Current Updates and Advances in Breast Cancer

Dear Colleagues,

Breast cancer is a highly heterogeneous disease and represents the leading tumor diagnosed and the most frequent cause of cancer death in women worldwide. Breast cancer develops following complex interplays between genetic and non-genetic factors, interacting with the hormones that regulate mammary development. Hereditary and familial cancers account for up to 20–30% of all breast cancers. Considering age, about 25–30% of women are ≥70 years old, and around 6–7% are young (<40 years old). Breast cancer rarely occurs in males and represents less than 1% of all diagnoses.

Over 90% of breast cancers are local or regional when first detected. Decisions on the adjuvant systemic treatment are based on estimations of the recurrence risk. Standard clinicopathological features and tumor biological characteristics can improve the identification of the likelihood of response to systemic therapies. A neoadjuvant approach is useful, particularly in the most aggressive breast cancer subtypes (HER2-positive and triple negative). It allows testing the in vivo sensibility to drugs, considering a breast-conserving surgery, and providing helpful information on prognosis.

In the advanced/metastatic setting, breast cancer is still an almost incurable disease in most patients. Despite recent advances (e.g., with the introduction of novel targeted therapies, antibody–drug conjugates, and immunotherapy), significant improvements in survival were observed particularly in the HER2-positive subtype. Further, the quality of life and the toxicities of novel treatments are important features to be considered.

All these elements render it challenging to pursue an individualized treatment tailored to each patient. Breast oncologists have a strong need to be updated on several domains, starting from biology, detection/diagnosis, and management of adverse events to survivorship issues.

This Special Issue will highlight the current state of the art on recent advances in breast cancer, both in the early and the advanced disease, in genetic counseling and fertility preservation, management of long-term toxicities, survivorship issues, and supportive and palliative care.

Dr. Cinzia Solinas
Guest Editor

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