Key Takeaways from SABCS 2024
The 2024 San Antonio Breast Cancer Symposium, now in its 47th year, kicked off on Dec. 10 and includes four days of research presentations, posters, networking, and educational events. More than 11,000 scientists, healthcare professionals, and advocates are gathering this year to exchange ideas about the latest research and other developments in breast cancer. Our on-the-ground reporters are gathering some of the conference's most important takeaways.
Marisa Weiss, MD, radiation oncologist and founder and chief medical officer of Breastcancer.org, breaks down the research presented at the 2024 San Antonio Breast Cancer Symposium that has the most immediate implications for people diagnosed with breast cancer.
Ibrance dramatically improves progression-free survival for metastatic triple-positive breast cancer
Adding Ibrance (chemical name: palbociclib) to standard-of-care first treatments for metastatic hormone receptor-positive, HER2-positive breast cancer improved progression-free survival (how long people lived without the cancer growing) by more than 15 months. The results, which were from the PATINA trial, were presented by Dr. Otto Metzger of the Dana-Farber Cancer Institute.
Read more about the PATINA study.
New hormonal therapy shows promise
Imlunestrant, an oral selective estrogen receptor downgrader (SERD), may be a new treatment option for people diagnosed with advanced-stage, hormone receptor-positive, HER2-negative breast cancer that has grown while they were receiving an aromatase inhibitor alone or with a CDK4/6 inhibitor.
Read our Research News story to learn more about the results of the EMBER-3 study.
Active monitoring may be as good as surgery for low-risk DCIS
Women with low-risk DCIS (ductal carcinoma in situ) who receive active monitoring instead of surgery at the time of diagnosis appear no more likely to develop invasive breast cancer in the affected breast after two years.
“Omission of surgery has been highly controversial, with both patients and providers fearing that it might result in an unacceptably high rate of patients who develop invasive cancer,” said E. Shelley Hwang, MD, of Duke University. “Our findings are reassuring, and longer-term follow up will have important implications for the future inclusion of active monitoring as a treatment option for low-risk DCIS.”
Read more about the results of the COMET study.
Tamoxifen after DCIS surgery reduces risk of recurrence
Some people with DCIS who have a lumpectomy without radiation therapy may be able to lower their risk of developing invasive breast cancer by taking tamoxifen, according to research presented by Jean L. Wright, MD, of the University of North Carolina.
The study included 878 people with hormone receptor-positive DCIS that was 2.5 cm or smaller and grade I or II. The researchers compared people who took tamoxifen for five years with those who didn’t take the medicine.
After a follow-up of about 15 years, the risk of recurrence in the same breast was 11.4% in the group that took tamoxifen and 19% in the group who didn’t take tamoxifen. Wright noted that the findings suggest it would be reasonable for people to choose tamoxifen in place of radiation.
“The more information we can provide patients about the impact of specific treatments, the more we can empower patients to make choices that are right for them,” Wright said.
More evidence some can safely skip lymph node surgery
Women with early-stage, low-risk breast cancer who didn’t have sentinel lymph nodes in the armpit removed at the time of lumpectomy had similar survival rates at five years as those who had these lymph nodes removed, a study has found. The findings, published Thursday in The New England Journal of Medicine, follow a 2023 study that also found that many people with early-stage, small breast cancers can skip lymph node surgery.
The clinical trial included women with invasive breast cancer (tumor size 5cm or less) who were considered node-negative (meaning cancer cells weren’t present in the lymph nodes) based on imaging of the armpit. About 90% of these women were 50 years or older, and 95% of them had breast cancer that was hormone receptor-positive and HER2-negative. They were assigned to either have sentinel node removal or not. All of the women received a lumpectomy followed by radiation and were then tracked for about six years.
Regardless of whether the women had lymph nodes removed or not, similar percentages of women were alive with no cancer recurrence at five years: about 92%.
“This de-escalation concept may be suitable for patients 50 years of age or older who present with low-risk … HR-positive, HER2-negative invasive breast cancer and clinical T1 tumors,” the authors wrote.
Young BRCA carriers with breast cancer history benefit from risk-reducing surgery
Women with a BRCA mutation and a history of early-onset breast cancer benefit from surgery to remove their breasts, ovaries, or both. An international study showed that they may be at lower risk of breast cancer recurrence, secondary cancer, and death than those who don’t have these surgeries. The findings were presented Wednesday by Matteo Lambertini, MD, PhD, an associate professor of medical oncology at the University of Genoa-IRCCS Policlinico San Martino Hospital in Italy.
The international study included 5,290 women with a BRCA mutation who had been diagnosed with invasive breast at or before the age of 40. One group underwent risk-reducing surgery — bilateral mastectomy, salpingo-oophorectomy (removal of ovaries and fallopian tubes), or both — and the other did not. The researchers tracked the women for eight years.
They found that those who had a risk-reducing mastectomy had a 35% lower risk of death and a 42% lower risk of breast cancer recurrence or a second primary cancer. Those who underwent a risk-reducing salpingo-oophorectomy had a 42% lower risk of death and a 32% lower risk of breast cancer recurrence or second primary malignancy.
Listen to a podcast with Dr. Lambertini discussing these results, as well as some of the unique issues faced by young women with breast cancer:
Breast Cancer in Young Women: What We Know and Reducing Risk
Dec 11, 2024Anthracycline chemo seems to benefit people with higher Oncotype scores
Among people diagnosed with hormone receptor-positive, HER2-negative, lymph node-negative breast cancer with an Onctotype DX Recurrence Score Test result of 31 or higher, a chemotherapy regimen that included an anthracycline, such as Adriamycin (chemical name: doxorubicin), offered better distant recurrence-free survival than a regimen without an anthracycline. Distant recurrence-free survival is how long people live without the cancer coming back in a part of the body away from the breast.
These results were from a new analysis of information from the TAILORx trial presented by Nan Chen, MD, assistant professor of medicine at the University of Chicago. Earlier results from the TAILORx trial showed that people with an intermediate Oncotype Recurrence Score (between 11 and 25) could safely skip chemo.
The anthracycline benefit was most clearly seen in people diagnosed with cancer that were 2 cm or larger in size. And, Chen noted, as Recurrence Scores increased, people got more benefits from adding an anthracycline.
Bardia explains Enhertu research; range of HER2 levels
Updated results from the DESTINY-Breast06 study confirm that Enhertu (chemical name: fam-trastuzumab deruxtecan-nxki; also called T-DXd) is better than doctors’ choice of chemotherapy for people with metastatic hormone receptor-positive, HER2-low or -ultralow breast cancer that grew during or after they received one or more hormonal therapy medicines.
Aditya Bardia, MD, MPH, director of the Breast Oncology Program and Translational Research Integration at the UCLA Health Jonsson Comprehensive Cancer Center, presented the results.
But what exactly is HER2-low and -ultralow breast cancer? And if you were diagnosed with metastatic HER2-negative breast cancer a few years ago, should the cancer be retested? Dr. Bardia joined The Breastcancer.org Podcast to tell us more about his research, and how scientists’ understanding of HER2 levels is changing.
Enhertu for HER2-Low and -Ultralow Metastatic Breast Cancer
Dec 12, 2024Dizon talks about the importance of sexual health
Don Dizon, MD, noted researcher on sexuality after cancer, discusses his presentation on sexual health as part of the “Sex, Drugs, and Rock and Roll” session. On The Breastcancer.org Podcast, he talks about “not accepting this idea that, unfortunately, is still out there that people should be grateful to be alive after an experience of breast cancer. Sexuality,” he explains, “is an inherent part of being a human being and not something that we should accept as gone. Even if it’s different, you don’t have to accept it."
Five breast cancer patient advocates, including a first-timer and a few who have attended for many years, tell The Breastcancer.org Podcast what they’re excited about at this year’s conference, as well as what keeps them coming back.
“I’m really excited to be here because this is where it happens,” said Barbara Bigelow, of Metavivor and the MBC Alliance. “It’s exciting to meet all these researchers and doctors that are working on our behalf. They are obviously working very hard and moving the research along faster and faster.”
Longer follow-up confirms benefits of Lynparza
Three more years of follow-up from the OlympiA trial continue to show that — for people with a BRCA mutation diagnosed with breast cancer with a high recurrence risk — taking Lynparza for one year after standard treatments improves survival. Results after the first three years of follow-up led to the approval of Lynparza (chemical name: olaparib) in 2022.
These latest results have a median follow-up of 6.1 years, meaning half the people were followed for longer than 6.1 years and half were followed for shorter periods of time. Lynparza continued to improve survival by 35% compared to placebo (a pill that looked just like Lynparza but contained no medicine). The results were the same whether people were diagnosed with triple-negative breast cancer or estrogen receptor-positive disease.
What’s it like being an Alamo Scholar? Andrea Hans explains
Breastcancer.org community moderator and meetup facilitator Andrea Hans was selected as a 2024 Alamo Breast Cancer Foundation Scholar. This allows her to attend the conference and take advantage of a number of other learning opportunities. “We get to interact with the other scholars and have sessions that summarize each day’s events,” she says. “It’s a wonderful experience so far.”
New model aims to predict response to CDK4/6 inhibitors
CDK4/6 inhibitors are an effective treatment for many metastatic hormone receptor-positive, HER2-negative breast cancers. But in some cases, the cancer responds poorly to it — or not at all. To help oncologists predict who would benefit from these medicines, researchers are developing a computer model that uses both the clinical characteristics and the genomic information of the cancer to predict response.
The results of a study to test and validate the model were presented by Pedram Razavi, MD, PhD, breast medical oncologist and scientific director of the Global Research Program at Memorial Sloan Kettering Cancer Center.
The clinical characteristics used in the model include age at diagnosis, cancer size, hormone receptor status, cancer grade, and where in the body the metastatic disease is located. The genomic data includes information about any genetic mutations in the cancer — such as mutations in the TP53, PTEN, or PIK3CA genes — as well as where in the gene the mutation was located.
Research done using the model so far has found that cancers with TP53 mutations were less likely to respond to CDK4/6 inhibitors.
Where you live may impact risk of lymphedema
People with breast cancer who live in lower-income communities may be at a greater risk of developing lymphedema than those who do not, new research suggests.
The study included the records of 650 people with breast cancer who had been diagnosed or treated at Montefiore Medical Center in New York City between 2011 and 2022. The researchers used the residential zip codes from these records to compare two groups — one group lived in areas with high economic distress and the other did not. These categories were based on the Distressed Communities Index (DCI) — a socioeconomic tool that takes into consideration such factors as poverty, housing vacancies, and unemployment to rank the economic well-being of communities.
After controlling for race, ethnicity, and insurance, the researchers found that people with breast cancer from highly distressed areas had a 20% increased risk of developing lymphedema compared with those in less distressed areas. The research may one day lead to better predictions of lymphedema risk, allowing for more targeted lymphedema screening and follow-ups.
Data lacking on safety of supplements, cannabis
More than half of breast cancer survivors use supplements and up to 30% use cannabis, but there’s little research on the safety and effectiveness of either. Heather Greenlee, ND, PhD, MPH, of the Fred Hutchinson Cancer Center and University of Washington School of Medicine, laid out some of the possible risks, benefits, and interactions of supplements and cannabis and shared the current state of research. Here are 11 things we learned.
This article is made possible by Lilly.
— Last updated on February 28, 2025 at 9:18 PM