Articles

Breast cancer and pregnancy-related issues

BJMO - volume 12, issue 1, february 2018

M. Lambertini , B. Nguyen MSc, G. Viglietti , S. Martel , E. de Azambuja MD, PhD

Summary

Breast cancer and pregnancy-related issues are important areas of concern for young women. Prior pregnancies and breastfeeding may impact the risk of developing breast cancer and its biologic features. Nowadays, thanks to major advances in oncology practice, breast cancer patients have excellent survival outcomes; hence, survivorship issues including the possibility to constitute a family after treatment are of crucial importance. Furthermore, considering the current trend of delaying childbearing, an increased awareness should be paid towards the possibility of breast cancer diagnosis during pregnancy. Despite increased amounts of data available and consensus guidelines having been published on these topics, it should be noted that current recommendations rely on limited evidence. Hence, further research efforts are needed to obtain more conclusive considerations in this regard.

This review article focuses on the link between reproductive behaviour, infertility treatments and the risk of developing breast cancer, the management of patients diagnosed with breast tumour during pregnancy, as well as the concerns of a pregnancy in survivors with prior history of breast malignancy.

(BELG J MED ONCOL 2018;12(1):9–14)

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Liquid biopsy in breast cancer: challenges and opportunities

BJMO - volume 11, issue 8, december 2017

C. Maggi MD, M. Lambertini , M. Ignatiadis MD, PhD

SUMMARY

Despite the use of effective loco-regional and systemic treatment approaches, many women with early-stage breast cancer still relapse and die of their disease. The early detection of small micrometastatic lesions that are currently undetectable by imaging procedures may potentially increase the chances to prevent the development of incurable metastatic disease. In patients with advanced disease, biological features of the tumour can change between the primary lesion and the metastases. However, in routine clinical practice, due to the difficulty of performing a biopsy of the recurrent lesions, treatment choices are often based on the biological features of the primary tumour. Moreover, one sample from a single metastatic lesion at a specific time point cannot capture the spatial and temporal intra-tumour heterogeneity of metastatic disease. Circulating-based biomarkers (i.e. ‘liquid biopsy’) such as circulating tumour cells and circulating tumour DNA are non-invasive biomarkers that have been developed to overcome the limitations of currently available tools in both the early and metastatic settings. In this manuscript, we review the current state of the art on circulating tumour cells and circulating tumour DNA in breast cancer focusing on their potential clinical utility as prognostic biomarkers, as tools to detect minimal residual disease, and to guide and monitor response and resistance to administered anticancer therapies.

(BELG J MED ONCOL 2017;11(8):357–363)

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