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Progress Made in Predicting Breast Cancer Risk
Date:12/12/2008

Breast density, tumor characteristics help fine-tune treatment, study says

FRIDAY, Dec. 12 (HealthDay News) -- Researchers are making progress in predicting breast cancer risk, recurrence risk and response to cancer treatment by looking at such factors as breast density and tumor size, a panel of experts report.

The scientists presented their data during a teleconference Friday at the annual San Antonio Breast Cancer Symposium in Texas.

Patients with breast cancer tumors known as HER2-positive, even those a centimeter or less in diameter, have a substantially increased risk for relapse, and additional treatment after surgery should be considered, said Dr. Ana Gonzalez-Angulo, a researcher at the University of Texas M.D. Anderson Cancer Center.

Currently, guidelines call for no further treatment after surgery for these small cancers, but Gonzalez-Angulo said her findings suggest that thinking be reconsidered.

She evaluated 965 patients from M.D. Anderson Cancer Center, and validated the results with 350 European patients. All had small tumors, one centimeter in diameter or smaller, and 10 percent had HER2-positive tumors. HER2-positive breast cancer tests positive for a protein called human epidermal growth factor receptor 2, and these cancers tend to be more aggressive.

"The patients who had HER2-positive disease were the ones with the worst prognosis," she said. The five-year recurrence was 23 percent for those with HER-2 positive disease, compared to about 6 percent for those with HER-2 negative disease.

"We should start thinking about adjuvant therapy, as well as clinical trials," she said. "Twenty-three percent [recurrence] is very high."

The data show that even women with small cancers, under 1 centimeter, are at risk of recurrence, especially if the tumor is HER2-positive, said Dr. Claudine Isaacs, director of the clinical breast cancer program at Georgetown University
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