For older news, please visit the ASBD news archives.
For Immediate Release
April 18, 2008
American Society of Breast Disease Policy Statement
Use of Breast Magnetic Resonance Imaging (Breast MRI) in Breast Cancer Screening
Mammography with clinical breast examination is the standard to screen women for breast cancer. The American Society of Breast Disease issued a policy statement regarding screening mammography on January 30, 2002, and we reaffirm this position.
It is recognized that there are limitations of mammography related to the physics of radiography as applied to the breast. A volume of new information has emerged since the prior ASBD Policy Statement. The American Cancer Society has issued new screening guidelines for breast MRI in the evaluation of high risk women.2
This revision reflects the opinions of the ASBD after incorporation of new study data and a review of 2007 guidelines issued by the American Cancer Society.
We conclude the following with regard to screening MRI:
- Breast MRI is an adjunct to mammography, clinical breast examination, and ultrasonography for breast cancer detection in women at high risk of breast cancer
- We concur with the American Cancer Society Guidelines on the following:
We recommend annual MRI screening based on evidence to include:
– BRCA mutation
– First-degree relative of BRCA carrier, but untested
– Lifetime risk ~20–25% or greater, as defined by BRCAPRO or other models that are largely dependent on family history
We recommend annual MRI screening based on expert consensus opinion to include:
– Radiation to chest between age 10 and 30 years
– Li-Fraumeni syndrome and first-degree relatives
– Cowden and Bannayan-Riley-Ruvalcaba syndromes and first-degree relatives
There is insufficient evidence to recommend for or against MRI screening for the following:
– Lifetime risk less than 15 to 20%, as defined by BRCAPRO or other models that are largely dependent on:
– family history
– Lobular carcinoma in situ (LCIS) or atypical lobular hyperplasia (ALH)
– Atypical ductal hyperplasia (ADH)
– Heterogeneously or extremely dense breast on mammography
– Women with a personal history of breast cancer, including ductal carcinoma in situ (DCIS)
- Although data has not yet determined the appropriate screening interval for breast MRI, it appears appropriate to perform breast MRI in conjunction with mammography on an annual basis. These examinations may be performed on the same day or different days. Some have preferred mammography and MRI to be alternated at 6 month intervals although there are no data to confirm a benefit for this approach.
- Performance standards and accreditation of breast MRI is forthcoming from the American College of Radiology and other groups. Adherence to American College of Radiology quality standards are strongly recommended by the ASBD. In particular, since breast MRI detects lesions not seen by conventional imaging, breast MRI should only be performed in centers demonstrating a capability for MRI directed biopsy and localization.
- Breast MRI should be interpretated according to ACR-BIRADS lexicon.
- Women should be informed of the benefits and limitations of breast MRI as well as confounding false positives and cost.
- We support and encourage prospective clinical trials of breast MRI for surveillance of women in other high risk for breast cancer cohorts but with as yet an unproven direct clinical benefit.
Click here for the full text of the policy statement including references and discussion.
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For Immediate Release
January 30, 2008
American Society of Breast Disease Names 2008 Global Pathfinders
The 2008 American Society of Breast Disease Pathfinder Lectures will be delivered by two giants in the field of breast cancer – Mary-Claire King, PhD, and Bernard Fisher, MD. The Pathfinder Lectures will be part of the Society’s Annual Symposium, April 10-12, 2008, at the Hilton San Diego Resort, San Diego, California.
In announcing the recipients of the ASBD’s only honorary recognition, Society president Julio A. Ibarra, MD, noted that this year’s honorees “through their research and vision Mary-Claire King and Bernard Fisher have set the highest of standards and benefited the lives of millions of women internationally.
Mary-Claire King is Professor of Medicine and Genetics and an American Cancer Society professor at the University of Washington. She is best known for discovering that BRCA1 mutations can cause hereditary breast cancer. Dr. King’s work changed historic views by finding a genetic marker for the existence of BRCA1, which made possible gene location, testing, screening and prophylactic procedures. Dr. King received her doctorate from the University of California, Berkeley, where she taught from 1976 until 1995 before moving to the University of Washington.
Bernard Fisher, MD, is a recognized pioneer in the biology and treatment of breast cancer. He was recently honored by the University of Pittsburgh, where he serves as distinguished service professor of surgery and scientific director of the National Surgical Adjuvant Breast and Bowel Project, which he chaired from 1967 to 1994. Dr. Fisher work has led to an understanding of breast cancer as a systemic disease that metastasizes unpredictably, and that can be treated with a combination of conservative local treatment and systemic therapy.
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For Immediate Release
October 22, 2007
Treatment options for “pre-breast cancer” condition
Breast specialists report no clear consensus on management of LCIS (lobular carcinoma in situ), generally considered a pre-cancerous condition that may indicate a patient’s future risk of developing invasive breast cancer in either breast. Nearly 120 breast specialists responded to a survey conducted August 2007 on their practices regarding LCIS and pleomorphic LCIS.
Overall, about 70% of all respondents will usually or always recommend an excisional biopsy for LCIS. For patients with LCIS, only a small percentage of respondents would recommend mastectomy, sentinel node biopsy, or axillary lymph node dissection. The percentage of respondents recommending these procedures increases considerably for patients with pleomorphic LCIS, which is generally considered to be more aggressive.
The findings, published in the ASBD Advisor issue 2, 2007, are available online at www.asbd.org.
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For Immediate Release
October 8, 2007
Training a New Generation of Breast Specialists
More than two-thirds of doctors who completed breast fellowships in 2005 and 2006 spend all their time in breast practice. The finding comes from a 2007 survey published in the latest issue of the ASBD Advisor – newsletter of the American Society of Breast Disease – that tracked the experiences of breast fellows who participated in a national multidisciplinary breast fellowship program, jointly sponsored by the American Society of Breast Disease, the American Society of Breast Surgeons, and the Society of Surgical Oncology.
Survey Highlights:
- More than 90% of the physicians who completed breast fellowship programs in 2005 and 2006 spent at least 50% of their time in clinical practice
- Only a small percentage spent more than 25% of their time in administration or clinical research
- Average work week was more than 57 hours a week
- 60% reported work weeks running beyond 60 hours
- 90% delivered public lectures
- 60% were active in a community-based breast cancer organization
The complete article is available for download at www.asbd.org
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FOR IMMEDIATE RELEASE
July 18, 2007
American Society of Breast Disease Launches School for Oncoplastic Surgery
Julio A. Ibarra, MD, Medical Director, Orange Coast Memorial Medical Center, Fountain Valley, California, and President of the American Society of Breast Disease, has announced that the Society will launch its first course in Oncoplastic Surgery December 7-9, 2007, at the Cooper Clinic’s conference center in Dallas, Texas.
This weekend program will provide breast surgeons with the basic principles and techniques for state-of-the-art surgical management of breast disease through hands-on lab experience, live models, and case discussions.
Alison Estabrook, MD, Director, Breast Center, St. Luke’s & Roosevelt Hospitals, New York, New York, Gail Lebovic, MD, Director of Women’s Services at the Cooper Clinic, and one of the nation’s leading oncoplastic surgeons, and Michael J. Cross, MD, Breast Treatment Associates, Fayetteville, Arkansas, will serve as course directors for this highly interactive and interdisciplinary CME accredited program.
As Dr. Lebovic notes, “oncoplastic surgery is fast becoming an essential skill for the dedicated breast surgeon. During our course, participants will learn how to achieve complete oncologic tumor resection with the best possible aesthetic outcome, gain hands-on experience with minimally invasive biopsy techniques, and engage in interactive assessment using live models. The program will focus on practical surgical techniques including pre-operative planning, skin markings and tissue resection.” The program will also include sessions on mammography, MRI, and ultrasound; managing high risk patients; pathology and risk of recurrence; and delivering radiation therapy so that surgeons fully appreciate the interdisciplinary aspects of oncoplastic surgery.
American Society of Breast Disease education advances an interdisciplinary team approach to breast healthcare and management of patients facing various breast issues. For course schedule and registration information on the program, visit the ASBD online at www.asbd.org.
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For Immediate Release
April 12, 2007
Taxane Use and Dose-Dense Scheduling May Benefit Patients with Early Stage Breast Cancer
The Consensus Committee of the American Society of Breast Disease agrees that the use of taxanes and dose-dense scheduling may both benefit patients with early stage breast cancer. Although the widespread use of adjuvant chemotherapy prescribed for early-stage breast cancer has contributed to an improvement in overall survival, the optimal chemotherapeutic regimen is still unknown.
Conclusions
- The addition of a taxane to adjuvant therapy may offer an advantage over a non-taxane-containing regimen.
- The optimal taxane has not been determined (paclitaxel vs. docetaxel).
- The use of the albumin-bound paclitaxel remains investigational in the adjuvant setting.
- A dose-dense schedule may benefit patients with lymph node positive disease, especially hormone-insensitive disease.
- Cytokine support is often required to reduce toxicity with dose-dense therapy, or with higher-dose docetaxel regimens.
The Committee considered multiple clinical trials and publications to reach the above conclusions. Background information leading to the Committee’s conclusions is available online at the Society’s web site at www.asbd.org. The statement was written by Committee member, Beth Overmoyer, MD, Connecticut Oncology, Torrington, Connecticut.
Click here for full statement with references.
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FOR IMMEDIATE RELEASE
March 28, 2007
7 Breast Cancer Leaders Elected American Society of Breast Disease Officers and Directors
Barbara F. Rabinowitz, PhD, Director of Oncology Services, Meridian Health, and immediate Past President of the American Society of Breast Disease announced today that seven outstanding leaders in the field of breast cancer had been elected to positions on the Society's Board of Directors.
Incoming President Julio A. Ibarra, MD, medical director of pathology services, Orange Coast Memorial Medical Center, Fountain Valley, California, will be joined by oncoplastic breast surgeon Gail Lebovic, MD, director of women's services at the Cooper Clinic, Dallas, Texas, as President-Elect and radiologist Stephen A. Feig, MD, director of breast imaging, University of California, Irvine, as Secretary-Treasurer, as Officers of the Society.
Newly elected members at large are: Robert W. Carlson, professor of medicine, division of medical oncology, Stanford University, California; Krystyna Kiel, MD, assistant professor of radiation oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois; Olufunmilayo Olopade, MD, Walter L. Palmer distinguished service professor; director, hematology/oncology fellowship program; director, Center for Clinical Cancer Genetics, University, Chicago, Illinois; and Sandhya Pruthi, MD, section head, breast clinic, division of general medicine, department of internal medicine, assistant professor of medicine, Mayo Clinic, Rochester, Minnesota. Ann D. Thor MD, Todd Professorship, chair, pathology department, University of Colorado at Denver and Health Sciences Center.
Dr. Rabinowitz noted that the Nominating Committee had identified a slate of exceptional candidates, who, while representing individual specialties, have a genuine interdisciplinary understanding of the needs and priorities of breast cancer and breast disease patients.
Profiles of the Newly Elected Board Members
Robert W. Carlson, MD, is Professor of Medicine, Division of Medical Oncology at Stanford University. Dr. Carlson received undergraduate and medical degrees from Stanford University, and did house staff training in internal medicine at Washington University, St. Louis, and Stanford. He returned to Stanford for his post-doctoral fellowship and joined the Stanford faculty in 1983. He has also served on a number of NCCN and ASCO committees and task forces. Dr. Carlson chairs the NCCN Breast Cancer Guidelines Panel, is an active clinical/translational investigator, and maintains a busy academic breast cancer practice. He has served on ASBD Program Committee for the 2007 Symposium and as session chair for systemic treatment discussion at the 2006 ASBD colloquium on Ensuring Optimal Interdisciplinary Breast Care in the United States.
Krystyna Kiel, MD, is assistant professor of radiation oncology, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, specializing in breast cancer. She received her medical education at University of Massachusetts Medical School and completed her residency at Massachusetts General Hospital. Dr. Kiel currently she sits on the breast cancer guidelines committee for the National Comprehensive Cancer Network, and served as chair of the 2007 Breast Track Committee for the ASCO annual meeting. She has served on the board of the Y-ME National Breast Cancer Organization, published numerous articles, and served on many national committees. She has been a frequent faculty member on many national medical education programs. She believes that identifying and manipulating basic cancer biology in breast cancer, and identifying responsible genes and turning them off and on will no doubt revolutionize breast cancer therapy. Dr. Kiel currently serves on the ASBD's Board of Directors; this election will be to her first full-term on the Board.
Olufunmilayo Olopade, MD, is Walter L. Palmer Distinguished Service Professor; Director, Hematology/Oncology Fellowship Program; Director, Center for Clinical Cancer Genetics, University of Chicago, which she founded in 1992. Dr. Olopade takes an interdisciplinary approach to breast cancer care with treatment plans tailored to each person's risk factors. She also focuses on quality of life concerns for young breast cancer patients, specifically addressing topics related to pregnancy, fertility, and employment. As an international leader in breast cancer research, Dr Olopade's research interests are diverse and include: treatment of breast cancer, especially in young or pregnant women; familial cancers; molecular genetics of cancer; cancer risk assessment and chemoprevention; breast cancer and minority populations and disparities in health outcomes. She has a special interest in women of African descent, who are at higher risk for the more aggressive breast cancer and more likely to be diagnosed at a younger age. In 2005, Dr. Olopade was named a MacArthur Fellow for her work in "translating findings on the molecular genetics of breast cancer in African and African-American women into innovative clinical practices in the United States and abroad." Dr. Olopade serves on the Medical Advisory Board of the Young Survival Coalition, and has served on the faculty of the ASBD's annual symposium. In 2005, she served on the Steering Committee for the Society's Clearinghouse on Breast Disease, and co-chaired its working group on Prevention and Risk.
Sandhya Pruthi, MD, is Section Head, Breast Clinic, Division of General Medicine, Department of Internal Medicine, Mayo Clinic, and Assistant Professor of Medicine, Mayo Clinic, Rochester, Minnesota. She received her undergraduate and medical degrees at the University of Manitoba, Canada, and completed her residency in family medicine at the Mayo Clinic. She is board certified in Family Practice by the American Board of Family Medicine and a fellow of the American Academy of Family Physicians. Dr. Pruthi has served as a reviewer for American Family Physician and American Journal of Surgery. She has served as a principal investigator in the STAR trial and other NIH trials. As a family practice specialist, Dr. Pruthi mentors residents and fellows, and presents frequently on issues surrounding breast healthcare, with an emphasis on the multidisciplinary care of breast disease patients. Her research interests include factors influencing breast self-examination, menopause, breast density, and hormonal therapies for breast cancer. Dr. Pruthi has served on numerous Society Committees and currently serves on the Editorial Board for the ASBD Advisor.
Ann D. Thor MD, holds the Todd Professorship and chairs the Pathology Department at the University of Colorado at Denver and Health Sciences Center. She oversees a large pathology department which serves 4 major and 4 minor hospitals, including: the University of Colorado Hospital, The Children's Hospital of Denver, the Denver Veterans Affairs Hospital and Denver Health Hospital. Dr. Thor is board certified in anatomic and clinical pathology as well as cytopathology. She completed fellowships in Clinical Oncology/Tumor Immunology and Biology at the National Cancer Institute and an American Cancer Society Career Development Fellowship in Gynecologic Pathology at the Massachusetts General Hospital. She currently chairs the Pathology Committee and is the Breast Pathology Cadre Leader of the Cancer and Leukemia Group B Cooperative Oncology Group, is on the Board of Scientific Counselors of the National Cancer Institute, NIH, chairs the Research Committee and is a Council Member of the Association of Pathology Chairs. Dr. Thor directs an active laboratory effort in breast cancer research, focusing on receptor tyrosine kinase and steroid hormone signaling pathways. She has published over 145 peer reviewed, over 100 non-reviewed articles and 30 book chapters and mentored over 28 graduate and medical students in her laboratory. She has been generously supported by the National Cancer Institute, the Department of Defense, the Department of Public Health of the State of Illinois, the American Cancer Society, the American Association of Cancer Research, the Komen Foundation, the Avon Foundation and the Mary Kay Ash Foundation. She has been a frequent faculty member at ASBD education programs. She currently serves on the ASBD's Board of Directors and chairs the Society's Communications Committee.
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2007 Global Breast Cancer Pathfinders Named
The American Society of Breast Disease will honor two internationally known leaders as Pathfinders in the fight against breast cancer during the Society's 31st annual symposium, April 12-14, 2007 at the Hotel Nikko, San Francisco. The 2007 Pathfinder Lecturers are:
Breast Imaging
Daniel B. Kopans, MD, Professor of Radiology, Harvard Medical School, Boston, Massachusetts
Breast Surgery
Melvin J. Silverstein, MD, Medical Director, Harold E. and Henrietta C. Lee Breast Center, University of Southern California/Norris, Los Angeles, California
In announcing the Pathfinder Lecturers, Society President Benjamin O. Anderson, MD, noted “this prestigious program recognizes the innovators who have combined research and clinical practice with an interdisciplinary understanding to advance the fight against breast disease and breast cancer.” Dr. Anderson stressed that “these Pathfinders reflect the spirit and commitment of the American Society of Breast Disease as the only clinically based organization to advocate an interdisciplinary team approach to managing breast disease and cancer prevention, risk assessment, early detection, diagnosis, treatment, rehabilitation, and research.”
Profiles of the 2007 American Society of Breast Disease Pathfinders
Dr. Kopans is a leading world expert on breast cancer screening for women in their forties. It was in large part due to his efforts in defining the scientific issues, analyzing the data, and pressuring the National Cancer Institute that women aged 40-49 have access to routine annual mammography screening. In 1978, he founded the Breast Imaging Division at the Massachusetts General Hospital where he was Director from 1978 to 2006. In the late 1970's Dr. Kopans invented a guide wire and techniques that made it possible to accurately direct surgeons to areas of concern found by mammography that were so small that they could not be felt. Dr. Kopans defined the field of Breast Imaging with a landmark article in the New England Journal of Medicine in 1984 recognizing the need for multimodality breast evaluation. He developed an organized approach to image interpretation and reporting that is the basis for the American College of Radiology Breast Imaging Reporting and Data System (BIRADS) and he was co-chairman of the original BIRADS committee.
Dr. Silverstein was the first person in the world to design and build a freestanding breast center as a place where all of a patient's needs could be met in one location. In 1973, he launched his first breast clinic at UCLA, where he served as director. He then went on to start the acclaimed Van Nuys Breast Center in 1979, the world's first free standing breast center. Dr. Silverstein joined the University of Southern California in 1998 and has since served as co-leader of the breast cancer research program and professor of surgery. His approach to breast cancer has been a highly individualized model of care that leans toward a "less is more" mentality. Dr. Silverstein continues to push forward breast health research, but remains focused on improvements for breast centers. He has written the only major textbook on ductal carcinoma in situ (DCIS) of the breast. His leadership as a surgical oncologist in treatment of DCIS and use of sentinel node biopsy has been recognized worldwide.
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