Sandra Swain, MD

Sandra Swain, MD, medical director of the Washington Cancer Institute at MedStar Washington Hospital Center, discusses pregnancy-related breast cancer.

Since more women are waiting until an older age to become pregnant, Swain says, there has been an increase in the number of patients who are pregnant and are diagnosed with breast cancer. Swain says there are about 4,000-5,000 patients with breast cancer in the U.S. each year who are pregnant.

A recent study compared patients who were pregnant to a control group of non-pregnant patients, Swain said. The study showed that outcomes were similar: Patients who were pregnant and received chemotherapy had similar outcomes to the control group.

Swain recommends that breast cancer patients who become pregnant should have a high-risk consultation with their OBGYN. Swain also recommends giving chemotherapy to patients after their first trimester.

The number of patients with breast cancer who become pregnant is increasing because more women are waiting until they are older to get pregnant

A study showed pregnant patients and non-pregnant patients reacted similarly when treated with chemotherapy

Breast cancer patients who become pregnant should have a high-risk consultation with their OBGYN and should not receive chemotherapy until after the first trimester

Videos

Sandra Swain, MD, discusses pregnancy-related breast cancer.

Treating Pregnancy-Related Breast Cancer

Sandra Swain, MD, medical director of the Washington Cancer Institute at MedStar Washington Hospital Center, discusses the utility for vinegar as a screening tool in the U.S.

In a cluster-randomized study that analyzed 150,000 women in Mumbai, India, vinegar (acetic acid) demonstrated to be an adequate screening tool for cervical cancer.

Swain believes that the use of vinegar as a screening tool has a greater implication in developing countries with no resources and probably will not be adopted in the U.S.

A recent study found that a DNA test was superior to vinegar, though screening was only done once. In the Mumbai study, screening was done four times every two years. The idea of an inexpensive DNA test is being examined, Swain says.

Swain says vinegar has little utility as a screening tool for cervical cancer in the U.S.

Research is being conducted looking at an inexpensive DNA test

The Mumbai study has more implication for developing countries

Vinegar as a Screening Tool in the U.S.

Sandra Swain, MD, medical director of the Washington Cancer Institute at MedStar Washington Hospital Center, professor of medicine at Georgetown University Medical Center, gives an overview of the next steps for pertuzumab in breast cancer.

Recently, pertuzumab was approved with trastuzumab and docetaxel, based on outstanding survival data from the CLEOPATRA trial. Having used it a lot, Swain says, she recommends that the combination be used according to its indication. However, a study presented at the 2013 ASCO meeting showed a high response (about 50%) when paclitaxel was used instead of docetaxel, suggesting that either taxane could be acceptable for this patient population. Swain estimates that about 8,000 to 9,000 patients nationwide would be eligible for this treatment in the first-line setting.

Beyond the first line, there are studies looking at trastuzumab and pertuzumab in heavily-pretreated patients. Studies are being done in this space, and while there is still not enough data, Swain says, she expects the combination to be effective.

Pertuzumab was approved with trastuzumab and docetaxel based on outstanding survival data from the CLEOPATRA trial

Beyond the first line, there are studies looking at the combination in heavily pretreated patients

Sandra Swain, MD, medical director of the Washington Cancer Institute at MedStar Washington Hospital Center, gives an overview of the next steps for pertuzumab in breast cancer.

The Next Steps for Pertuzumab in Breast Cancer

Sandra Swain, MD, medical director of the Washington Cancer Institute at MedStar Washington Hospital Center, gives an overview of the practice-changing information from the 2013 American Society of Clinical Oncology (ASCO) Meeting.

Swain mentions a trial in stage I seminoma, which showed that radiation or chemotherapy is not necessary after surgery. In a breast cancer trial, there is not a need for an axillary nodal dissection after a positive sentinel node biopsy. Radiation is as effective in this setting as axillary dissection.

Swain highlights another study that found that fitness among middle-aged men can decrease cancer incidence and improve survival.

View all coverage from the 2013 ASCO Meeting

Sandra Swain, MD, from the Washington Cancer Institute at MedStar Washington Hospital Center, on the practice-changing information from the 2013 ASCO Meeting.

Sandra Swain, MD | Authors

Articles

Treating Pregnancy-Related Breast Cancer

Vinegar as a Screening Tool in the U.S.

The Next Steps for Pertuzumab in Breast Cancer

An Overview of the Practice-Changing Information From the 2013 ASCO Meeting