2024 Breast Health Forum: Five highlights 

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This year’s Breast Health Forum focused on the importance of evaluating the benefit-impact balance in the shared decision-making process.  

Experts from across Quebec came to speak to about the latest advances in optimizing breast cancer treatments to achieve greater efficacy and fewer side effects.  

Here are five highlights from the eighth edition of the event:  

1. NexPlasmaGen: an upcoming clinical trial at the CHUM, a world first 

Quebec-based NexPlasmaGen has developed a cold-plasma application technology to treat breast cancer. This product is injected directly into the surgical cavity or onto skin flaps, targeting cancer cells while preserving healthy ones.  

The objective of NexPlasmaGen’s technology is to reduce the need for subsequent treatments (radiation or further margin surgery) and its side effects, as well as the risk of local recurrence after a lumpectomy. It also makes it possible to keep the skin in place without any issues. This method has several other advantages, such as its speed and tolerance. It also does not require general anesthesia or further planned procedures. 

Research has already demonstrated the effectiveness of cold plasma in destroying cancer cells in-vitro and in rodents. A clinical study to evaluate its efficacy and safety in humans in a cohort of 18 patients will soon begin at the Centre hospitalier de l’Université de Montréal (CHUM).  

NexPlasmaGen received the award for Best MedTech Oncology Business – Canada at the 2024 Biotechnology Awards. The Quebec Breast Cancer Foundation is funding this project. We are convinced of its potential to improve the survival and quality of life of people with breast cancer.  

2. Presentation of the Grand Prix Scientifique to Jacques Simard for PERSPECTIVE  

The Grand Prix Scientifique is awarded to recognize the career and impact of a researcher. This distinction comes with a $25,000 grant. This year, the Quebec Breast Cancer Foundation awarded this prize to Professor Jacques Simard for his public-interest research carried out as part of the PERSPECTIVE project.  

Professor Simard’s team has introduced an innovative approach to breast cancer prevention and screening based on an assessment of individual risk, which is much more precise than age alone. A simple saliva sample can be used to analyze nearly 300 breast cancer susceptibility genes identified by the research team. 

This multigenic risk assessment, combined with the analysis of other factors, is used to classify each woman’s risk level into three categories. Risk stratification makes it easier to recommend prevention and screening strategies that are more specifically suited to each individual. 

This personalized approach helps to avoid unnecessary examinations in some women, while more effectively identifying those who require closer follow-up. Ultimately, more effective risk reduction could lead to fewer cases of breast cancer. Earlier detection of the disease would improve survival and quality of life for those affected.  

The Foundation has provided financial support for the PERSPECTIVE project from the outset, a crucial factor in its progress.  

3. Pushing the limits of Oncotype DX  

Oncotype DX is a valuable tool for personalizing breast cancer treatment. This test analyzes the expression of 21 genes in breast cancer tumour cells and provides a recurrence score (RS) that helps predict the likelihood of distant cancer recurrence (in other parts of the body) in the years following diagnosis. 

It is this RS that helps doctors and patients decide whether chemotherapy is necessary. Until now, Oncotype DX has been performed in a specific context: prior to surgery, mainly for patients with early-stage, hormone receptor-positive, HER2-negative invasive breast cancer. 

However, studies are under way to determine whether and how this test could be used in other contexts. In particular, the potential use of the test in pre-menopausal women with node-positive breast cancer is being evaluated.  

In addition, since biopsy results have been shown to be reliable for assessing lymph node status, research is now looking at the possibility of performing the Oncotype DX test prior to surgery. If the test reveals that the person could benefit from chemotherapy, the treatment could then be given prior to surgery (neo-adjuvant), enabling less invasive surgery.  

4. Increasingly targeted and less invasive radiation treatments  

Radiation is often used after breast-conserving surgery (such as a lumpectomy) to eliminate residual cancer cells and thereby reduce the risk of local recurrence. In recent years, several advances have been made to optimize radiation treatments, including hypofractionated radiation therapy.  

Conventional radiation usually involves multiple sessions over several weeks. Hypofractionated radiation, on the other hand, delivers a more concentrated dose over fewer visits.  

Hypofractionated radiation therapy has been around for a long time. But since 2020, its effectiveness has been demonstrated in fewer visits (five sessions) for earlier stages (without lymph node involvement). It reduces the number of visits to five from 15.  

For early-stage breast cancer without reconstruction or lymph node involvement, studies have shown that hypofractionated radiation therapy can be as effective as conventional radiation. It allows for local control of the disease and overall survival, while presenting similar rates of short- and long-term toxicity. This means that patients can benefit from the same therapeutic results with fewer treatment sessions.  

Reducing the number of hospital visits also reduces costs and inconveniences for patients; for example, if they live far from the treatment centre.  

The Phase III study Hypofractionated LocoRegional Radiotherapy in Breast Cancer (RHEAL) is currently investigating whether people diagnosed with node-positive breast cancer could also benefit from hypofractionated radiotherapy with only five visits instead of 15.  

5. Future advances with the Quebec Metastatic Breast Cancer Registry  

The Quebec Metastatic Breast Cancer Registry has been financially supported by the Quebec Breast Cancer Foundation since its creation in 2021. This initiative consists of a platform for collecting and sharing information on metastatic breast cancer cases in Quebec. Knowledge of today’s patient pathways is fundamental to improving the care and quality of life of tomorrow’s patients.  

This valuable tool provides researchers, pharmaceutical companies and clinicians with access to crucial real-world data on treatments and their impacts. The objective is to advance research and care. Currently, 744 patients are already on the Registry thanks to the participation of a dozen partner institutions. 

These include the McGill University Health Centre, the CHUM, Centre hospitalier universitaire Québec-Université Laval, Hôpital Maisonneuve-Rosemont, Hôpital du Sacré-Cœur-de-Montréal, St. Mary’s Hospital, Centre hospitalier régional de Lanaudière, Centre hospitalier universitaire de Sherbrooke and Hôpital de Chicoutimi. Other institutions will be joining in the future to add to this essential database across the entire province of Quebec. 

If you are interested in joining the Registry, staff at our partner hospitals will be in contact with the people to whom it applies. However, if you are being treated in one of the above-mentioned hospitals and have not been asked to participate, please do not hesitate to speak to your medical team.