DeCure for Female breast carcinoma

A nationwide Finnish cohort study of 93,843 women aged 30–49 who used a levonorgestrel-releasing intrauterine system (LNG-IUS) for menorrhagia between 1994 and 2007 found an increased risk of both ductal and lobular breast cancer compared with the general female population. Over 1,032,767 woman-years of follow-up, 2015 breast cancers were diagnosed. The standardized incidence ratio for ductal cancer was 1.20 (95% CI 1.14–1.25) and for lobular cancer 1.33 (95% CI 1.20–1.46). Among women who purchased the device at least twice, the lobular cancer risk rose to 1.73 (95% CI 1.37–2.15). The authors conclude that intrauterine levonorgestrel is associated with an excess risk of both lobular and ductal breast cancer, contrary to earlier assumptions that only lobular risk was elevated.

In octogenarian women (≥80 years) with early-stage breast cancer (stages I–IIB), a single-centre retrospective study of 259 patients (median age 84) reported that standard surgical treatment was associated with better breast-cancer-specific survival than non-surgical therapy. Among the 189 patients with early-stage disease, mean breast-cancer-specific survival was 108 months (95% CI 101–115) in the surgical group versus 50 months (95% CI 39–61) in the non-surgical group (P < 0.01). For the 70 patients with locally advanced disease (stages IIIA–IIIC), breast-cancer-specific survival did not differ between surgical and non-surgical groups. The study also noted that standard surgical treatment yielded better survival than suboptimal surgery.

A 2024 review article on female breast carcinoma states that the disease is rare in women but carries substantial morbidity and mortality. It notes that female breast cancer differs biologically from male breast cancer, with a higher frequency of oestrogen receptor positivity and more aggressive clinical behaviour in some African regions. The review says the disease responds to chemotherapy and hormonal therapy, but that optimal treatment plans for female patients remain unknown and that most knowledge about its biology and treatment has come from research on its female counterpart.

A phase 1b study (SPI-POZ-101, NCT03429101) is evaluating the combination of poziotinib, an irreversible ErbB receptor tyrosine kinase inhibitor, with T-DM1 (an HER2 antibody-drug conjugate) in women with advanced or metastatic HER2-positive breast cancer who have received at least two prior lines of anti-HER2 therapy. The primary objectives are to determine the maximum tolerated dose or maximum administered dose of daily poziotinib plus T-DM1 every three weeks, and to evaluate objective response rate. Part 1 uses a 3+3 dose-escalation design with up to three dose levels (8, 10, and 12 mg, with possible de-escalation to 6 mg). Part 2 will enrol approximately 10 patients at the MTD/MAD to confirm safety and assess preliminary efficacy. The trial is ongoing; poziotinib is not approved for breast cancer. What remains missing are completed safety and efficacy data from this phase 1b trial, and any larger randomised studies that would be needed to determine whether the combination improves outcomes over existing HER2-directed therapies. No trial has yet addressed whether patient stratification by prior treatment response or biomarker profile could identify those most likely to benefit.