14 Nov MRI Screening and Treatment Options Improve Survival for Triple Negative Breast Cancer
MedicalResearch.com Interview with:
Dr. Franca Podo, Dr Sci
Former Director of the Molecular and Cellular Imaging Unit
Department of Cell Biology and Neurosciences
Istituto Superiore di Sanità
Medical Research: What is the background for this study? What are the main findings?
Dr. Podo: Population-based studies showed that triple negative breast cancers (TNBCs), i.e. those which are negative for estrogen and progesterone receptors without HER-2/neu overexpression, have a more aggressive clinical course and a 2-to-3 fold higher likelihood of distant recurrence and death from breast cancer within 5 years from diagnosis, compared with non-TNBCs.
In a study published in Clinical Cancer Research (Online First 26 October 2015) Dr. F. Podo and Dr. F. Santoro (Istituto Superiore di Sanità, Rome) and Prof. F. Sardanelli (Università degli Studi di Milano, IRCCS Policlinico San Donato) in collaboration with other Italian co-authors, compared phenotype features and survival rates of invasive TNBCs versus non-TNBCs detected during the HIBCRIT-1 screening study of 501 asymptomatic women at high genetic-familial risk for breast cancer. The screening included BRCA1 and BRCA2 mutation carriers, as well as women with a strong family history of breast and/or ovarian cancer, enrolled between 2000 and 2008 in 18 centers. Data analysis from a median 9.7-year follow-up until June 2015 showed that, combining an annual screening including magnetic resonance imaging (MRI) with adequate treatment options, the mean 5-year overall survival of triple negative breast cancers was not significantly different from that of non-TNBCs (86% vs 93%), in spite of a 3-fold higher rate of cases of grade 3 invasive ductal carcinoma in the former subgroup (71% in TNBCs vs 23% in non-TNBCs). The mean disease-free survival rates were also very similar (77% vs 76%, respectively).
Medical Research: What should clinicians and patients take away from your report?
Dr. Podo: This study is the first to show that the significant differences commonly reported for the overall and disease-free survival rates between triple negative breast cancers and non-TNBC subsets could be drastically reduced in high-risk women, as an effect of the combination of a multimodal MRI-including screening and adequate treatment options.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Podo: An individual patient data meta-analysis of similar screening studies performed on high-risk women in different countries could
- a) further improve and simplify radiological protocols for an early diagnosis and optimized guidelines for treatment of TNBC cases in these women, and
- b) provide the grounds for offering individualized evidence-based recommendations to women belonging to different classes of risk of developing a breast cancer in their life time.
Franca Podo, Filippo Santoro, Giovanni Di Leo, Siranoush Manoukian,Clelia De Giacomi, Stefano Corcione, Laura Cortesi, Luca A. Carbonaro,Rubina M. Trimboli, Anna Cilotti, Lorenzo Preda, Bernardo Bonanni,Matilde Pensabene, Laura Martincich, Antonella Savarese, Alma Contegiacomo, and Francesco Sardanelli
Dr. Franca Podo, Dr Sci (2015). MRI Screening and Treatment Options Improve Survival for Triple Negative Breast Cancer MedicalResearch.com