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Eleonora Teplinsky, MD, Luckow Pavilion One Valley Health Plaza, Paramus, NJ (2025)

11/20/2025

Sharing a few key facts about genetic testing for cancer. Have you had genetic testing? Share your experiences and your questions!

11/19/2025

🚨Exciting new press release in HR+/HER2- breast cancer!

Current standard of care for the past 20 years in early stage HR+ breast cancer has been endocrine therapy with tamoxifen or an aromatase inhibitor.

In metastatic breast cancer, we are increasingly using oral SERDs, which are selective estrogen receptor degraders. SERDs work by binding to the estrogen receptor, which causes a conformational change that leads to the receptor’s degradation through the proteasome pathway. There are several SERDs available in MBC and currently we use them for patients who have developed an ESR1 mutation and have developed resistance to endocrine therapy, specifically aromatase inhibitors.

There has been a lot of interest in using oral SERDs in early stage breast cancer. Could they be more effective? Better tolerated than aromatase inhibitors?

Many studies are ongoing and today, a press release came out on the results of the phase III lidERA trial. This study evaluates giredestrant, an oral SERD, as adjuvant endocrine therapy in patients with early-stage (stage I–III), hormone receptor-positive (ER+), HER2-negative . The study enrolled over 4,100 participants and compared giredestrant versus standard-of-care endocrine monotherapy. Patients were moderate to high risk (specific eligibility criteria are not available yet). Patients who were pre/perimenopausal received ovarian suppression.

Giredestrant led to a statistically significant and clinically meaningful improvement in invasive disease-free survival (iDFS) with giredestrant versus standard therapy (meaning, more people stayed alive and cancer-free w giredestrant for longer compared to endocrine therapy). Overall survival (OS) data are still immature but show a positive trend. Common side effects with giredestrant in MBC include fatigue, nausea, joint pain, dizziness, diarrhea, constipation, back pain but mostly reported on milder side. (Anecdotally, oral SERDs as a class seem to be better tolerated than aromatase inhibitors).

This is just a press release, we don’t have full results yet (hopefully soon!) and not yet FDA approved but very promising! Let me know questions!

11/15/2025

Sharing info about a new study published in JAMA Oncology this week and highlighted in the media looking at the association between higher ultraprocessed food consumption and an increased risk of colorectal adenomas (the most common type of precancerous polyp). Both ultraprocessed food consumption and early onset colorectal cancer are on the rise. Ultraprocessed food consumption now makes more than half of the average American diet.

This study of nearly 30,000 women under 50 found that those who ate the most ultra-processed foods had a 45% relative increase in the odds of having conventional adenomas — compared to the women who ate the least amount of ultra processed foods.
This is relative, not absolute risk, but it adds to growing evidence that diet patterns influence colon health and may provide some info into why we are seeing an increase in early onset colorectal cancer.

The study used data from the Nurses’ Health Study II, looking at women who had undergone colonoscopy/endoscopy before age 50 and had detailed dietary questionnaires over 24 years (from 1991-2015).

On average, participants consumed about 5.7 servings/day of UPFs (≈35 % of their calories) and those in the highest quintile (≈10 servings/day) had the elevated risk. We now know that many Americans are consuming more than 5.7 servings daily.

What can you do with this info:
✅ Lower UPF intake: more whole/minimally processed foods, fewer packaged/ready-to-eat items (we need to fix this on a societal level as UPFs are cheaper and more convenient).
✅ Boost fiber: fruits, veggies, whole grains, beans
✅ Move your body
✅ Know your colon cancer risk: family history, symptoms, and personal polyp history matter
✅ Get screened for colon cancer: average-risk screening starts at 45, earlier if high-risk

Let me know your questions on this study and your thoughts!

Study reference: Wang C et al. JAMA Oncology 2025, doi: 10.1001/jamaoncol.2025.4777.

11/14/2025

One of the current gaps in current research is whether or not to do routine screening for brain metastases in patients with metastatic breast cancer who don’t have any concerning symptoms for brain metastases.

Historically, we did not screen for brain metastases because therapies were toxic and we didn’t have good therapies but things are changing w better therapies (although we still have a way to go). This has raised the question of whether we should do brain imaging in people w MBC (and if so, how often?) Will it lead to an improvement in outcomes?

Current National Comprehensive Cancer Network and ABC guidelines do not recommend surveillance to detect asymptomatic brain metastases. European Society of Medical Oncology (ESMO) guidelines indicate that subtype-oriented surveillance may be considered for certain subtypes such as HER2+ and TNBC. ASCO guidelines indicate that screening can be considered based on shared decision making with patients. (Jerzak et al. J Clin Oncol. 2025.).

A survey of over 500 patients in Europe showed that 86% of patients were willing to undergo surveillance brain imaging even with uncertain clinical benefit (Matos et al Annals of Oncology 2024).

Comment BRAIN for the link to an excellent editorial called “Brain imaging screening in metastatic breast cancer: Is it time to rethink clinical guidelines and practice?” by Sammons S et al in The Breast October 2025.

What do you think? If you are living with , do you do routine imaging?

11/12/2025

Current evidence and guidelines consistently support that low-dose vaginal estrogen can be safely considered for breast cancer survivors who have persistent symptoms of genitourinary syndrome of menopause (GSM).

These are the references you can provide to your medical team to discuss vaginal estrogen with them. Comment ESTROGEN and I’ll DM you all the link!

🔸Guidelines supporting the use of vaginal estrogen:

American Urologic Association: https://www.auanet.org/guidelines-and-quality/guidelines/genitourinary-syndrome-of-menopause

ACOG: https://www.acog.org/clinical/clinical-guidance/clinical-consensus/articles/2021/12/treatment-of-urogenital-symptoms-in-individuals-with-a-history-of-estrogen-dependent-breast-cancer

ASCO: https://ascopubs.org/doi/10.1200/EDBK_390442

The Menopause Society: https://journals.lww.com/menopausejournal/fulltext/2020/09000/the_2020_genitourinary_syndrome_of_menopause.5.aspx

🔸Studies showing no increase in death from breast cancer in using vaginal estrogen:
McVicker L et al. JAMA Oncol. 2023 Nov 2;10(1):103–108.

Beste MM et al. Am J Obstet Gynecol. 2025; 233(2): 123–134.

Cold S et al. J Natl Cancer Inst. 2022; 114(9): 1243–1253. doi:10.1093/jnci/djac041.

Let me know all your questions and thoughts and experiences with using low-dose vaginal estrogen.

11/11/2025

Circulating tumor DNA in breast cancer. Sharing what it is, what it can tell us and significant limitations in its current use right now. Watch the video and please share your experiences with the test, questions about it, whether you’ve had it done, the conversations you’ve had around it and more!

11/10/2025

A few more of my thoughts on the removal of the black box warning. I hope it will open the door for more conversation.

11/10/2025

The FDA announced today that it is removing the black box warning on menopausal hormone therapy including vaginal estrogen. Currently, the black box warning includes risks of cardiovascular disease and breast cancer.

I do think this is a huge step in the right direction especially for vaginal estrogen. I think removing the black box warning will help those also who are told they’re not candidates for MHT because they have a family history of breast cancer for example.

I am hopeful this will prompt more nuanced and informed conversations with patients and their doctors. Removal of the black box warning doesn’t mean MHT is without side effects but it should prompt more conversations. I suspect the black box warning will be moved the “warnings and precautions” of the package insert for a drug.

Vaginal estrogen CAN be used if you have a diagnosis of hormone receptor breast cancer.

The removal of the black box warning doesn’t really address what to do if you’ve had HR+ breast cancer and I go into this more in the video but I do think it’s a positive step regardless.

I also want to stress that you are not doomed if you cannot take menopausal hormone therapy and there is a lot we can do.

11/10/2025

Historic announcement today. FDA is removing black box warning labels from all-combined estrogen-progestogen, estrogen-only, other estrogen-containing, and progestogen-only products used for hormone therapy (including vaginal estrogen!!). The agency said it’s asking companies to remove the warnings from their products, specifically mentions of cardiovascular, dementia, and breast cancer risk. Sharing ’s remarks during the FDA panel.

11/10/2025

Historic announcement today. FDA is removing black box warning labels from all-combined estrogen-progestogen, estrogen-only, other estrogen-containing, and progestogen-only products used for hormone therapy (including vaginal estrogen!!). The agency said it’s asking companies to remove the warnings from their products, specifically mentions of cardiovascular, dementia, and breast cancer risk. Sharing ’s remark during the FDA panel.

11/09/2025

Tentative FDA announcement coming on 11/10/2025 on hormone therapy. Not sure what it will be but I am hoping they will remove the black box warning on vaginal estrogen.

11/08/2025

Thank you and for interviewing me for this article (along with the incredible and Dr. Carmen Calfa, another fantastic medical oncologist) on pregnancy and postpartum associated breast cancer.

Some key points:
🔸Pregnancy-associated breast cancer (PABC) occurs during or within a year after pregnancy. Postpartum breast cancer (PPBC) is breast cancer that develops after childbirth to 5-10 years postpartum (definitions vary). The incidence of pregnancy associated and postpartum breast cancer are rising. Although pregnancy is thought to decrease breast cancer risk later in life, pregnancy and the postpartum period can temporarily raise breast cancer risk, particularly for people having children later in life.

🔸Because symptoms like lumps, swelling, pain, skin changes all can mimic normal pregnancy and breastfeeding changes, a breast cancer diagnosis can be delayed or symptoms attributed to mastitis or a clogged duct.

🔸Breast cancer can be treated during pregnancy but there are challenges such as what chemotherapy and other treatments can be given. It’s critical to be treated by a team with experience in treating breast cancer during pregnancy.

🔸 In certain situations, it can be possible to safely breastfeed around chemotherapy. I’m thrilled is included in this article to share her story of how she did it.

🔸Bottom line: we must be aware of the risks of pregnancy and postpartum breast cancer. Do not ignore symptoms, especially if persistent and please advocate for yourself!!

Let’s talk about this topic- leave your questions in the comments. Comment PREGNANCY for the link to the article!

Eleonora Teplinsky, MD

11/20/2025

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Monday	9am - 5pm
Tuesday	9am - 5pm
Wednesday	9am - 5pm
Thursday	9am - 5pm
Friday	9am - 5pm