Mayo Clinic researchers present findings at the 2019 San Antonio Breast Cancer Symposium

SAN ANTONIO — Mayo Clinic researchers will present findings at the San Antonio Breast Cancer Symposium Dec. 10–14 in San Antonio.

New Mayo Clinic studies to be presented include:

“Women at Elevated Risk of Developing Breast Cancer May Benefit From Taking Anti-inflammatory Drugs”

Embargoed until Friday, Dec. 13, at 6 p.m. EST

Research from Mayo Clinic investigators suggest that some women with an elevated risk of developing breast cancer may benefit from taking anti-inflammatory medications.

“Several studies have evaluated whether the use of anti-inflammatory medications such as aspirin, ibuprofen and naproxen affect a woman’s risk of developing breast cancer,” says Amy Degnim, M.D., a breast surgical oncologist at Mayo Clinic in Minnesota, “but little is known about how use of these drugs might affect their risk after a benign breast biopsy.” Dr. Degnim says about one million women receive a diagnosis of benign breast disease annually in the U.S. and having this history increases their risk of developing breast cancer.

Researchers surveyed women who had undergone a benign breast biopsy at Mayo Clinic between 1992 and 2001, and asked them to report which types of these medications they had used and for how long. Researchers also obtained information on which women had developed breast cancer at any point in the years after their initial benign biopsy.

“We found that women who reported using ibuprofen or naproxen had an approximately 40% reduction in breast cancer risk, while women who reported using aspirin had no reduction in breast cancer risk,” says Dr. Degnim. “Women who used the drugs more frequently on a regular basis also had greater protection from breast cancer.”

Dr. Degnim says the findings suggest that women who have had a benign breast biopsy may benefit from medications that reduce inflammation, except for aspirin, in terms of reducing later breast cancer risk. She cautions that this study was not a clinical trial and she does not recommend that all women should take these medications to reduce their breast cancer risk. “Our results support the need for a clinical trial to further investigate the risks and benefits of taking these medications to lower breast cancer risk.”

“Young Women With Breast Cancer May Help Preserve Fertility by Avoiding Intensive Chemotherapy”

Embargoed until Thursday, Dec. 12, at 8 a.m. EST

Young women with HER 2-positive breast cancer may help preserve their fertility by choosing one type of chemotherapy over another according to the findings of a study led by Kathryn Ruddy, M.D., an oncologist at Mayo Clinic. 

“Ovarian dysfunction is an important issue after cancer treatment because it can be associated with infertility and menopausal symptoms, such as hot flashes and impaired sexual function,” says Dr. Ruddy.

Dr. Ruddy and her team surveyed study participants taking part in a randomized clinical trial testing the efficacy of T-DM1 versus a combination of paclitaxel and trastuzumab. Participants were asked questions about menstrual periods. “We found that young women with HER 2-positive breast cancer may be more likely to resume menstruation after receipt of two relatively new treatments, T-DM1 or a combination of paclitaxel and trastuzumab, than we have seen previously in young women who received older, more intensive chemotherapy regimens.”

Dr. Ruddy says the findings should be good news for women who want to maintain fertility after treatment for breast cancer and that menopausal symptoms such as hot flashes may be less burdensome for patients treated with the newer regimens. Dr. Ruddy and her colleagues will perform additional analyses on the effect of tamoxifen on these results before publishing a paper on this study. 

“Researchers Develop Tool to Identify Patients at Higher Risk of Heart Damage From Breast Cancer Therapy”

Embargoed until Friday, Dec. 13, at 6 p.m. EST

Researchers at Mayo Clinic in Florida have developed a tool to help identify patients who may be at higher risk of developing heart damage from anti HER 2 breast cancer therapy at an early stage.

“Cardiac toxicity is a known complication of anti-HER 2 therapy,” says Pooja Advani, M.B.B.S., M.D., a Mayo Clinic oncologist. Dr. Advani says clinical studies have confirmed that the use of anti-HER 2 therapy in breast cancer patients can have a profound effect on patient survival.

“The most common manifestation of cardiac toxicity in breast cancer patients receiving anti-HER 2 therapy is a reduction in the ejection fraction without any symptoms,” says Dr. Advani. Ejection fraction is a measurement of the percentage of blood leaving the heart each time it contracts.

Dr. Advani says risk factors, such as older age; a lower ejection fraction prior to the start of treatment; and the use of anthracycline chemotherapy, such as doxorubin or Adriamycin, have been consistently associated with a higher risk of cardiac toxicity from anti-HER 2 therapy.

Dr. Advani and her colleagues followed 604 breast cancer patients who were treated with anti-HER 2 agents at Mayo Clinic. They collected patient data, including, age, race, gender, body mass index, smoking history, medical comorbidities, use of heart medications, baseline heart function, thickness of the heart muscle and prior use of anthracycline chemotherapy.

Researchers identified patients who developed cardiac toxicity — asymptomatic, symptomatic, or both. They performed a statistical analysis to identify risk factors that were associated with a high risk of developing cardiac dysfunction. 

“We found that patients with certain risk factors including being over the age of 55, having a lower baseline heart function (ejection fraction less than 60 percent), having received anthracycline chemotherapy or patients having enlargement and thickening of the heart walls were most significantly associated with an increased risk of developing cardiac toxicity,” says Dr. Advani. “This is consistent with previously reported studies.”

Dr. Advani says patients receiving radiation therapy as a part of their breast cancer treatment were not found to be at a significantly higher risk of developing cardiac toxicity from anti-HER 2 therapy based on their findings.

Dr. Advani and her colleagues created a risk prediction model by assigning a score to each factor mentioned above and found that the cumulative risk score was a highly significant predictor of cardiac toxicity in patients.

“Using a risk prediction model at therapy initiation may help us identify patients who may benefit from an early referral to a cardiologist for close cardiac monitoring and treatment with medications to protect their heart function,” says Dr. Advani.

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