Wednesday 3 August 2011

Management of uncommon chemotherapy-induced emergencies

Management of uncommon chemotherapy-induced emergencies. The Lancet Oncology, Aug 2011, vol. 12(8), p.806-814.

Morgan, C., et al.

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(10)70208-4/abstract?rss=yes

Chemotherapy can induce various clinical emergencies. Prompt recognition and management of these adverse events are important for avoiding further morbidity and mortality.

Mastectomy and reconstruction in stage IV breast cancer

Mastectomy and reconstruction in stage IV breast cancer: A survery of UK breast and plastic surgeons. The Breast, Aug 2011, vol. 20(4), p.373-79.

Durrant, CAT, et al.

http://www.thebreastonline.com/article/PIIS0960977611000452/abstract?rss=yes

The number of women with stage IV disease who have breast reconstruction is small. The primary aim of this study was to examine opinions as to the appropriateness of breast reconstruction in this group.

Interest in cavity shaving in breast conservation treatment does not depend on lumpectomy technique

Interest in cavity shaving in breast conservation treatment does not depend on lumpectomy technique. The Breast, Aug 2011, vol. 20(4), p.358-64.

Feron, JG., et al.

http://www.thebreastonline.com/article/PIIS0960977611000300/abstract?rss=yes

In breast conserving surgery (BCS), the usefulness to perform systematic cavity shaving is actively debated. Some investigators argued that systematic cavity shaving could avoid surgical re-excision and make diagnosis of unexpected multifocality. Others argued that usefulness of cavity shaving depends on volumes of resection.

Optimal adjuvant therapy for very young breast cancer patients

Optimal adjuvant therapy for very young brest cancer patients. The Breast, Aug 2011, vol. 20(4), p.297-302.

Francis, PA.

http://www.thebreastonline.com/article/PIIS0960977611001032/abstract?rss=yes

Approximately one in forty women diagnosed with early breast cancer is very young (<35 years) and this age group has a worse prognosis. The inferior prognosis in very young women appears to have two aspects. Very young women present more frequently with tumors with adverse histo-pathologic features. However, even when the histo-pathologic features appear favorable (ie. endocrine responsive tumors), analyses suggest that very young women with hormone receptor positive tumors are a sub-group at particular risk for adverse outcomes, compared to older premenopausal women with similar tumors

How not to neglect the care of the elderly breast cancer patients

How not to neglect the care of the elderly breast cancer patient. The Breast, Aug 2011, vol. 20(4), p.293-96.

Tahir, M., et al.

http://www.thebreastonline.com/article/PIIS0960977611000907/abstract?rss=yes

Breast cancer is one of the leading causes of cancer mortality in women. Its incidence increases with increasing age; those over 70 years constitute more than one-third of the current breast cancer population. Despite significant advances in the field of breast cancer treatment, elderly patients have seen neither a meaningful improvement in treatment strategies, nor a decline in breast cancer-specific mortality.

Four-year follow-up of trastuzumab plus adjuvant chemotherapy for operable HER2 positive breast cancer

Four year follow-up of trastuzumab plus adjuvant chemotherpy for operable HER2 positive breast cancer: Joint analysis of NNCTG N9831 and NSABP B-31. J Clin Oncol published online before print July 18, 2011

Wan, Y. (summary)

http://www.nelm.nhs.uk/en/NeLM-Area/News/2011---July/19/Four-year-follow-up-of-trastuzumab-plus-adjuvant-chemotherapy-for-operable-HER2-positive-breast-cancer-Joint-analysis-of-NCCTG-N9831-and-NSABP-B-31/

Four large trials evaluating adjuvant trastuzumab for HER2-positive breast cancer demonstrated significant improvements in disease-free survival (DFS; 36% to 52% reduction in DFS events) and overall survival (OS; 33% to 37% reduction in deaths). These data has led adjuvant trastuzumab becoming the foundation of care for HER2-positive early breast cancer.

High-dose chemotherapy with stem-cell support gives no apparent survival benefit in breast cancer

High-dose chemotherapy with stem-cell support gives no apparent survival benefit in breast cancer. J Clin Oncol, published early online 18 July 2011

Glare, J. (summary)

http://www.nelm.nhs.uk/en/NeLM-Area/News/2011---July/20/High-dose-chemotherapy-with-stem-cell-support-gives-no-apparent-survival-benefit-in-breast-cancer/

Two meta-analyses published early online by the Journal of Clinical Oncology examine the evidence on high-dose chemotherapy with stem-cell support in high-risk primary and in metastatic breast cancer: both found that while the technique produced small increases in relapse-free survival, it did not significantly prolong overall survival.

Triptorelin reduces risk of ovarian failure due to chemotherapy for breast cancer

Triptorelin reduces risk of ovarian failure due to chemotherapy for breast cancer. JAMA 2011; 306: 269-76

Glare, J. (summary)

http://www.nelm.nhs.uk/en/NeLM-Area/News/2011---July/20/Triptorelin-reduces-risk-of-ovarian-failure-due-to-chemotherapy-for-breast-cancer/

Breast cancer in younger women is less common, about 12% aged under 45 years, but they are at increased risk of an adverse outcome and therefore most will receive intensive systemic chemotherapy. This may cause early ovarian failure leading to premature menopause: it is estimated that each month of chemotherapy translates into 1.5 years of lost reproductive life. There are no proven standard strategies for preventing this toxicity, however experimental work and pilot studies suggest that suppressing ovarian function with a gonadotropin-releasing hormone (GnRH) analogue might be helpful. This trial examined the hypothesis.