CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2018; 78(03): 237-245
DOI: 10.1055/s-0044-101613
GebFra Science
Review/Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Update Breast Cancer 2018 (Part 1) – Primary Breast Cancer and Biomarkers

Artikel in mehreren Sprachen: English | deutsch
Florin-Andrei Taran
1   Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
,
Andreas Schneeweiss
2   National Center for Tumor Diseases, Division Gynecologic Oncology, University Hospital Heidelberg, Heidelberg, Germany
3   Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
,
Michael P. Lux
4   Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
,
Wolfgang Janni
5   Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
,
Andreas D. Hartkopf
1   Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
,
Naiba Nabieva
4   Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
,
Friedrich Overkamp
6   OncoConsult Hamburg GmbH, Hamburg, Germany
,
Hans-Christian Kolberg
7   Department of Gynecology and Obstetrics, Marienhospital Bottrop, Bottrop, Germany
,
Peyman Hadji
8   Department of Bone Oncology, Nordwest Hospital, Frankfurt, Germany
,
Hans Tesch
9   Oncology Practice at Bethanien Hospital Frankfurt, Frankfurt, Germany
,
Achim Wöckel
10   Department of Gynecology and Obstetrics, University Hospital Würzburg, Würzburg, Germany
,
Johannes Ettl
11   Department of Obstetrics and Gynecology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
,
Diana Lüftner
12   Charité University Hospital, Berlin, Campus Benjamin Franklin, Department of Hematology, Oncology and Tumour Immunology, Berlin, Germany
,
Markus Wallwiener
3   Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
,
Volkmar Müller
13   Department of Gynecology, Hamburg-Eppendorf University Medical Center, Hamburg, Germany
,
Matthias W. Beckmann
4   Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
,
Erik Belleville
14   ClinSol GmbH & Co KG, Würzburg, Germany
,
Diethelm Wallwiener
1   Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
,
Sara Y. Brucker
1   Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
,
Peter A. Fasching
4   Erlangen University Hospital, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
,
Tanja N. Fehm
15   Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Düsseldorf, Germany
,
Florian Schütz
3   Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
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Weitere Informationen

Publikationsverlauf

received 19. Januar 2018
revised 24. Januar 2018

accepted 24. Januar 2018

Publikationsdatum:
21. März 2018 (online)

Abstract

This summary provides an overview of how new therapies or new aspects of established therapies relate to the latest findings. Neoadjuvant therapy, local therapy, new aspects of systemic therapy, and prognostic and predictive factors are presented. In the neoadjuvant setting, the association between pathological complete response (pCR) and prognosis is still of interest as is the identification of new molecular predictors for new therapies such as CDK4/6 inhibitors. As regards surgical treatment, the target is still to reduce the aggressiveness of surgery. To achieve this, a better understanding particularly of ductal carcinoma in situ is required. With regard to systemic therapy, more data on the best combinations and therapy sequences for existing therapies is available. Finally, the use of prognostic and predictive factors may help to avoid overtreatment and ensure that patients only receive therapies which have been shown to be effective for their specific condition and have fewer side effects.

 
  • References/Literatur

  • 1 Kolberg HC, Luftner D, Lux MP. et al. Breast cancer 2012 – new aspects. Geburtsh Frauenheilk 2012; 72: 602-615
  • 2 Lux MP, Janni W, Hartkopf AD. et al. Update breast cancer 2017 – implementation of novel therapies. Geburtsh Frauenheilk 2017; 77: 1281-1290
  • 3 Maass N, Schutz F, Fasching PA. et al. Breast cancer update 2014 – focus on the patient and the tumour. Geburtsh Frauenheilk 2015; 75: 170-182
  • 4 Kolberg HC. Editorial: Primary systemic therapy for breast cancer. Rev Recent Clin Trials 2017; 12: 66
  • 5 Fasching PA, Heusinger K, Haeberle L. et al. Ki67, chemotherapy response, and prognosis in breast cancer patients receiving neoadjuvant treatment. BMC Cancer 2011; 11: 486
  • 6 Fujii T, Kogawa T, Dong W. et al. Revisiting the definition of estrogen receptor positivity in HER2-negative primary breast cancer. Ann Oncol 2017; 28: 2420-2428
  • 7 Untch M, Huober J, Jackisch C. et al. Initial treatment of patients with primary breast cancer: evidence, controversies, consensus: spectrum of opinion of German specialists at the 15th International St. Gallen Breast Cancer Conference (Vienna 2017). Geburtsh Frauenheilk 2017; 77: 633-644
  • 8 Early Breast Cancer Trialistsʼ Collaborative Group (EBCTCG). Long-term outcomes for neoadjuvant versus adjuvant chemotherapy in early breast cancer: meta-analysis of individual patient data from ten randomised trials. Lancet Oncol 2018; 19: 27-39
  • 9 Sotiriou C, Rothé F, Maetens M. et al. Copy number aberration analysis to predict response to neoadjuvant anti-HER2 therapy: results from the NeoALTTO phase III trial [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5–9; San Antonio, TX Philadelphia (PA): AACR Cancer Res 2018; 78: Abstr.. GS1-04
  • 10 Krop IE, Hillman D, Polley MY. et al. Invasive disease-free survival and gene expression signatures in CALGB (Alliance) 40601, a randomized phase III neoadjuvant trial of dual HER2-targeting with lapatinib added to chemotherapy plus trastuzumab [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5–9; San Antonio, TX Philadelphia (PA): AACR Cancer Res 2018; 78: Abstr.. GS3-02
  • 11 Cortazar P, Geyer jr. CE. Pathological complete response in neoadjuvant treatment of breast cancer. Ann Surg Oncol 2015; 22: 1441-1446
  • 12 von Minckwitz G, Untch M, Blohmer JU. et al. Definition and impact of pathologic complete response on prognosis after neoadjuvant chemotherapy in various intrinsic breast cancer subtypes. J Clin Oncol 2012; 30: 1796-1804
  • 13 Yee D, DeMichele A, Isaacs C. et al. Pathological complete response predicts event-free and distant disease-free survival in the I-SPY2 TRIAL [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5–9; San Antonio, TX Philadelphia (PA): AACR Cancer Res 2018; 78: Abstr.. GS3-08
  • 14 Schneeweiss A, Jackisch C, Schmatloch S. et al. Survival analysis of the prospectively randomized phase III GeparSepto trial comparing neoadjuvant chemotherapy with weekly nab-paclitaxel with solvent-based paclitaxel followed by anthracycline-cyclosphosphamide for patients with early breast cancer – GBG69 [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5–9; San Antonio, TX Philadelphia (PA): AACR Cancer Res 2018; 78: Abstr.. GS3-05
  • 15 Fasching PA, Abad MF, Garcia-Saenz JA. et al. Biological and clinical effects of abemaciclib in a phase 2 neoadjuvant study for postmenopausal patients with HR+/HER2-breast cancer. Oncol Res Treat 2017; 40: 225-226
  • 16 Guarneri V, Fasching PA, Abad MF. et al. Biological and clinical effects of abemaciclib in a phase 2 neoadjuvant study for postmenopausal patients with HR+/HER2− breast cancer. Ann Oncol 2017; DOI: 10.1093/annonc/mdx424.002.
  • 17 Martin M, Hurvitz SA, Chan D. et al. Final results of NeoMONARCH: a phase 2 neoadjuvant study of abemaciclib in postmenopausal women with hormone receptor positive (HR+), HER2 negative breast cancer (BC) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5–9; San Antonio, TX Philadelphia (PA): AACR Cancer Res 2018; 78: Abstr.. PD5-01
  • 18 Buchholz TA, Somerfield MR, Griggs JJ. et al. Margins for breast-conserving surgery with whole-breast irradiation in stage I and II invasive breast cancer: American Society of Clinical Oncology endorsement of the Society of Surgical Oncology/American Society for Radiation Oncology consensus guideline. J Clin Oncol 2014; 32: 1502-1506
  • 19 Houssami N, Macaskill P, Marinovich ML. et al. The association of surgical margins and local recurrence in women with early-stage invasive breast cancer treated with breast-conserving therapy: a meta-analysis. Ann Surg Oncol 2014; 21: 717-730
  • 20 Shah C, Verma V, Sayles H. et al. Appropriate margins for breast conserving surgery in patients with early stage breast cancer: a meta-analysis [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5–9; San Antonio, TX Philadelphia (PA): AACR Cancer Res 2018; 78: Abstr.. GS5-01
  • 21 Giuliano AE, Hunt KK, Ballman KV. et al. Axillary dissection vs. no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA 2011; 305: 569-575
  • 22 Galimberti V, Cole BF, Viale G. et al. Axillary dissection vs. no axillary dissection in patients with cT1-T2 cN0M0 breast cancer and only micrometastases in the sentinel node(s): Ten-year results of the IBCSG 23-01 trial [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5–9; San Antonio, TX Philadelphia (PA): AACR Cancer Res 2018; 78: Abstr.. GS5-02
  • 23 Fasching PA, Jud SM, Hauschild M. et al. FemZone trial: a randomized phase II trial comparing neoadjuvant letrozole and zoledronic acid with letrozole in primary breast cancer patients. BMC Cancer 2014; 14: 66
  • 24 Hwang ES, Duong S, Bedrosian I. et al. Primary endocrine therapy for ER-positive ductal carcinoma in situ (DCIS) CALGB 40903 (Alliance) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5–9; San Antonio, TX Philadelphia (PA): AACR Cancer Res 2018; 78: Abstr.. GS5-05
  • 25 Dowsett M, Ebbs SR, Dixon JM. et al. Biomarker changes during neoadjuvant anastrozole, tamoxifen, or the combination: influence of hormonal status and HER-2 in breast cancer–a study from the IMPACT trialists. J Clin Oncol 2005; 23: 2477-2492
  • 26 Smith IE, Dowsett M, Ebbs SR. et al. Neoadjuvant treatment of postmenopausal breast cancer with anastrozole, tamoxifen, or both in combination: the Immediate Preoperative Anastrozole, Tamoxifen, or Combined with Tamoxifen (IMPACT) multicenter double-blind randomized trial. J Clin Oncol 2005; 23: 5108-5116
  • 27 Robertson JFR, Dowsett M, Bliss JM. et al. Peri-operative aromatase inhibitor treatment in determining or predicting longterm outcome in early breast cancer-the POETIC* trial (CRUK/07/015) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5–9; San Antonio, TX Philadelphia (PA): AACR Cancer Res 2018; 78: Abstr.. GS1-03
  • 28 Lambertini M, Moore HCF, Leonard RCF. et al. Pooled analysis of five randomized trials investigating temporary ovarian suppression with gonadotropin-releasing hormone analogs during chemotherapy as a strategy to preserve ovarian function and fertility in premenopausal early breast cancer patients [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5–9; San Antonio, TX Philadelphia (PA): AACR Cancer Res 2018; 78: Abstr.. GS4-01
  • 29 Trapp E, Steidl J, Rack B. et al. Anti-Mullerian hormone (AMH) levels in premenopausal breast cancer patients treated with taxane-based adjuvant chemotherapy – a translational research project of the SUCCESS A study. Breast 2017; 35: 130-135
  • 30 Day FR, Thompson DJ, Helgason H. et al. Genomic analyses identify hundreds of variants associated with age at menarche and support a role for puberty timing in cancer risk. Nat Genet 2017; 49: 834-841
  • 31 Perry JR, Hsu YH, Chasman DI. et al. DNA mismatch repair gene MSH6 implicated in determining age at natural menopause. Hum Mol Genet 2014; 23: 2490-2497
  • 32 Day FR, Ruth KS, Thompson DJ. et al. Large-scale genomic analyses link reproductive aging to hypothalamic signaling, breast cancer susceptibility and BRCA1-mediated DNA repair. Nat Genet 2015; 47: 1294-1303
  • 33 Perry JR, Day F, Elks CE. et al. Parent-of-origin-specific allelic associations among 106 genomic loci for age at menarche. Nature 2014; 514: 92-97
  • 34 Gray R, Bradley R, Braybrooke J. et al. Increasing the dose density of adjuvant chemotherapy by shortening intervals between courses or by sequential drug administration significantly reduces both disease recurrence and breast cancer mortality: an EBCTCG meta-analysis of 21,000 women in 16 randomised trials [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5–9; San Antonio, TX Philadelphia (PA): AACR Cancer Res 2018; 78: Abstr.. GS1-01
  • 35 Francis PA, Regan MM, Fleming GF. Adjuvant ovarian suppression in premenopausal breast cancer. N Engl J Med 2015; 372: 1673
  • 36 Francis PA, Pagani O, Regan MM. et al. Randomized comparison of adjuvant aromatase inhibitor exemestane (E) plus ovarian function suppression (OFS) vs. tamoxifen (T) plus OFS in premenopausal women with hormone receptor positive (HR+) early breast cancer (BC): update of the combined TEXT and SOFT trials [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5–9; San Antonio, TX Philadelphia (PA): AACR Cancer Res 2018; 78: Abstr.. GS4-02
  • 37 Goss PE, Muss HB, Ingle JN. et al. Extended adjuvant endocrine therapy in breast cancer: current status and future directions. Clin Breast Cancer 2008; 8: 411-417
  • 38 Goss PE, Ingle JN, Pritchard KI. et al. Extending aromatase-inhibitor adjuvant therapy to 10 years. N Engl J Med 2016; 375: 209-219
  • 39 Goldvaser H, Barnes TA, Seruga B. et al. Toxicity of extended adjuvant therapy with aromatase inhibitors in early breast cancer: a systematic review and meta-analysis. J Natl Cancer Inst 2018; DOI: 10.1093/jnci/djx141.
  • 40 Song F, Zhang J, Li S. et al. ER-positive breast cancer patients with more than three positive nodes or grade 3 tumors are at high risk of late recurrence after 5-year adjuvant endocrine therapy. Onco Targets Ther 2017; 10: 4859-4867
  • 41 Colleoni M, Luo W, Karlsson P. et al. Extended adjuvant intermittent letrozole versus continuous letrozole in postmenopausal women with breast cancer (SOLE): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 2018; 19: 127-138
  • 42 Blok EJ, Kroep JR, Meershoek-Klein Kranenbarg E. et al. Optimal duration of extended adjuvant endocrine therapy for early breast cancer; results of the IDEAL trial (BOOG 2006-05). J Natl Cancer Inst 2018; DOI: 10.1093/jnci/djx134.
  • 43 Gnant M, Steger G, Greil R. et al. A prospective randomized multi-center phase-III trial of additional 2 versus additional 5 years of Anastrozole after initial 5 years of adjuvant endocrine therapy – results from 3,484 postmenopausal women in the ABCSG-16 trial [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5–9; San Antonio, TX Philadelphia (PA): AACR Cancer Res 2018; 78: Abstr.. GS3-01
  • 44 Cameron D, Piccart-Gebhart MJ, Gelber RD. et al. 11 yearsʼ follow-up of trastuzumab after adjuvant chemotherapy in HER2-positive early breast cancer: final analysis of the HERceptin Adjuvant (HERA) trial. Lancet 2017; 389: 1195-1205
  • 45 Pivot X, Romieu G, Debled M. et al. 6 months versus 12 months of adjuvant trastuzumab for patients with HER2-positive early breast cancer (PHARE): a randomised phase 3 trial. Lancet Oncol 2013; 14: 741-748
  • 46 Perez EA, Suman VJ, Davidson NE. et al. Sequential versus concurrent trastuzumab in adjuvant chemotherapy for breast cancer. J Clin Oncol 2011; 29: 4491-4497
  • 47 Joensuu H, Fraser J, Wildiers H. et al. A randomized phase III study of adjuvant trastuzumab for a duration of 9 weeks versus 1 year, combined with adjuvant taxane-anthracycline chemotherapy, for early HER2-positive breast cancer (the SOLD study) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5–9; San Antonio, TX Philadelphia (PA): AACR Cancer Res 2018; 78: Abstr.. GS3-04
  • 48 von Minckwitz G, Ponomarova O, Morales S. et al. Efficacy and safety of biosimilar ABP 980 compared with trastuzumab in HER2 positive early breast cancer. Ann Oncol 2017; 28 (Suppl. 05) v43-v67 Abstr. 151PD
  • 49 Kolberg HC, Demetriou GS, Zhang N. et al. Safety results from a randomized, double-blind, phase 3 study of ABP 980 compared with trastuzumab in patients with breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5–9; San Antonio, TX Philadelphia (PA): AACR Cancer Res 2018; 78: Abstr. PD3-10
  • 50 Yasiejko C. Roche sues Pfizer to bar biosimilar of cancer drug Herceptin. Bloomberg Technology; 2017 Online: https://www.bloomberg.com/news/articles/2017-11-20/roche-sues-pfizer-to-block-biosimilar-of-cancer-drug-herceptin last access: 16.01.2018
  • 51 Fasching PA, Brucker SY, Fehm TN. et al. Biomarkers in patients with metastatic breast cancer and the PRAEGNANT Study Network. Geburtsh Frauenheilk 2015; 75: 41-50
  • 52 Schmidt M, Fasching PA, Beckmann MW. et al. Biomarkers in breast cancer – an update. Geburtsh Frauenheilk 2012; 72: 819-832
  • 53 Sparano JA, Gray RJ, Makower DF. et al. Prospective validation of a 21-gene expression assay in breast cancer. N Engl J Med 2015; 373: 2005-2014
  • 54 Cardoso F, vanʼt Veer LJ, Bogaerts J. et al. 70-Gene signature as an aid to treatment decisions in early-stage breast cancer. N Engl J Med 2016; 375: 717-729
  • 55 Polasik A, Tzschaschel M, Schochter F. et al. Circulating tumour cells, circulating tumour DNA and circulating MicroRNA in metastatic breast carcinoma – what is the role of liquid biopsy in breast cancer?. Geburtsh Frauenheilk 2017; 77: 1291-1298
  • 56 Riethdorf S, Muller V, Loibl S. et al. Prognostic impact of circulating tumor cells for breast cancer patients treated in the neoadjuvant “Geparquattro” trial. Clin Cancer Res 2017; 23: 5384-5393
  • 57 Janni WJ, Rack B, Terstappen LW. et al. Pooled analysis of the prognostic relevance of circulating tumor cells in primary breast cancer. Clin Cancer Res 2016; 22: 2583-2593
  • 58 Rack B, Schindlbeck C, Juckstock J. et al. Circulating tumor cells predict survival in early average-to-high risk breast cancer patients. J Natl Cancer Inst 2014; DOI: 10.1093/jnci/dju066.
  • 59 Sparano JA, OʼNeill A, Alpaugh K. et al. Circulating tumor cells (CTCs) five years after diagnosis are prognostic for late recurrence in operable stage II–III breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5–9; San Antonio, TX Philadelphia (PA): AACR Cancer Res 2018; 78: Abstr.. GS6-03
  • 60 Janni W, Rack B, Fasching P. et al. Persistence of circulating tumor cells in high risk early breast cancer patients during follow-up care suggests poor prognosis – results from the adjuvant SUCCESS A trial. Cancer Res 2016; 76: Abstr.. S2-03
  • 61 Hein A, Rack B, Li L. et al. Genetic breast cancer susceptibility variants and prognosis in the prospectively randomized SUCCESS A study. Geburtsh Frauenheilk 2017; 77: 651-659
  • 62 Fasching PA, Haberle L, Rack B. et al. Clinical validation of genetic variants associated with in vitro chemotherapy-related lymphoblastoid cell toxicity. Oncotarget 2017; 8: 78133-78143
  • 63 Hein A, Lambrechts D, von Minckwitz G. et al. Genetic variants in VEGF pathway genes in neoadjuvant breast cancer patients receiving bevacizumab: results from the randomized phase III GeparQuinto study. Int J Cancer 2015; 137: 2981-2988
  • 64 Guo Q, Schmidt MK, Kraft P. et al. Identification of novel genetic markers of breast cancer survival. J Natl Cancer Inst 2015; 107: pii:djv081 doi:10.1093/jnci/djv081
  • 65 Hein A, Bayer CM, Schrauder MG. et al. Polymorphisms in the RANK/RANKL genes and their effect on bone specific prognosis in breast cancer patients. Biomed Res Int 2014; 2014: 842452
  • 66 Fasching PA, Pharoah PD, Cox A. et al. The role of genetic breast cancer susceptibility variants as prognostic factors. Hum Mol Genet 2012; 21: 3926-3939
  • 67 Fasching PA, Loehberg CR, Strissel PL. et al. Single nucleotide polymorphisms of the aromatase gene (CYP19A1), HER2/neu status, and prognosis in breast cancer patients. Breast Cancer Res Treat 2008; 112: 89-98
  • 68 Fagerholm R, Schmidt MK, Khan S. et al. The SNP rs6500843 in 16p13.3 is associated with survival specifically among chemotherapy-treated breast cancer patients. Oncotarget 2015; 6: 7390-7407
  • 69 Weischer M, Nordestgaard BG, Pharoah P. et al. CHEK2*1100delC heterozygosity in women with breast cancer associated with early death, breast cancer-specific death, and increased risk of a second breast cancer. J Clin Oncol 2012; 30: 4308-4316
  • 70 Copson ER, Maishman TC, Tapper WJ. et al. Germline BRCA mutation and outcome in young-onset breast cancer (POSH): a prospective cohort study. Lancet Oncol 2018; DOI: 10.1016/S1470-2045(17)30891-4.
  • 71 Fasching PA. Breast cancer in young women: do BRCA1 or BRCA2 mutations matter?. Lancet Oncol 2018; DOI: 10.1016/S1470-2045(18)30008-1.
  • 72 United States Food and Drug Administration (FDA). FDA approves first treatment for breast cancer with a certain inherited genetic mutation. 2018 Online: https://wwwfdagov/NewsEvents/Newsroom/PressAnnouncements/ucm592347htm last access: 16.01.2018
  • 73 Fasching PA, Hu C, Hart SN. et al. Cancer predisposition genes in metastatic breast cancer – association with metastatic pattern, prognosis, patient and tumor characteristics [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5–9; San Antonio, TX Philadelphia (PA): AACR Cancer Res 2018; 78: Abstr.. PD1-02
  • 74 Schneeweiss A, Lux MP, Janni W. et al. Update breast cancer 2018 (part 2) – advanced breast cancer, quality of life and prevention. Geburtsh Frauenheilk 2018; 78: 246-259