 women are projected to die from the disease in 2025. Prevention and early detection of breast cancer are key to improving survival and both rely on understanding personal risk. 'The problem is that risk matters, but we are not good at measuring risk,' says Dr. Constance Lehman, professor of radiology at Harvard Medical School and breast imaging specialist. Current Breast Cancer Risk Assessment Current risk assessment focuses primarily on understanding family history and genetic risk factors. A strong family history—especially of breast and ovarian cancer—may suggest inherited mutations, like BRCA1/BRCA2. A mature African-American woman in her 40s wearing a hospital gown, getting her annual mammogram. ... More She is being helped by a technologist, a blond woman wearing scrubs. Mammograms can find cancer and also help estimate future risk by assessing breast density. While most women with dense breasts do not develop breast cancer, dense tissue does increase risk. Most radiologists use a scale called BI-RADS to rate breast density, with higher scores indicating more dense tissue and greater risk. The BI-RADS scale, however, relies on human interpretation and readings can vary between radiologists, making results inconsistent. Ancillary risk assessment tools, like the Tyrer-Cuzick and Gail models, gather information from patient questionnaires, such as 'any second-degree relatives with breast or ovarian cancer?' These answers estimate the likelihood of developing breast cancer. As these tools rely heavily on patient recall, they can also be inaccurate or incomplete. Health Inequities with Breast Cancer Risk Assessment Many of the current risk assessment tools, such as the Tyrer-Cuzick and Gail models, often underperform in racially and ethnically diverse populations—especially Black, Hispanic, Asian, and Indigenous women—due to limited representation in the original data used to train these models. In a study using the Tyrer‑Cuzick risk calculator of over 15,000 women, Black women were less likely to be classified as high-risk compared to white women, 10.7% vs. 17.5%, despite having similar incidence rates and higher mortality. This suggests that the model underestimates risk for Black women, increasing likelihood of inadequate monitoring, delayed diagnosis, and worse outcomes. Future of Breast Cancer Risk Assessment Doctor and patient discuss breast cancer screening 'Many women have never discussed breast cancer risk with their doctors,' Lehman says. 'Some calculate their score online, others fill out a questionnaire sent by their health system. It's chaotic.' To address this gap in care, Dr. Lehman founded Clairity, Inc. and developed Clairity Breast, an FDA-authorized platform that uses AI to analyze standard mammograms and generate a five-year breast cancer risk score. Unlike traditional risk assessment models, like Tyrer-Cuzick and Gail models, which rely on survey data from the patient, Clairity Breast uses the mammogram itself to assess risk—making it the first widely used model to do so. Their data set was also developed using images from a diverse patient population, unlike older models built on data primarily from racially homogenous populations. Clairity Breast is not a diagnostic tool, meaning it does not tell patients they have active cancer. Instead, it looks at mammograms and assesses risk of future cancer. 'This is a prognostic test,' Dr. Lehman emphasizes. 'We take a four-view standard mammogram and our model assesses it and generates a percentage risk score for the next five years,' Lehman states. The AI is trained to detect subtle patterns of concern on the mammogram that are invisible to the human eye. Dr. Andrea Merrill, a breast surgeon at Sentara Breast Surgery Specialists in Charlottesville, Virginia, sees promise in Clairity's approach. She says that currently about 10% of breast cancers go undetected on imaging, even with MRI. 'It's very possible that with more time and improvements, AI could eventually help detect subtle changes that indicate a cancer that normally wouldn't be seen,' she says. Merrill adds that current tools fail to detect cancer in women under 40 who don't meet criteria for high-risk screening. For patients detected to have increased risk by Clairity Breast, doctors 'can add supplemental imaging, such as MRI or contrast-enhanced mammograms, to detect cancers earlier and treat them at an earlier stage,' says Merrill. 'It might also inform treatment plans that include prescribing medications to reduce their predicted risk of breast cancer.' Clairity Breast launch in 2025 Clairity Breast is expected to become available in 2025, initially as a self-pay option. The company is working with insurers to pursue coverage, but cost remains a concern in regards to assuring access to all, especially marginalized groups. Though excited for this new technology, Merrill cautions patients against delaying care until Clairity Breast is released. 'I would not wait for this tool to get your mammogram,' Merrill emphasizes. 'Current screening mammography is still very effective and detects the majority of breast cancers.'
Health Line
08-07-2025
- Health
- Health Line
The Future of Treatments for Triple-Negative Breast Cancer
This type of breast cancer can be difficult to treat, but advances in therapeutic approaches are promising. Triple-negative breast cancer (TNBC) is a rare type of breast cancer that doesn't respond to common hormone-based therapies. However, other treatments are available. 'Triple-negative' describes cancer cells that test negative for three types of receptors: estrogen progesterone HER2 Because of its triple-negative status, TNBC doesn't respond to treatments that target estrogen or progesterone receptors. It also doesn't respond to the various HER2 cancer treatments. However, TNBC is sensitive to chemotherapy and immunotherapy, which can shrink tumors so they're easier to remove surgically. About 10% to 15% of all breast cancer types are of the triple-negative type. Most instances of TNBC are invasive ductal carcinoma, but ductal carcinoma in situ can also be estrogen-receptor and progesterone-receptor negative. The cell type, not the location, determines whether breast cancer is TNBC. Black and Latinx people are more likely to develop TNBC than those of other ethnicities. A 2021 study found that Black women were 2.7 times more likely than white women to receive a TNBC diagnosis. Many Black females don't have access to the insurance or resources they need to manage this type of cancer. They may experience delays between diagnosis and treatment and challenges communicating with doctors. People with mutations on their BRCA gene, especially on the BRCA1 gene, are also at risk for this type of breast cancer, as are those younger than age 50. Types of treatment Even though TBNC is harder to treat compared to other types of breast cancer, treatments continue to evolve. Chemotherapy A common TNBC treatment strategy is to begin with chemotherapy, either alone or in combination with an immunotherapy drug. This helps shrink tumors so they're easier to remove with surgery. It can also shrink affected lymph nodes. Some research suggests that neoadjuvant chemotherapy (chemotherapy that occurs before other treatments) can eliminate invasive breast cancer in about 30% to 50% of cases. Other studies have found that it is effective in over 58% of those with TNBC. Research has found that when chemo can eliminate TNBC, the 5-year event-free survival rate is 92% and the 10-year event-free survival rate is 87%. Event-free survival includes cancer recurrence and further complications. However, this is dependent upon the stage of the tumor. Your doctor might prescribe additional chemotherapy treatment after surgery. Chemotherapy after surgery is known as adjuvant chemotherapy and is performed to reduce the likelihood of a cancer recurrence. Surgery Surgery can be performed before or after chemotherapy. When an early stage TNBC tumor is small enough, treatment may begin with surgery. The surgeon will remove the tumor and check your lymph nodes. Surgery might involve: a lumpectomy, which removes the tumor while preserving breast tissue a mastectomy, which removes the entire breast a sentinel lymph node biopsy, which removes nearby lymph nodes Additional treatment may be needed after surgery to help improve outcomes. Immunotherapy Immunotherapy works by boosting your immune system and teaching it to target cancer cells by controlling the action of protein checkpoints that turn your immune response on or off. It can be used before or after surgery. Pembrolizumab (Keytruda) is an immunotherapy drug that targets the immune cell protein PD-1. This protein usually stops immune cells from attacking. Pembrolizumab prevents PD-1 from blocking immune system cells so they can attack breast cancer cells. About 1 in 5 instances of TNBC have the PD-1 protein. Targeted therapy Targeted therapy works by targeting specific proteins in breast cancer cells to slow or stop the cancer from growing and spreading. This type of treatment can also help you live longer. Targeted therapy can be used to help other types of treatment work better or in place of other interventions that aren't effective. One type of targeted therapy is an antibody drug conjugate, such as sacituzumab govitecan (Trodelvy). This attaches itself to a specific protein in the cancer cell to directly deliver chemotherapy to it. If you have a BRCA mutation, your doctor may recommend taking olaparib (Lynparza) or talazoparib (Talzenna). Radiation Radiation treatment is recommended if you elect for breast conservation with a lumpectomy. It can also be used if you've had a mastectomy with positive lymph nodes. Radiation treatment uses high energy radiation that destroys remaining breast cancer cells. There are two types of radiation treatment: external beam radiation and internal radiation. During external beam radiation, a machine outside your body will direct radiation to the target area. For brachytherapy, or internal radiation, a healthcare professional will place radioactive material inside your body, next to the cancer site. Clinical trials Clinical trials are research studies using human volunteers. Trials are available for all stages of cancer. If you're part of a clinical trial, you might have advanced access to new treatments. By participating in a trial, you will also contribute to improving medical knowledge and progress in cancer treatments. You can discuss the option of a clinical trial with your doctor. You can also find more information through the following online resources: Treatment considerations Your unique circumstances determine the approach to TNBC treatment. Your care team will develop a specific treatment plan based on your situation. In some cases, you'll have surgery first to remove the cancerous tumor, followed by other treatments to reduce the risk of cancer coming back, helping prolong your life. In other cases, you'll undergo treatment first to help shrink the tumors before having them surgically removed. Follow-up treatment may then also be recommended after surgery. People diagnosed with stage 4 TNBC rarely undergo surgery or radiation. However, they may be prescribed stronger types of chemotherapy, targeted therapy, or immunotherapy — or different combinations of these treatments — to help improve outcomes. Personalized treatment approach Newer treatment options, such as targeted therapy and immunotherapy, have advanced the personalized approach to TNBC treatment. The BRCA mutation may present an opportunity for a precision treatment approach. It occurs in about 20% to 30% of TNBC cancer instances and responds to treatment using poly (ADP-ribose) polymerase (PARP) inhibitors. Using pembrolizumab to target PD-1 is another personalized approach for TNBC cancer cells with this protein. For more advanced TNBC where other treatments aren't effective, using sacituzumab govitecan can be another personalized option. Research is also ongoing to determine whether the aggressive nature of TNBC in Black women is because of health issues such as obesity or factors like socioeconomic status, healthcare access, or cultural practices. This may lead to much-needed precision treatment approaches for Black women. However, TNBC can still be challenging to treat. This is mainly due to its aggressive nature and lack of certain protein receptors. There are also few outlook (related to a person's overall outcome, regardless of therapy) and predictive (related specifically to treatment outcomes) biomarkers. Outlook The National Cancer Institute (NCI) maintains a database called the Surveillance, Epidemiology, and End Results Program (SEER). The SEER database tracks 5-year relative survival rates by grouping cancers into categories based on how far they've spread. A relative survival rate compares a person with cancer against the overall population. For example, if you have breast cancer with a 90% 5-year relative survival rate, you're 90% as likely to live for 5 years as someone without this disease. According to the American Cancer Society, the SEER 5-year relative survival rates for TNBC are: 92% for localized (cancer is contained within the breast) 67% for regional (cancer is located in the breast and nearby lymph nodes and tissues) 15% for distant (cancer is located in distant areas like the liver, bones, or lungs) 78% for all stages combined These percentages have increased slightly in recent years, as treatment methods continue to evolve.
New Indian Express
07-07-2025
- Health
- New Indian Express
In the early stage, most breast cancers are painless
Myth: Breast cancer only affects middle-aged or older women Fact: Postmenopausal ladies are at more risk of developing breast cancer. However, we are seeing an increase in the number of young women in their 30s and40s also developing an aggressive breast cancer variant called triple negative type. Myth: One will develop breast cancer only if there is family history Fact: Majority of breast cancer occurs in those without any family history. Risk increases in those whose first degree relatives (mother, siblings, children) develop breast cancer, particularly at a young age. Genetic predisposition like BRCA also increases risk, although it's rare, less than a percentage. Myth: Breast pain is the symptoms of breast cancer Fact: In the early stage, most breast cancers are painless. Only once they grow and invade surrounding muscles or nerves do they cause pain. Myth: Breast lumps are breast cancers Fact: In young women, hormonal changes can lead to development of fibrocystic disease, which is common and not cancerous. In such lumps they feel engorgement and pain during some days of the menstrual cycle. An ultrasound will help to differentiate these lumps from cancer. Myth: Men do not get breast cancer Fact: One per cent of all breast cancers occur in men. Unfortunately they are more aggressive than those in women, as they come at a late stage. Irrespective of gender, a persistent, growing swelling needs evaluation. (Dr Arun Warrier is a senior consultant, medical oncologist, Aster Medcity)
