Monday, 22 October 2012

The impact of mammographic screening on breast cancer mortality in Europe

The impact of mammographic screening on breast cancer mortality in Europe: a review of observational studies. Journal of medical screening, Sept. 2012, Vol. 19 Supp.1, p.14-25.

Broeders, M., et al.

http://jms.rsmjournals.com/content/19/suppl_1/14.full.pdf+html


Valid observational designs are those where suf´Čücient longitudinal individual data are
available, directly linking a woman’s screening history to her cause of death. From such studies, the
best ‘European’ estimate of breast cancer mortality reduction is 25–31% for women invited for
screening, and 38–48% for women actually screened. Much of the current controversy on breast
cancer screening is due to the use of inappropriate methodological approaches that are unable to capture the true effect of mammographic screening.

Breast cancer: incidence, mortality and survival

Breast cancer: incidence, mortality and survival. Office for national statistics, England, September 2012.

http://www.ons.gov.uk/ons/rel/cancer-unit/breast-cancer-in-england/2010/sum-1.html

Breast cancer is the most common cancer in women in England. In 2010, 41,259 new cases were diagnosed, an increase of 1.8 per cent (731 cases) compared to 2009. There were 126 new cases per 100,000 women in 2010, compared with 125 new cases per 100,000 women in 2009. These incidence rates have increased by 90 per cent between 1971 and 2010.

Trastuzumab emtansine for HER2-positive advanced breast cancer

Trastuzumab emtansine for HER2-positive advanced breast cancer. New england journal of medicine, October 2012.

Verma, S., et al.

http://www.nejm.org/doi/full/10.1056/NEJMoa1209124#t=articleTop

We randomly assigned patients with HER2-positive advanced breast cancer, who had previously been treated with trastuzumab and a taxane, to T-DM1 or lapatinib plus capecitabine. The primary end points were progression-free survival (as assessed by independent review), overall survival, and safety. Secondary end points included progression-free survival (investigator-assessed), the objective response rate, and the time to symptom progression. Two interim analyses of overall survival were conducted.

Bevacizumab in combination with capecitabine for the first-line treatment of metastatic breast cancer

Bevacizumab in combination with capecitabine for the first-line treatment of metastatic breast cancer (TA263). NICE guidance, August 2012.

http://guidance.nice.org.uk/TA263

NICE does not recommend bevacizumab in combination with capecitabine as first-line treatment for metastatic breast cancer when other chemotherapy (including drugs known as taxanes or anthracyclines) is not appropriate, or taxanes or anthracyclines have been given in the past 12 months.

lnfiltration of epinephrine in reduction mammoplasty

Infiltration of epinephrine in reduction mammoplasty: a systematic review of the literature. Plastic & reconstructive surgery, October 2012, Vol. 130(4), p.773-778.

Hardwicke, J.T., et al.

http://journals.lww.com/plasreconsurg/Abstract/2012/10000/Infiltration_of_Epinephrine_in_Reduction.7.aspx

Evidence of the benefit of dilute epinephrine infiltration before reduction mammaplasty is provided by several controlled trials. Despite variation in operative technique and data collection, a reduction in intraoperative blood loss has been shown. The aim of this review of the literature is to weigh the available evidence with respect to reducing blood loss during surgery and other outcome measures such as postoperative drainage.

Breast augmentation

Breast augmentation.  Journal of plastic & reconstructive surgery, October 2012, Vol. 130(4), p.5983-612e.

Adams, W.P. & Mallucci, P.

http://journals.lww.com/plasreconsurg/Abstract/2012/10000/Breast_Augmentation.40.aspx

The process of breast augmentation includes patient education, tissue-based preoperative planning, refined surgical technique, and defined postoperative management. This CME article reviews and discusses the current relevant topics and issues surrounding breast implants.

Current status of implant-based breast reconstruction

Current status of implant-based breast reconstruction in patients receiving post-mastectomy radiation therapy. Plastic & reconstructive surgery, October 2012, Vol. 130(4), p.513e-524e.

Kronowitz, S.J.

http://journals.lww.com/plasreconsurg/Fulltext/2012/10000/Current_Status_of_Implant_Based_Breast.9.aspx

Increasing numbers of patients with breast cancer are being treated with postmastectomy radiation therapy. The author reviewed the literature to determine the clinical impact of this increasing use of postmastectomy radiation therapy in patients with breast cancer who desire implant-based breast reconstruction.

Differentiating fat necrosis from recurrent malignancy in fat-grafted breasts

Differentiating fat necrosis from recurrent malignancy in fat-grafted breasts: an imaging classification system to guide management.  Plastic & reconstructive surgery, October 2012, Vol.130(4), p.761-72.

Parikh, R.P., et al.

http://journals.lww.com/plasreconsurg/Abstract/2012/10000/Differentiating_Fat_Necrosis_from_Recurrent.6.aspx

In breast reconstruction with autologous fat grafting, concerns persist about the ability to differentiate palpable masses representing fat necrosis from recurrent cancer. The authors' objective was to develop standardized imaging classifications to distinguish benign from malignant lesions after fat grafting. 

Bad medicine: clinical breast examination

Bad medicine: clinical breast examination, October 2012, BMJ 2012; 345: e6789.

Spence, D.


http://www.bmj.com/content/345/bmj.e6789?rss=1&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%25253A+bmj%25252Frecent+%252528Latest+from+BMJ%252529

To question clinical examination is to open a rich vein of debate. Clinical examinations are unquestioned, given disproportionate weight, and considered “must do.” Not doing a full examination implies you are a bad doctor. But much of examination is mere ritualistic dogma passed down through the ages.